Detection of deep venous thrombosis by DMP 444, a platelet IIb/IIIa antagonist: a preliminary report.
BACKGROUND
We report a method for detection of deep venous thrombosis with a technetium 99m-labeled peptide (DMP 444). The N-methyl-arginine-glycine-aspartic acid sequence on DMP 444 binds the glycoprotein IIb/IIIa receptor on activated platelets (inhibition constant [IC50] for fibrinogen binding = 6 nmol/L).


METHODS
DMP 444 (23 to 27 mCi) was injected into 11 patients with clinical suspicion of deep venous thrombosis, diagnostic confirmation by ultrasound, and a positive D-dimer test result. Planar images in the anterior and posterior projections were obtained at 10 to 40 minutes, 50 to 80 minutes, and 120 to 150 minutes after injection.


RESULTS
No clinically significant adverse effects were noted after DMP 444 administration. One patient (excluded from the analysis) withdrew consent, so image acquisition was not complete. By 10 to 40 minutes after injection, 8 of 10 patients demonstrated an area of increased activity that was clearly related to the abnormality noted on ultrasound. Most patients were taking warfarin (Coumadin) and heparin (n = 8) or heparin (n = 1) and warfarin (n = 1) alone at the time of the imaging. The average time from onset of symptoms to injection of DMP 444 was 5 days (range 1 to 18 days).


CONCLUSIONS
These preliminary human studies indicate that DMP 444 is safe and may be of value in the diagnosis of deep venous thrombosis.
Klem
J A
JA
Yale University School of Medicine, West Haven VA Medical Center, USA.
Schaffer
J V
JV
Crane
P D
PD
Barrett
J A
JA
Henry
G A
GA
Canestri
L
L
Ezekowitz
M D
MD
D000368:Aged; D000818:Animals; D001792:Blood Platelets / Q000378:metabolism; D004285:Dogs; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000494:pharmacology; D015609:Organotechnetium Compounds / Q000494:pharmacology; D010974:Platelet Aggregation / Q000187:drug effects; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*
C411949:DMP 444; D009842:Oligopeptides; D015609:Organotechnetium Compounds; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D005340:Fibrinogen