title: D-Dimer and prothrombin fragment 1 + 2 in urine and plasma in patients with clinically suspected venous thromboembolism.
abstract: Increased levels of urine prothrombin fragment 1 + 2 was recently reported to be associated with imaging-verified venous thromboembolism. In this study we evaluated the relationship between plasma D-dimer and plasma and urine prothrombin fragment 1 + 2 in patients with suspected venous thromboembolism. Urine and blood samples were collected from patients with suspected pulmonary embolism or deep vein thrombosis. The samples were analysed with commercially available ELISA kits. The diagnosis of venous thromboembolism was verified with contrast-enhanced computer tomography of the pulmonary arteries or lower extremity deep vein compression ultrasound and venography as appropriate. Venous thromboembolism was diagnosed in 150 of 720 patients. Significantly higher levels of plasma D-dimer and prothrombin fragment 1 + 2 in plasma and urine were found in those with imaging-confirmed venous thromboembolism versus those without (P < 0.001). The correlation between the three biomarkers was statistically significant (range of rs values 0.45-0.65, P < 0.001). Plasma D-dimer had the highest diagnostic accuracy followed by prothrombin fragment 1 + 2 in plasma. Further development of ELISA analyses for urine testing of prothrombin fragment 1 + 2 may improve its diagnostic accuracy.
authors.affiliation: aDepartment of Radiology, Vestre Viken Hospital Trust, DrammenbFaculty of Medicine, University of OslocDepartment of Cardiology, Centre for Clinical Heart Research, Oslo University HospitaldOslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, OsloeCentre of Medical Science, Education and Innovation, Innlandet Hospital Trust, Brumunddal, NorwayfThrombosis Research Institute, London, UK.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Wexels
authors.forename: Ingebjørg
authors.initials: I
authors.lastname: Seljeflot
authors.forename: Are H
authors.initials: AH
authors.lastname: Pripp
authors.forename: Ola E
authors.initials: OE
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood* / Q000652:urine; D010690:Phlebography; D011516:Prothrombin / Q000652:urine; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D014057:Tomography, X-Ray Computed; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000652:urine
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; C036309:fibrin fragment D; C045879:prothrombin fragment 1.2; D011516:Prothrombin