Plasma D-dimer is a Promising Indicator for the Treatment of Acute Gouty Attack.

BACKGROUND AND AIM Gout is an inflammatory disease affecting multiple joints. Abnormal coagulation can elevate the levels of plasma D-dimer (DD) and is associated with inflammation and joint-related disease activity. Patients with gout usually develop acute gouty attack. However, there is no information on whether abnormal levels of plasma DD are associated with a gout flare. This study examined the levels of blood C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum uric acid (UA) and plasma DD in patients with gout flare and those with gout in remission phase and evaluated their value in predicting a gout flare as well as in the treatment of gout flare. METHODS The levels of serum UA, plasma DD and blood CRP as well as blood ESR in 50 patients with gout flare and 27 patients with gout in remission phase were determined. The data were stratified and their potential values in predicting the onset of gout flare were analyzed by receiver-operating characteristic (ROC) analysis. RESULTS The levels of DD, CRP and ESR in patients with gout flare were significantly higher than that in patients with gout in remission. The ROC analysis indicated that the area under curve (AUC) of DD, ESR as well as CRP were 0.914 (95% CI: 0.909~1.001, p<0.05), 0.956 (95%CI: 0.917~0.994, p<0.05), and 0.942 (95%CI: 0.894~0.989, p<0.05), respectively. The current study revealed that sensitivity of plasma DD concentration in predicting gout attack was significantly higher than that of blood ESR (p<0.05). CONCLUSION Plasma DD may be a sensitive biomarker in predicting the onset of gout flare, but more importantly, it might serve as an indicator of treatment for the dysfunction of blood coagulation in gout patients.