title: Urinary fibrinopeptide A in evaluation of patients with suspected acute pulmonary embolism. A prospective pilot study.
abstract: This pilot study assessed the urinary fibrinopeptide A (uFPA) levels and the combination of uFPA test plus ventilation/perfusion (V/Q) scan in the diagnostic evaluation of acute pulmonary embolism (PE). One hundred consecutive patients were studied prospectively. Twenty-nine patients fulfilled diagnostic criteria defined in this study (seven with and 22 without PE). The uFPA concentration was significantly higher in patients with than without PE (41.1 +/- 2.6 vs 4.8 +/- 2.5 ng/mg of creatinine, p less than 0.0001). In all patients with PE, the uFPA levels were higher than threshold value derived by adding 2 standard deviations to the mean uFPA concentration of patients without PE. In patients without PE, the V/Q scan was negative in 16, the uFPA test was negative in 18, and at least one of the tests was negative in 21. These preliminary data suggest that a negative uFPA test may be helpful in excluding PE and that uFPA in combination with V/Q lung scans may correctly exclude PE in more patients than either test alone. Further studies in a large unselected population are needed to confirm these results.
authors.affiliation: Veterans Administration Medical Center, Department of Nuclear Medicine, Philadelphia.
authors.forename: M
authors.initials: M
authors.lastname: Tulchinsky
authors.forename: J A
authors.initials: JA
authors.lastname: Zeller
authors.forename: R C
authors.initials: RC
authors.lastname: Reba
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000792:Angiography; D005260:Female; D005344:Fibrinopeptide A / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000652:urine*; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013668:Technetium Tc 99m Aggregated Albumin; D014692:Ventilation-Perfusion Ratio / Q000502:physiology*
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; D005344:Fibrinopeptide A