We discover that a higher level of D-dimer is an independent risk factor for CRT in hospitalized children, consistent with the results of adult studies.66 D-dimer is a soluble fibrin degradation product deriving from the plasmin-mediated degradation of cross-linked fibrin that is increased or positive in secondary hyperfibrinolysis, such as hypercoagulable states, disseminated intravascular coagulation, and thrombolytic therapy.67,68 Increased D-dimer suggests an association with thrombotic disorders in the body of various origins and an increase in fibrinolytic activity. This evidence concerns the gene PLG and Disseminated intravascular coagulation.