D-dimer as a risk factor for cardiovascular events in patients with liver diseases
https://doi.org/10.15829/1728-8800-2025-4361
EDN: FQMMNW
Abstract
The relationship between cardiovascular and liver diseases is a significant clinical problem; since diseases of one system can aggravate the other. One of the key markers for cardiovascular risk assessment in patients with liver diseases is D-dimer. This is a fibrin degradation product; the level of which increases with the coagulation system activation. It is important to note the role of ademetionine (Heptral®) in supporting liver function; reducing inflammation and oxidative stress; which can reduce the development and progression of atherosclerosis and cardiovascular complications in patients with liver disease. Determination of D-dimer is important in risk stratification and assessment of clinical outcomes in patients with liver and cardiovascular comorbidity; including those treated with ademetionine.
About the Authors
O. A. Rubanenko
Samara State Medical University
Russian Federation
Russian Federation
Samara
I. A. Zolotovskaya
Samara State Medical University
Russian Federation
Russian Federation
Samara
P. R. Shatskaya
Samara State Medical University;
Polyakov Samara Regional Clinical Cardiology Dispensary
Russian Federation
Russian Federation
Samara
References
1. Iglesias Morcillo M, Freuer D, Peters A, et al. Association between fatty liver index and blood coagulation markers: a population-based study. Lipids Health Dis. 2023;22(1):83. doi:10.1186/s12944-023-01854-8.
2. Hörber S, Lehmann R, Stefan N, et al. Hemostatic alterations linked to body fat distribution, fatty liver, and insulin resistance. Mol Metab. 2021;53:101262. doi:10.1016/j.molmet.2021.101262.
3. Virović-Jukić L, Stojsavljević-¬Shapeski S, Forgač J, et al. Non-alcoholic fatty liver disease — a procoagulant condition? Croat Med J. 2021;62(1):25-33. doi:10.3325/cmj.2021.62.25.
4. Berardo C, Di Pasqua LG, Cagna M, et al. Nonalcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis: Current Issues and Future Perspectives in Preclinical and Clinical Research. Int J Mol Sci. 2020;21(24):9646. doi:10.3390/ijms21249646.
5. Eslam M, Newsome PN, Sarin SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020;73(1):202-9. doi:10.1016/j.jhep.2020.03.039.
6. Geier A, Tiniakos D, Denk H, et al. From the origin of NASH to the future of metabolic fatty liver disease. Gut. 2021;70(8):1570-9. doi:10.1136/gutjnl-2020-323202.
7. Ogresta D, Mrzljak A, Cigrovski Berkovic M, et al. Coagulation and Endothelial Dysfunction Associated with NAFLD: Current Status and Therapeutic Implications. J Clin Transl Hepatol. 2022;10(2):339-55. doi:10.14218/JCTH.2021.00268.
8. Li Y, Qi X, Li H, et al. D-dimer level for predicting the in-hospital mortality in liver cirrhosis: a retrospective study. Exp Ther Med. 2017;13(1):285-9. doi:10.3892/etm.2016.3930.
9. Zou B, Yeo YH, Cheung R, et al. Fatty Liver Index and Development of Cardiovascular Disease: Findings from the UK Biobank. Dig Dis Sci. 2021;66(6):2092-100. doi:10.1007/s10620-021-06954-y.
10. Kim JH, Moon JS, Byun SJ, et al. Fatty liver index and development of cardiovascular disease in Koreans without pre-existing myocardial infarction and ischemic stroke: a large population-¬based study. Cardiovasc Diabetol. 2020;19(1):51. doi:10.1186/s12933-020-01025-4.
11. Sharma D, Gotlieb N, Farkouh ME, et al. Machine Learning Approach to Classify Cardiovascular Disease in Patients With Nonalcoholic Fatty Liver Disease in the UK Biobank Cohort. J Am Heart Assoc. 2022;11(1):e022576. doi:10.1161/JAHA.121.022576.
12. Tripodi A. Hemostasis in acute and chronic liver disease. Semin Liver Dis. 2017;37(1):28-32.
13. van Dievoet MA, Eeckhoudt S, Stephenne X. Primary Hemostasis in Chronic Liver Disease and Cirrhosis: What Did We Learn over the Past Decade? Int J Mol Sci. 2020;21(9):3294. doi:10.3390/ijms21093294.
14. Stotts MJ, Lisman T, Intagliata NM. The Spectrum of Disea¬se Severity in Cirrhosis and Its Implications for Hemostasis. Semin Thromb Hemost. 2020;46(6):716-23. doi:10.1055/s-0040-1715449.
15. Bisaccia G, Ricci F, Khanji MY, et al. Cardiovascular Morbidity and Mortality Related to Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. Curr Probl Cardiol. 2023;48(6):101643. doi:10.1016/j.cpcardiol.2023.101643.
16. Huang D, Refaat M, Mohammedi K, et al. Macrovascular Complications in Patients with Diabetes and Prediabetes. Biomed Res Int. 2017;2017:7839101. doi:10.1155/2017/7839101.
17. Yang ZJ, Costa KA, Novelli EM, et al. Venous thromboembolism in cirrhosis. Clin Appl Thromb Hemost. 2014;20(2):169-78. doi:10.1177/1076029612461846.
