Prothrombin fragment 1+2 in urine as a marker on coagulation activity in patients with suspected pulmonary embolism.
BACKGROUND
We have recently reported that increased levels of urine prothrombin fragment 1+2 reflected radiologically verified deep vein thrombosis. In this study we evaluated whether urine prothrombin fragment 1+2 was associated with pulmonary embolism in non-selected patients.


METHODS
Patients with clinical suspected pulmonary embolism were interviewed on comorbidities and medications. Urine was collected from each patient before radiological examination and snap frozen until analysed on urine prothrombin fragment 1+2 with an ELISA kit. Imaging of the pulmonary arteries were conducted with contrast enhanced computer tomography.


RESULTS
Pulmonary embolism was diagnosed in 44/197 patients. Non-significantly higher urine prothrombin fragment 1+2 levels were found in non-selected patients with pulmonary embolism vs. those without (p=0.324). Significantly higher urine prothrombin fragment 1+2 levels were found in the pulmonary embolism positive patients without comorbidities (n=13) compared to the control group (n=28) (p=0.009). The calculated sensitivity, specificity and negative predictive value using the lowest detectable urine prothrombin fragment 1+2 level was 82%, 34% and 87%, respectively.


CONCLUSIONS
There was no significant urine prothrombin fragment 1+2 level difference in patients with and without pulmonary embolism. In non-comorbide pulmonary embolism positive patients the urine prothrombin fragment 1+2 levels were significantly higher compared to the control group. The negative predictive value found in this study indicates that uF1+2 has the potential to identify patients with a low risk of PE.
Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway. Electronic address: fredrik.wexels@vestreviken.no.
Fredrik
F
Wexels
Centre of Medical Science, Education and Innovation, Innlandet Hospital Trust, Brumunddal, Norway; Thrombosis Research Institute, London, UK.
Ola E
OE
Dahl
Department of Biostatistics, Epidemiology and Health Economics, Oslo University Hospital, Oslo, Norway.
Are H
AH
Pripp
Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway.
Ingebjørg
I
Seljeflot
Department of Orthopaedics, Section of Traumatology, Århus University Hospital, Århus, Denmark.
Lars C
LC
Borris
Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway.
Anniken
A
Haslund
Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway.
Tor E
TE
Gudmundsen
Department of Biochemistry, Vestre Viken Hospital Trust, Drammen, Norway.
Trine
T
Lauritzen
Copenhagen Spine Center, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
Michael R
MR
Lassen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000652:urine*; D011516:Prothrombin / Q000652:urine*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000652:urine*; D055815:Young Adult
D015415:Biomarkers; D010446:Peptide Fragments; C045879:prothrombin fragment 1.2; D011516:Prothrombin
Prothrombin fragment 1 2; Pulmonary embolism; Radiology; Urine