The usefulness of five D-dimer assays in the exclusion of deep venous thrombosis

被引:42
作者
Schutgens, REG
Haas, FJLM
Gerritsen, WBM
Van der Horst, F
Nieuwenhuis, HK
Biesma, DH
机构
[1] St Antonius Hosp, Dept Internal Med, NL-3430 EM Nieuwegein, Netherlands
[2] St Antonius Hosp, Dept Clin Chem, NL-3430 EM Nieuwegein, Netherlands
[3] Univ Utrecht, Med Ctr, Dept Hematol, Utrecht, Netherlands
关键词
D-dimer; thrombosis;
D O I
10.1046/j.1538-7836.2003.00148.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
D-Dimer measurement is a promising tool in the exclusion of venous thrombosis. New D-dimer assays have been introduced, but need clinical validation. Our objective was to evaluate the clinical usefulness of four relatively new D-dimer assays and a classical ELISA in outpatients suspected for deep venous thrombosis. In 537 patients, participants in a large prospective management study using a clinical probability score and a D-dimer measurement (Tina-quant(R)), additional samples were taken for D-dimer measurement using the Asserachrom ELISA(R), the VIDAS New(R), the STA-LIA(R) and the Miniquant(R) assay. Performances of each test were calculated using clinical data during a 3-month follow-up. Thrombosis was detected in 224 patients (42%). The area under the ROC curve was significantly higher for the Tina-quant as compared to the other assays. Using standard cut-off values, sensitivity, negative predictive value (NPV) and specificity of the Asserachrom were 97, 94 and 33%, respectively. For the VIDAS New, values were 100, 96 and 8%, respectively. The Tina-quant showed values of 99, 98 and 41%, respectively, and the STA-LIA 98, 95 and 32%. Values for the Miniquant were 95, 94 and 52%. The D-dimer assays in our study all show a high sensitivity and negative predictive value, but none of the assays reached an NPV of > 98% at standard cut-off values. D-Dimer assays with a low specificity still necessitate additional diagnostic tests in the majority of the patients.
引用
收藏
页码:976 / 981
页数:6
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