C-reactive protein in the diagnosis of deep vein thrombosis.
The role of C-reactive protein (CRP) in the diagnosis of suspected deep vein thrombosis (DVT) and a possible advantage of its additional evaluation with D-dimer has not been clearly evaluated. We therefore studied plasma CRP and D-dimer levels in 233 consecutive patients with suspected DVT; the final diagnosis was based on the results of colour duplex ultrasound or venography. DVT was diagnosed in 31.3%. CRP and D-dimer correlated significantly (r = 0.64, P < 0.01); both were increased significantly in patients suffering from DVT (P < 0.001). Multivariate analysis revealed a significant influence of the presence of DVT (P < 0.001), the presence of malignancy (P < 0.001) and the presence of inflammatory diseases (P = 0.009) on plasma CRP, while there was no significant influence of the duration of symptoms (P = 0.30). The sensitivity (75% vs 93%) to specificity (69% vs 55%) relationship showed inferior results for CRP compared with D-dimer; its additional evaluation did not improve the diagnostic value of D-dimer. We conclude that CRP can provide additional information neither for the diagnostic process in patients with suspected DVT nor for the differential diagnosis of DVT and inflammatory diseases.
Bucek
Robert A
RA
University Clinic of Internal Medicine II, Department of Angiology, General Hospital, Vienna, Austria. robert.bucek@akh-wien.ac.at
Reiter
Markus
M
Quehenberger
Peter
P
Minar
Erich
E
D000210:Acute-Phase Reaction; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D002097:C-Reactive Protein