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Effect of Antiplatelet Drugs on D-Dimer Levels

A Systematic Review and Meta-analysis

Morelli, Francesca, MD*; Schol-Gelok, Suzanne, MD*; Arends, Lidia R., PhD; Boersma, Eric, PhD; Kruip, Marieke J. H. A., MD, PhD§; Versmissen, Jorie, MD, PhD*; van Gelder, Teun, MD, PhD*

Journal of Cardiovascular Pharmacology: June 2019 - Volume 73 - Issue 6 - p 343–351
doi: 10.1097/FJC.0000000000000670
Review Article

Aims: D-dimer is a product of fibrinolysis. In clinical practice, D-dimer levels are commonly used to rule out venous thromboembolism. Antiplatelet drugs may influence D-dimer levels, potentially affecting the accuracy of this diagnostic tool. To evaluate the effect of antiplatelet drugs on D-dimer levels, we performed a systematic review and meta-analysis of all published articles on this topic (PROSPERO registration number CRD42017058932).

Methods and Results: We electronically searched EMBASE, MEDLINE Epub, Cochrane, Web of Science, and Google Scholar (100 top relevance) (last search on October 5, 2017). We included randomized controlled trials, cohort studies, and cross-sectional studies conducted in humans, with a drug exposure time of at least 7 days. Two reviewers independently selected eligible articles and extracted the data. Five controlled trials, 7 cohort studies, and 5 cross-sectional studies were finally included. Meta-analysis involving all 1117 participants showed no change in dimer levels (standardized mean difference: −0.015, 95% confidence interval, 0.182–0.151, P = 0.855).

Conclusions: In conclusion, antiplatelet drugs do not seem to influence D-dimer levels.

Departments of *Internal Medicine and Hospital Pharmacy;


Hematology; and

§Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Reprints: Francesca Morelli, MD, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Room NE-411, Molewaterplein 40, Rotterdam 3015 GD, the Netherlands (e-mail:

The authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received January 24, 2019

Accepted March 02, 2019

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