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In Reply: I agree with Dr Brotman that our cutoff value for a low risk of recurrent VTE is assay-specific. Similar to the exclusion of acute VTE or pulmonary embolism, an appropriate cutoff must be defined for each different D-dimer assay. I therefore disagree with Brotman's suggestion that D-dimer levels less than half the threshold level used for exclusion of recurrent VTE can be used to identify patients at low risk of future VTE.

Sabine Eichinger, MD
Department of Internal Medicine I
University of Vienna
Vienna, Austria

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290:3192.

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Identifying Patients at Risk of Recurrent Venous Thromboembolism
Daniel J. Brotman
JAMA. 2003;290(24):3192.
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