title: Thrombus precursor protein, endogenous thrombin potential, von-Willebrand factor and activated factor VII in suspected deep vein thrombosis: is there a place for new parameters?
abstract: Because of its high negative predictive value, D-Dimer is an important parameter in the exclusion of deep vein thrombosis (DVT) but it produces a high number of false-positive results. We therefore evaluated different blood parameters in 74 consecutive patients with suspected DVT, whose final diagnosis was based on the results of Duplex ultrasound or venography. DVT was diagnosed in 52.7%. While D-Dimer, thrombin-antithrombin complexes, prothrombin fragment 1+2, von-Willebrand factor and thrombus precursor protein were significantly increased in patients with DVT, there was no influence concerning endogenous thrombin potential and activated factor VII. There was no significant correlation between the thrombus extension or the duration of symptoms with any of these parameters. D-Dimer showed the best sensitivity (94.9%) to specificity (45.7%) ratio and neither the sole nor the additional evaluation of any other investigated parameter increased its diagnostic performance. We, therefore, conclude that the determination of D-Dimer remains the 'gold standard' in the laboratory testing of patients with suspected DVT.
authors.affiliation: University Clinic of Internal Medicine II, Department of Angiology, Wien, Austria. robert.bucek@akh-wien.ac.at
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bucek
authors.forename: Markus
authors.initials: M
authors.lastname: Reiter
authors.forename: Peter
authors.initials: P
authors.lastname: Quehenberger
authors.forename: Ansgar
authors.initials: A
authors.lastname: Weltermann
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kyrle
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000032:analysis*; D015942:Factor VIIa / Q000032:analysis; D005260:Female; D005337:Fibrin / Q000032:analysis; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013917:Thrombin / Q000032:analysis; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; C465961:thrombus precursor protein, human; D014841:von Willebrand Factor; D005337:Fibrin; D015942:Factor VIIa; D013917:Thrombin