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Comparison of the clinical usefulness of two quantitative D-Dimer tests in patients with a low clinical probability of pulmonary embolism.
Thromb Res. 2009 Mar; 123(5):771-4.TR

Abstract

BACKGROUND

Quantitative D-Dimer tests are established methods in the non-invasive diagnostic management to rule out venous thromboembolism (VTE). The diagnostic performance and the clinical efficiency different D-Dimer assays in the exclusion of pulmonary embolism (PE) have not yet been compared in a clinical outcome study.

OBJECTIVE

Evaluation of the efficiency and safety of excluding the diagnosis of PE with two different quantitative D-Dimer assays in consecutive patients with clinically suspected PE.

PATIENTS AND METHODS

We studied the VTE-failure rate of 2206 consecutive patients with an unlikely clinical probability in whom VIDAS or Tinaquant D-Dimer tests were performed.

RESULTS

The prevalence of PE in 1238 patients whose D-Dimer level was analyzed with Tinaquant assay was 11%. The VIDAS assay group consisted of 968 patients with a PE prevalence of 13%. The VIDAS assay had a sensitivity of 99.2% (95%CI; 96- >99.9%), the Tinaquant assay of 97.3% (95%CI; 93 -99%). The negative predictive value (NPV) in the Tinaquant assay group was 99.4% (95%CI 98-99.8%) in comparison to 99.7% (95%CI 99->99.9%) in the VIDAS assay group. During 3 month of follow-up, there were no fatal cases of PE among patients with normal D-Dimer and unlikely clinical probability in both D-Dimer assay groups. In addition, the test efficiency of Tinaquant assay was significantly higher in comparison to VIDAS assay (52% vs 42%, p<0.001).

CONCLUSION

Both Tinaquant and VIDAS D-Dimer tests perform equally well in combination with an unlikely clinical probability in excluding PE. The Tinaquant test was shown to be more efficient.

Authors+Show Affiliations

Section of Vascular Medicine, Department of General Internal Medicine - Endocrinology, Leiden University Medical Center, Leiden, the Netherlands.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)

Comparative Study
Journal Article

Language

eng

PubMed ID

18814904

Citation

Djurabi, R Karami, et al. "Comparison of the Clinical Usefulness of Two Quantitative D-Dimer Tests in Patients With a Low Clinical Probability of Pulmonary Embolism." Thrombosis Research, vol. 123, no. 5, 2009, pp. 771-4.
Djurabi RK, Klok FA, Nijkeuter M, et al. Comparison of the clinical usefulness of two quantitative D-Dimer tests in patients with a low clinical probability of pulmonary embolism. Thromb Res. 2009;123(5):771-4.
Djurabi, R. K., Klok, F. A., Nijkeuter, M., Kaasjager, K., Kamphuisen, P. W., Kramer, M. H., Kruip, M. J., Leebeek, F. W., Büller, H. R., & Huisman, M. V. (2009). Comparison of the clinical usefulness of two quantitative D-Dimer tests in patients with a low clinical probability of pulmonary embolism. Thrombosis Research, 123(5), 771-4. https://doi.org/10.1016/j.thromres.2008.07.014
Djurabi RK, et al. Comparison of the Clinical Usefulness of Two Quantitative D-Dimer Tests in Patients With a Low Clinical Probability of Pulmonary Embolism. Thromb Res. 2009;123(5):771-4. PubMed PMID: 18814904.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the clinical usefulness of two quantitative D-Dimer tests in patients with a low clinical probability of pulmonary embolism. AU - Djurabi,R Karami, AU - Klok,F A, AU - Nijkeuter,M, AU - Kaasjager,K, AU - Kamphuisen,P W, AU - Kramer,M H H, AU - Kruip,M J H A, AU - Leebeek,F W G, AU - Büller,Harry R, AU - Huisman,M V, Y1 - 2008/09/24/ PY - 2008/05/29/received PY - 2008/07/14/revised PY - 2008/07/29/accepted PY - 2008/9/26/pubmed PY - 2009/6/16/medline PY - 2008/9/26/entrez SP - 771 EP - 4 JF - Thrombosis research JO - Thromb Res VL - 123 IS - 5 N2 - BACKGROUND: Quantitative D-Dimer tests are established methods in the non-invasive diagnostic management to rule out venous thromboembolism (VTE). The diagnostic performance and the clinical efficiency different D-Dimer assays in the exclusion of pulmonary embolism (PE) have not yet been compared in a clinical outcome study. OBJECTIVE: Evaluation of the efficiency and safety of excluding the diagnosis of PE with two different quantitative D-Dimer assays in consecutive patients with clinically suspected PE. PATIENTS AND METHODS: We studied the VTE-failure rate of 2206 consecutive patients with an unlikely clinical probability in whom VIDAS or Tinaquant D-Dimer tests were performed. RESULTS: The prevalence of PE in 1238 patients whose D-Dimer level was analyzed with Tinaquant assay was 11%. The VIDAS assay group consisted of 968 patients with a PE prevalence of 13%. The VIDAS assay had a sensitivity of 99.2% (95%CI; 96- >99.9%), the Tinaquant assay of 97.3% (95%CI; 93 -99%). The negative predictive value (NPV) in the Tinaquant assay group was 99.4% (95%CI 98-99.8%) in comparison to 99.7% (95%CI 99->99.9%) in the VIDAS assay group. During 3 month of follow-up, there were no fatal cases of PE among patients with normal D-Dimer and unlikely clinical probability in both D-Dimer assay groups. In addition, the test efficiency of Tinaquant assay was significantly higher in comparison to VIDAS assay (52% vs 42%, p<0.001). CONCLUSION: Both Tinaquant and VIDAS D-Dimer tests perform equally well in combination with an unlikely clinical probability in excluding PE. The Tinaquant test was shown to be more efficient. SN - 0049-3848 UR - https://www.unboundmedicine.com/medline/citation/18814904/Comparison_of_the_clinical_usefulness_of_two_quantitative_D_Dimer_tests_in_patients_with_a_low_clinical_probability_of_pulmonary_embolism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-3848(08)00355-1 DB - PRIME DP - Unbound Medicine ER -