Results of a new rapid d-dimer assay (cardiac d-dimer) in the diagnosis of deep vein thrombosis.
The objective was to evaluate the accuracy of a new full blood rapid D-dimer assay in the diagnosis of suspected deep vein thrombosis (DVT). In 100 consecutive patients with suspected DVT, clinical probability was staged according to a pretest score proposed by Wells. For the determination of plasma D-dimer, heparin and citrate blood samples were drawn, and Cardiac D-dimer, STA-LIA, and Tina-quant tests were performed. Final diagnosis was confirmed either by duplex sonography or ascending venography. DVT was diagnosed in 37%, thrombophlebitis in 10%, and no venous thromboembolism was diagnosed in 52%. In 2% pulmonary embolism was detected and one patient was dismissed before final diagnosis. Cardiac D-dimer assay from citrate tubes showed a sensitivity of 88.6%, a specificity of 54%, a positive predictive value of 57.4%, and a negative predictive value of 87.1%. Nearly identical results were observed with heparin tubes. Corresponding results were 88.6%, 48%, 52.5%, and 85.7% for STA-LIA and 88.6%, 46%, 53.4%, and 85.2% for Tina-quant, respectively. In conclusion, we can say that Cardiac D-dimer is a rapid, whole blood assay with a great potential for clinical use. It can help in diagnosing DVT from citrate as well as heparin tubes with comparable sensitivity, specificity, positive and negative predictive values as STA-LIA and Tina-quant tests.
Bucek
R A
RA
Department of Angiology, University Clinic of Internal Medicine II, General Hospital, Vienna, Austria. robert.bucek@akh-wien.ac.at
Quehenberger
P
P
Feliks
I
I
Handler
S
S
Reiter
M
M
Minar
E
E
D000328:Adult; D000368:Aged; D000906:Antibodies / Q000097:blood; D001330:Electronic Data Processing; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000276:immunology*; D006801:Humans; D007118:Immunoassay / Q000295:instrumentation* / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic / Q000592:standards; D012680:Sensitivity and Specificity; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000175:diagnosis*
D000906:Antibodies; D005338:Fibrin Fibrinogen Degradation Products; D011933:Reagent Kits, Diagnostic; C036309:fibrin fragment D