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A prospective evaluation of a quantitative D-dimer assay in the evaluation of acute pulmonary embolism.
J Vasc Interv Radiol. 2007 Aug; 18(8):970-4.JV

Abstract

PURPOSE

A prospective study was designed to determine if a screening quantitative serum D-dimer measurement of 1.0 microg/mL or less precludes pulmonary computed tomographic (CT) angiography in patients with possible acute pulmonary embolism (PE).

MATERIALS AND METHODS

Over a period of 16 months, every patient seen in the emergency department in whom there was clinical suspicion of PE sufficient to warrant pulmonary CT angiography was also requested to have a quantitative serum D-dimer level measurement taken. All pulmonary CT angiography procedures were performed on a four-slice scanner and every examination was overread by a radiologist who was blinded to the D-dimer assay results. Three-month medical record and telephone follow-up was carried out for all participants who had a serum D-dimer level of 1.0 microg/mL or less to verify no new diagnosis or death from PE.

RESULTS

In this prospective study, 361 consecutive patients who received pulmonary CT angiography had a D-dimer level of 1.0 microg/mL or less. There were 310 patients who had negative pulmonary CT angiography results and 50 patients who had indeterminate CT angiography results. Only one patient had positive pulmonary CT angiography findings. Minimum 3-month follow-up information was available for 349 patients, none of whom reported subsequent PE, including those with indeterminate pulmonary CT angiography results.

CONCLUSION

The use of a screening D-dimer measurement of 1.0 microg/mL or less precludes pulmonary CT angiography in patients with possible acute PE. The use of this quantitative D-dimer assay would decrease radiation exposure, contrast medium toxicity, cost, and time for patients seen in the emergency medicine department.

Authors+Show Affiliations

John A. Burns School of Medicine, Kaiser Foundation Hospital, 3288 Moanalua Road, Honolulu, Hawaii 96819, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17675613

Citation

Hirai, Lana K., et al. "A Prospective Evaluation of a Quantitative D-dimer Assay in the Evaluation of Acute Pulmonary Embolism." Journal of Vascular and Interventional Radiology : JVIR, vol. 18, no. 8, 2007, pp. 970-4.
Hirai LK, Takahashi JM, Yoon HC. A prospective evaluation of a quantitative D-dimer assay in the evaluation of acute pulmonary embolism. J Vasc Interv Radiol. 2007;18(8):970-4.
Hirai, L. K., Takahashi, J. M., & Yoon, H. C. (2007). A prospective evaluation of a quantitative D-dimer assay in the evaluation of acute pulmonary embolism. Journal of Vascular and Interventional Radiology : JVIR, 18(8), 970-4.
Hirai LK, Takahashi JM, Yoon HC. A Prospective Evaluation of a Quantitative D-dimer Assay in the Evaluation of Acute Pulmonary Embolism. J Vasc Interv Radiol. 2007;18(8):970-4. PubMed PMID: 17675613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective evaluation of a quantitative D-dimer assay in the evaluation of acute pulmonary embolism. AU - Hirai,Lana K, AU - Takahashi,Jayme M, AU - Yoon,Hyo-Chun, PY - 2007/8/7/pubmed PY - 2008/4/5/medline PY - 2007/8/7/entrez SP - 970 EP - 4 JF - Journal of vascular and interventional radiology : JVIR JO - J Vasc Interv Radiol VL - 18 IS - 8 N2 - PURPOSE: A prospective study was designed to determine if a screening quantitative serum D-dimer measurement of 1.0 microg/mL or less precludes pulmonary computed tomographic (CT) angiography in patients with possible acute pulmonary embolism (PE). MATERIALS AND METHODS: Over a period of 16 months, every patient seen in the emergency department in whom there was clinical suspicion of PE sufficient to warrant pulmonary CT angiography was also requested to have a quantitative serum D-dimer level measurement taken. All pulmonary CT angiography procedures were performed on a four-slice scanner and every examination was overread by a radiologist who was blinded to the D-dimer assay results. Three-month medical record and telephone follow-up was carried out for all participants who had a serum D-dimer level of 1.0 microg/mL or less to verify no new diagnosis or death from PE. RESULTS: In this prospective study, 361 consecutive patients who received pulmonary CT angiography had a D-dimer level of 1.0 microg/mL or less. There were 310 patients who had negative pulmonary CT angiography results and 50 patients who had indeterminate CT angiography results. Only one patient had positive pulmonary CT angiography findings. Minimum 3-month follow-up information was available for 349 patients, none of whom reported subsequent PE, including those with indeterminate pulmonary CT angiography results. CONCLUSION: The use of a screening D-dimer measurement of 1.0 microg/mL or less precludes pulmonary CT angiography in patients with possible acute PE. The use of this quantitative D-dimer assay would decrease radiation exposure, contrast medium toxicity, cost, and time for patients seen in the emergency medicine department. SN - 1051-0443 UR - https://www.unboundmedicine.com/medline/citation/17675613/A_prospective_evaluation_of_a_quantitative_D_dimer_assay_in_the_evaluation_of_acute_pulmonary_embolism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/18/8/970 DB - PRIME DP - Unbound Medicine ER -