18. O’Leary JG, Greenberg CS, et al. AGA Clinical Practice Update: Coagulation in Cirrhosis. Gastroenterology. 2019;157(1):34-43.e1. doi:10.1053/j.gastro.2019.03.070.
19. Eniseeva ES. Anticoagulation in Patients with Liver Cirrhosis (Literature Review). Acta Biomedica Scientifica. 2019;4(2):23-8. (In Russ.) doi:10.29413/ABS.2019-4.2.3.
20. Ivashkin VT, Maevskaya MV, Zharkova MS, et al. Clinical Recommendations of the Russian Scientific Liver Society and Rus¬sian Gastroenterological Association on Diagnosis and Treatment of Liver Fibrosis, Cirrhosis and Their Complications. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(6):56-102. (In Russ.) doi:10.22416/1382-4376-2021-31-6-56-102.
21. Kanorskii SG. Non-alcoholic fatty liver disease: modern ap¬proaches to diagnosis and treatment. South Russian Jour¬nal of Therapeutic Practice. 2021;2(3):18-29. (In Russ.) doi:10.21886/2712-8156-2021-2-3-18-29.
22. Kremers B, Wübbeke L, Mees B, et al. Plasma Biomarkers to Predict Cardiovascular Outcome in Patients With Peripheral Artery Disease: A Systematic Review and Meta-Analysis. Arterioscler Thromb Vasc Biol. 2020;40(9):2018-32. doi:10.1161/ATVBAHA.120.314774.
23. Kleinegris MC, ten Cate H, ten Cate-Hoek AJ. D-dimer as a marker for cardiovascular and arterial thrombotic events in patients with peripheral arterial disease. A systematic review. Thromb Haemost. 2013;110(2):233-43. doi:10.1160/TH13-01-0032.
24. Qi T, Zhu C, Lu G, et al. Elevated D-dimer is associated with increased 28-day mortality in acute-on-chronic liver failure in China: a retrospective study. BMC Gastroenterol. 2019;19(1):20. doi:10.1186/s12876-019-0941-0.
25. Zhou T, Sun X, Zhou T, et al. Efficacy and Safety of Nadroparin Calcium-Warfarin Sequential Anticoagulation in Portal Vein Thrombosis in Cirrhotic Patients: A Randomized Controlled Trial. Clin Transl Gastroenterol. 2020;11(9):e00228. doi:10.14309/ctg.0000000000000228.
26. Pan J, Wang L, Gao F, et al. Epidemiology of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis. Eur J Intern Med. 2022;104:21-32. doi:10.1016/j.ejim.2022.05.032.
27. Lin GS, Xu Q, Zhao SY, et al. Clinical features of liver cirrhosis complicated by portal vein thrombosis and related risk factors. Zhonghua Gan Zang Bing Za Zhi. 2016;24(7):513-7. Chinese. doi:10.3760/cma.j.issn.1007-3418.2016.07.006.
28. Song Z, Uriarte S, Sahoo R, et al. S-adenosylmethionine (SAMe) modulates interleukin-10 and interleukin-6, but not TNF, production via the adenosine (A2) receptor. Biochim Biophys Acta. 2005;1743(3):205-13. doi:10.1016/j.bbamcr.2004.12.001.
29. Vergani L, Baldini F, Khalil M, et al. New Perspectives of S-Adeno-sylmethionine (SAMe) Applications to Attenuate Fatty Acid-¬Induced Steatosis and Oxidative Stress in Hepatic and Endothelial Cells. Molecules. 2020;25(18):4237. doi:10.3390/molecules25184237.
30. Anstee QM, Day CP. S-adenosylmethionine (SAMe) therapy in liver disease: a review of current evidence and clinical utility. J Hepatol. 2012;57(5):1097-109. doi:10.1016/j.jhep.2012.04.041.
31. Ivashkin VT, Baranovsky AYu, Raikhelson KL, et al. Drug-Induced Liver Injuries (Clinical Guidelines for Physicians). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2019;29(1):85-115. (In Russ.) doi:10.22416/1382-4376-2019-29-1-101-131.
32. Raikhelson KL, Bueverov AO, Kondrashina EA, et al. Cholestasis in Chronic Liver Disease and the Role of Ademetionine in its Treatment (Literature Review and Expert Panel Resolution). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2024;34(4):20-33. (In Russ.) doi:10.22416/1382-4376-2024-1167-3098-1.
What is already known about the subject?
- D-dimer is an important marker of coagulation of the hemostasis system, its level increases with activation of the blood coagulation system. High levels of D-dimer correlate with an increased risk of cardiovascular diseases, such as venous thromboembolism, myocardial infarction and stroke.
What might this study add?
- D-dimer level is an important cardiovascular risk marker in patients with liver disease.
- Heptral®improves lipid metabolism, reducing the level of triglycerides, blood cholesterol, and also possibly stabilizes the inflammatory process, reducing the risk of increased D-dimer and, accordingly, thrombogenesis.
Review
For citations:
Rubanenko O.A., Zolotovskaya I.A., Shatskaya P.R. D-dimer as a risk factor for cardiovascular events in patients with liver diseases. Cardiovascular Therapy and Prevention. 2025;24(3):4361. (In Russ.) https://doi.org/10.15829/1728-8800-2025-4361. EDN: FQMMNW
Views:
185
Email this article 
