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Thromb Haemost 1996; 76(01): 009-011
DOI: 10.1055/s-0038-1650513
Original Article
Schattauer GmbH Stuttgart

Reliable Rapid Blood Test for the Exclusion of Venous Thromboembolism in Symptomatic Outpatients

Franktien Turkstra
The Center for Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Academic Medical Centre, Amsterdam, The Netherlands
,
Edwin J R van Beek
The Center for Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Academic Medical Centre, Amsterdam, The Netherlands
,
Jan W ten Cate
The Center for Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Academic Medical Centre, Amsterdam, The Netherlands
,
Harry R Buller
The Center for Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Academic Medical Centre, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

Received: 05 February 1996

Accepted after revision15 April 1996

Publication Date:
10 July 2018 (online)

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Summary

In this study we assessed the reliability of a rapid bed-side whole blood D-dimer assay prospectively in patients with clinically suspected venous thromboembolism, referred to the Academic Medical Centre, Amsterdam. In consecutive outpatients with clinically suspected deep vein thrombosis or pulmonary embolism we measured the sensitivity, specificity and negative predictive value of the assay compared to the outcome of standard diagnostic tests and 3-month follow-up. A total of 234 patients were included; the prevalence of venous thromboembolism was 29%. A sensitivity, specificity and negative predictive value of 100% (95% Cl: 95% -100%), 58% (95% Cl: 50% - 65%) and 100% (95% Cl: 96% -100%), respectively, were obtained. The exclusion rate was 41% of all referred patients. Conclusion: The SimpliRED whole blood D-dimer assay appears to be a simple and reliable method for the exclusion of venous thromboembolism in symptomatic outpatients.

 

  • References

  • 1 Value of the ventilation-perfusion scan in acute pulmonary embolism: results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). JAMA 1990 263. 2753-2759
    PubMedSearch in Google Scholar
  • 2 Lensing AWA, Hirsh J, Biiller HR. Diagnosis of venous thrombosis. In: Hemostasis and Thrombosis, basic principles and clinical practice Colman RW, Hirsh J, Marder VJ, Salzman EW. (eds) 3rd edition Philadelphia: JP Lippincott; 1994: 1297-1321
  • 3 Hull RD, Hirsh J, Carter CJ, Raskob GE, Gill GJ, Jay RM, Leclerck JR, David M, Coates J. Diagnostic value of ventilation-perfusion lung scanning in patients with suspected pulmonary embolism. Chest 1985; 88: 819-828
    CrossrefPubMedSearch in Google Scholar
  • 4 Stein PD, Hull RD, Saltzman HA, Pineo G. Strategy for the diagnosis of patients with suspected acute pulmonary embolism. Chest 1993; 104: 1472-1476
    CrossrefPubMedSearch in Google Scholar
  • 5 Heijboer H, Biiller HR, Lensing AWA, Turpie AGG, Colly LP, ten Cate JW. A comparison of real-time compression ultrasonography with impedance plethysmography for the diagnosis of deep vein thrombosis in symptomatic outpatients. N Engl J Med 1993; 329: 1365-1369
    CrossrefPubMedSearch in Google Scholar
  • 6 Bounameaux H, Cirafici P, de Moerloose P, Schneider P-A, Slosman D, Reber G, Unger PF. Measurement of D-dimer in plasma as diagnostic aid in suspected pulmonary embolism. Lancet 1991; 337: 196-200
    CrossrefPubMedSearch in Google Scholar
  • 7 van Beek EJR, van den Ende B, Berckmans R, van der Heide YT, Brandjes DPM, Sturk A, ten Cate JW. A comparative analysis of D-dimer assays in patients with clinically suspected pulmonary embolism. Thromb Haemost 1993; 70: 408-413
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Ginsberg JS, Brill-Edwards P, Demers C, Donovan D, Panju A. D-dimer in patients with clinically suspected pulmonary embolism. Chest 1993; 104: 1679-1684
    CrossrefPubMedSearch in Google Scholar
  • 9 Charles LA, Edwards T, Macik G. Evaluation of sensitivity and specificity of six D-dimer latex assays. Arch Pathol Lab Med 1994; 118: 1102-1105
    PubMedSearch in Google Scholar
  • 10 Moser KM. Diagnosing pulmonary embolism; D-dimer needs rigorous evaluation. BMJ 1994; 309: 1525-1526
    CrossrefPubMedSearch in Google Scholar
  • 11 de Moerloose P, Desmarais S, Bounameaux H, Reber G, Perrier A, Dupuy G, Pittet JL. Contribution of a new rapid, individual and quantitative automated D-dimer ELISA to exclude pulmonary embolism. Thromb Haemost 1996; 75: 11-13
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 John MA, Elms MJ, O’Reilly EJ, Rylatt DB, Bundesen PG, Hillyard CJ. The SimpliRED D-dimer test: a novel assay for the detection of cross-linked fibrin degradation products in whole blood. Thromb Res 1990; 58: 273-281
    CrossrefPubMedSearch in Google Scholar
  • 13 Demers C, Ginsberg JS, Johnston M, Brill-Edwards P, Panju A. D-dimer and thrombin-antithrombin III complexes in patients with clinically suspected pulmonary embolism. Thromb Haemost 1992; 67: 408-412
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 van den Ende A, van Beek EJR, Brandjes DPM, Bossuyt PMM, Biiller HR. Plasma D-dimer concentration in the exclusion of pulmonary embolism: a cost-effective approach. Thromb Haemost 1995; 73: 1099
    PubMedSearch in Google Scholar
  • 15 Ginsberg JS, Wells PS, Brill-Edwards P, Donovan D, Panju A, van Beek EJR, Patel A. Application of a novel and rapid whole blood assay for D-dimer in patients with clinically suspected pulmonary embolism. Thromb Haemost 1995; 73: 35-38
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Wells PS, Brill-Edwards P, Stevens P, Panju A, Patel A, Douketis J, Massi-cotte P, Hirsh J, Weitz JR, Kearon C, Ginsberg JS. A novel and rapid whole blood assay for D-dimers in patients with clinically suspected deep vein thrombosis. Circulation 1995; 91: 2184-2187
    CrossrefPubMedSearch in Google Scholar
  • 17 Hull RD, Hirsh J, Sackett DL, Taylor DW, Carter C, Turpie AGG, Powers P, Gent M. Clinical validity of a negative venogram in patients with clinically suspected venous thrombosis. Circulation 1981; 64: 622-625
    CrossrefPubMedSearch in Google Scholar
  • 18 Henry JW, Relyea B, Stein PD. Continuing risk of thromboemboli with normal pulmonary angiograms. Chest 1995; 107: 1375-1378
    CrossrefPubMedSearch in Google Scholar