Higher D-dimer levels were associated with increased frequencies of stroke or systemic embolism ( hazard ratio -LSB- HR -RSB- -LSB- Q@ vs. Q@ -RSB- @ , @ % confidence interval -LSB- CI -RSB- @-@ @ , P = @ ) , death ( HR -LSB- Q@ vs. Q@ -RSB- @ , @ % CI@-@ @ ) and major bleeding ( HR -LSB- Q@ vs. Q@ -RSB- @ , @ % CI@-@ @ , P < @ ) in the no-VKA group .