D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis

Abstract Despite D-dimer to fibrinogen ratio (DFR) being reported as a prognostic factor for cerebral venous thrombosis (CVT), we note some concerns about the misused terminology (prognostic versus predictive), potential variability in D-dimer and fibrinogen assays that may impact the reliability an...

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Main Authors: Minh-Hoang Tran, Kim-Huong Truong-Nguyen
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Thrombosis Journal
Subjects:
Online Access:https://doi.org/10.1186/s12959-025-00730-y
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author Minh-Hoang Tran
Kim-Huong Truong-Nguyen
author_facet Minh-Hoang Tran
Kim-Huong Truong-Nguyen
author_sort Minh-Hoang Tran
collection DOAJ
description Abstract Despite D-dimer to fibrinogen ratio (DFR) being reported as a prognostic factor for cerebral venous thrombosis (CVT), we note some concerns about the misused terminology (prognostic versus predictive), potential variability in D-dimer and fibrinogen assays that may impact the reliability and utility of DFR. From the statistical aspect, its validity was not adequately ensured due to inappropriate methods (inability to address multicollinearity, confounding, and multiple comparisons) and lack of validation for unvalidated discrimination cut-offs. The prognostic value of DFR was not clinically or statistically justified, given its poor-to-acceptable discrimination. Finally, an unexpectedly positive association between venous cerebral infarction and non-severe CVT suggests possible issues in data labelling, reference value, uncontrolled confounders/biases, or overadjustment. Addressing these issues would strengthen the reliability, validity, and utility of DFR in CVT prognosis.
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spelling doaj-art-d9ddb2539fff4e2289bd7c602ded35e72025-08-20T01:51:32ZengBMCThrombosis Journal1477-95602025-05-012311210.1186/s12959-025-00730-yD-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosisMinh-Hoang Tran0Kim-Huong Truong-Nguyen1NTT Hi-Tech Institute, Nguyen Tat Thanh UniversityDepartment of Pharmacy, Nhan Dan Gia Dinh HospitalAbstract Despite D-dimer to fibrinogen ratio (DFR) being reported as a prognostic factor for cerebral venous thrombosis (CVT), we note some concerns about the misused terminology (prognostic versus predictive), potential variability in D-dimer and fibrinogen assays that may impact the reliability and utility of DFR. From the statistical aspect, its validity was not adequately ensured due to inappropriate methods (inability to address multicollinearity, confounding, and multiple comparisons) and lack of validation for unvalidated discrimination cut-offs. The prognostic value of DFR was not clinically or statistically justified, given its poor-to-acceptable discrimination. Finally, an unexpectedly positive association between venous cerebral infarction and non-severe CVT suggests possible issues in data labelling, reference value, uncontrolled confounders/biases, or overadjustment. Addressing these issues would strengthen the reliability, validity, and utility of DFR in CVT prognosis.https://doi.org/10.1186/s12959-025-00730-yD-dimerFibrinogenVenous thromboembolismCerebral venous thrombosis
spellingShingle Minh-Hoang Tran
Kim-Huong Truong-Nguyen
D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis
Thrombosis Journal
D-dimer
Fibrinogen
Venous thromboembolism
Cerebral venous thrombosis
title D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis
title_full D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis
title_fullStr D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis
title_full_unstemmed D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis
title_short D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis
title_sort d dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis
topic D-dimer
Fibrinogen
Venous thromboembolism
Cerebral venous thrombosis
url https://doi.org/10.1186/s12959-025-00730-y
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AT kimhuongtruongnguyen ddimertofibrinogenratioasamarkerforacutecerebralvenousthrombosis