Urine and plasma levels of fibrinopeptide B in patients with deep vein thrombosis and pulmonary embolism.
BACKGROUND
Many patients with pulmonary thromboembolism remain undiagnosed, possibly because of the difficulty clinicians have in determining which patients merit work-up with accurate (but expensive) imaging techniques.


OBJECTIVE
We present the first prospective clinical study of pulmonary embolism (PE) and deep venous thrombosis (DVT) detection using the FPBtot assay, which measures fibrinopeptide B and its first derivative, des-arginine fibrinopeptide B.


METHODS
Twenty three patients with signs or symptoms of PE or DVT were enrolled in the study prior to the performance of definitive testing. Using a novel immunoassay, FPBtot levels were measured in urine and plasma samples from patients as well as from healthy controls. Urine and plasma FPBtot levels were compared to the diagnostic results, as blindly adjudicated by one of the investigators. Patients were excluded if they withdrew (n =1), had inconclusive diagnostic testing (n = 7), or did not give samples (n = 2 for urine, n = 3 for plasma).


RESULTS
The mean FPBtot concentration in the urine of the 'DVT/PE positive' group was 78.4 +/- 35.2 ng/ml and 2.7 +/- 1.9 ng/ml in the 'DVT/PE negative' group (p = 0.03). The urine FPB(tot) concentrations in the 'DVT/PE negative' group were not significantly different from those in the healthy control group (2.2 +/- 0.4 ng/ml, p = 0.40). The area under the ROC curve for urine FPB(tot) concentrations was 97.3 +/- 3.8%, suggesting a high degree of diagnostic accuracy. Plasma FPB(tot) concentrations were not significantly different between groups.


CONCLUSIONS
Urine FPBtot levels may help detect patients with PE and DVT.
Morris
Timothy A
TA
Department of Medicine, Division of Pulmonary/Critical Care Medicine, University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103-8378, USA. t1morris@ucsd.edu
Marsh
James J
JJ
Burrows
Craig M
CM
Chiles
Peter G
PG
Konopka
Ronald G
RG
Pedersen
Craig A
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods / Q000592:standards; D005260:Female; D005345:Fibrinopeptide B / Q000378:metabolism* / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000652:urine*; D020246:Venous Thrombosis / Q000097:blood* / Q000652:urine*
D005345:Fibrinopeptide B