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[Value of the association of D-dimer measurement and the evaluation of clinical probability in a non-invasive diagnostic strategy of pulmonary embolism].
Arch Mal Coeur Vaiss. 2004 Feb; 97(2):93-9.AM

Abstract

New diagnostic tools in suspected pulmonary embolism complete the classical diagnostic strategy of pulmonary scintigraphy and pulmonary angiography to limit the indications of these two invasive investigations. In a prospective series of 204 consecutive patients with suspected pulmonary embolism the association of D-dimer measurement and clinical probability was assessed for the exclusion of the diagnosis of pulmonary embolism. The D-DI Liatest is a new generation, unitary, rapid and quantitative latex test with a comparative diagnostic performance to that of the reference ELISA test, and well adapted to emergency situations.The clinical probability was assessed by a quantitative score based on past history, clinical symptoms and signs. The positive diagnosis of pulmonary embolism was made by spiral CT scanner and/or pulmonary angiography, associated with Duplex ultrasonography of the leg veins in nondiagnostic results. The prevalence of pulmonary embolism was 42.6% and the absence of anticoagulation in patients considered not to have pulmonary embolism was associated with a thrombo-embolic incidence of 0.9% at 3 months. Fifty-six patients had D-dimer concentrations equal or inferior to the threshold of 500 microg/L; the sensitivity was 99% and the specificity 47% with a negative predictive value of 98% to 100% in cases with a low clinical probability. D-dimer measurement is reliable and has a high cost-benefit value in ambulatory patients with suspected of pulmonary embolism and is even more valuable when the clinical probability of this diagnosis is low.

Authors+Show Affiliations

Département de cardiologie et maladies vasculaires, CHU Pontchaillou, Rennes.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

15032407

Citation

Palud, L, et al. "[Value of the Association of D-dimer Measurement and the Evaluation of Clinical Probability in a Non-invasive Diagnostic Strategy of Pulmonary Embolism]." Archives Des Maladies Du Coeur Et Des Vaisseaux, vol. 97, no. 2, 2004, pp. 93-9.
Palud L, Laurent M, Guéret P, et al. [Value of the association of D-dimer measurement and the evaluation of clinical probability in a non-invasive diagnostic strategy of pulmonary embolism]. Arch Mal Coeur Vaiss. 2004;97(2):93-9.
Palud, L., Laurent, M., Guéret, P., Meunier, C., Garin, E., Benoît, P. O., Belléguic, C., Bernard du Haut Cilly, F., Almange, C., & Daubert, J. C. (2004). [Value of the association of D-dimer measurement and the evaluation of clinical probability in a non-invasive diagnostic strategy of pulmonary embolism]. Archives Des Maladies Du Coeur Et Des Vaisseaux, 97(2), 93-9.
Palud L, et al. [Value of the Association of D-dimer Measurement and the Evaluation of Clinical Probability in a Non-invasive Diagnostic Strategy of Pulmonary Embolism]. Arch Mal Coeur Vaiss. 2004;97(2):93-9. PubMed PMID: 15032407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Value of the association of D-dimer measurement and the evaluation of clinical probability in a non-invasive diagnostic strategy of pulmonary embolism]. AU - Palud,L, AU - Laurent,M, AU - Guéret,P, AU - Meunier,C, AU - Garin,E, AU - Benoît,P O, AU - Belléguic,C, AU - Bernard du Haut Cilly,F, AU - Almange,C, AU - Daubert,J C, PY - 2004/3/23/pubmed PY - 2005/2/4/medline PY - 2004/3/23/entrez SP - 93 EP - 9 JF - Archives des maladies du coeur et des vaisseaux JO - Arch Mal Coeur Vaiss VL - 97 IS - 2 N2 - New diagnostic tools in suspected pulmonary embolism complete the classical diagnostic strategy of pulmonary scintigraphy and pulmonary angiography to limit the indications of these two invasive investigations. In a prospective series of 204 consecutive patients with suspected pulmonary embolism the association of D-dimer measurement and clinical probability was assessed for the exclusion of the diagnosis of pulmonary embolism. The D-DI Liatest is a new generation, unitary, rapid and quantitative latex test with a comparative diagnostic performance to that of the reference ELISA test, and well adapted to emergency situations.The clinical probability was assessed by a quantitative score based on past history, clinical symptoms and signs. The positive diagnosis of pulmonary embolism was made by spiral CT scanner and/or pulmonary angiography, associated with Duplex ultrasonography of the leg veins in nondiagnostic results. The prevalence of pulmonary embolism was 42.6% and the absence of anticoagulation in patients considered not to have pulmonary embolism was associated with a thrombo-embolic incidence of 0.9% at 3 months. Fifty-six patients had D-dimer concentrations equal or inferior to the threshold of 500 microg/L; the sensitivity was 99% and the specificity 47% with a negative predictive value of 98% to 100% in cases with a low clinical probability. D-dimer measurement is reliable and has a high cost-benefit value in ambulatory patients with suspected of pulmonary embolism and is even more valuable when the clinical probability of this diagnosis is low. SN - 0003-9683 UR - https://www.unboundmedicine.com/medline/citation/15032407/[Value_of_the_association_of_D_dimer_measurement_and_the_evaluation_of_clinical_probability_in_a_non_invasive_diagnostic_strategy_of_pulmonary_embolism]_ L2 - http://www.diseaseinfosearch.org/result/2504 DB - PRIME DP - Unbound Medicine ER -