Diagnostic and prognostic value of fibrinopeptides in patients with clinically suspected pulmonary embolism.
To determine the diagnostic and prognostic value of fibrinopeptides in patients with clinically suspected pulmonary embolism (PE), we made a pilot study in the Emergency Department with a general ICU. 32 patients with clinically suspected pulmonary embolism were the participants and 16 cases were diagnosed as PE-positive. After the diagnosis of PE, thrombolytic therapy with urokinase was administered, followed by heparin therapy. Plasma fibrinopeptide A (FPA) and fibrinopeptide B beta 15-42 (FPB beta 15-42) were measured before treatment and at 1, 2 and 6 days after treatment. In the PE-positive patients, the levels of both fibrinopeptides measured prior to the treatment were above the normal values, and were significantly higher than those of PE-negative patients. When the cutoff points of FPA and, FPB beta 15-42 were set at 15 ng/ml, 15 ng/ml respectively, both markers had a high sensitivity, a highly negative predictive value and a moderate specificity. Six of the PE-positive patients died. The FPB beta 15-42 levels were significantly lower in the survivors than those in the patients who died at 2 days (p = 0.0092) and 6 days (p = 0.0011). We can conclude that: 1) the fibrinopeptide measured in this study are useful for screening for PE; and 2) FPB beta 15-42 may possibly be useful as a method for predicting the clinical outcome of PE.
Department of Emergency and Critical Care Medicine, Sapporo City General Hospital, Japan.
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Gando
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Tedo
D015415:Biomarkers / Q000097:blood; D005338:Fibrin Fibrinogen Degradation Products; D005344:Fibrinopeptide A / Q000032:analysis*; D005345:Fibrinopeptide B / Q000032:analysis*; D006801:Humans; D010446:Peptide Fragments / Q000032:analysis*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis*; D012016:Reference Values
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; C033786:fibrinogen Bbeta (15-42); D005344:Fibrinopeptide A; D005345:Fibrinopeptide B