title: Evaluation of soluble P-selectin as a marker for the diagnosis of deep venous thrombosis.
abstract: OBJECTIVE
  The combination of D-dimer and Wells score can exclude, but not confirm, the diagnosis of deep venous thrombosis (DVT). Since thrombosis and inflammation are interrelated, we evaluated the combination of soluble P-selectin (sPsel) with other inflammatory biomarkers for the diagnosis of DVT.
  
  
  METHODS
  Sixty-two positive and one hundred and sixteen patients with negative DVT, by duplex scan, were prospectively evaluated for sPsel, D-dimer, C-reactive protein (CRP), microparticles (MPs; total, leukocyte, and platelet-derived and tissue factor positive microparticles), and clinical Wells score.
  
  
  RESULTS
  Biomarkers and clinical scores that differentiated DVT positives from negatives were sPsel (87.3 vs 53.4 ng/mL, P < .0001), D-dimer (5.8 vs 2.1 mg/ L, P < .0001), CRP (2.1 vs 0.8 μg/mL, P < .0005), and Wells score (3.2 vs 2.0, P < .0001). For MP analysis, platelet-derived MPs were found to differentiate DVT from negatives. Using multivariable logistic regression, a combination of sPsel and Wells score could establish the diagnosis of DVT (cut point ≥ 90 ng/mL + Wells ≥ 2), with a specificity of 96% and positive predictive value (PPV) of 100%, and could exclude DVT diagnosis (cut point ≤ 60 ng/mL and Wells <2) with a sensitivity of 99%, a specificity of 33%, and a negative predictive value (NPV) of 96%.
  
  
  CONCLUSIONS
  This study establishes a biomarker and clinical profile combination that can both confirm and exclude the diagnosis of DVT.
authors: Conrad Jobst Vascular Research Laboratories, Section of Vascular Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA. eduardoramacciotti@gmail.com
authors: Eduardo
authors: E
authors: Ramacciotti
authors: Susan
authors: S
authors: Blackburn
authors: Angela E
authors: AE
authors: Hawley
authors: Frank
authors: F
authors: Vandy
authors: Nicole
authors: N
authors: Ballard-Lipka
authors: Cathy
authors: C
authors: Stabler
authors: Nichole
authors: N
authors: Baker
authors: Kenneth E
authors: KE
authors: Guire
authors: John E
authors: JE
authors: Rectenwald
authors: Peter K
authors: PK
authors: Henke
authors: Daniel D
authors: DD
authors: Myers
authors: Thomas W
authors: TW
authors: Wakefield
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