Document Detail


Determinants of ELISA D-dimer sensitivity for unstable angina pectoris as defined by coronary catheterization.
MedLine Citation:
PMID:  15164376     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Unstable angina pectoris is associated with elevated D-dimer levels. However, the operating characteristics (sensitivity, specificity, positive and negative predictive value) of the D-dimer assay for the diagnosis of coronary artery disease (CAD) are unknown. Using a prospective, observational design, we collected blood from 54 patients with unstable angina pectoris at admission and assayed for ELISA D-dimer levels. The sensitivity, specificity, and negative and positive prediction values for angiographically determined coronary artery disease were calculated at multiple discriminate levels. All patients underwent coronary catheterization. A statistically significant correlation was noted between ELISA D-dimer levels and age, male sex, hypertension, use of beta-blocker, fibrinogen levels and catheterization findings. No correlation was noted between ELISA D-dimer levels and degree of the coronary artery disease. Best results were provided at a discriminate level of 270 ng/ml, with sensitivity 70%, negative predictive value 72%, and overall accuracy 67%. All discriminate levels, however, provided values too low for diagnosis. In conclusion, ELISA D-dimer assay is a non-sensitive, non-specific test for coronary artery disease as defined by coronary catheterization. However, the assay adds information regarding the severity of disease in patients presenting with acute coronary syndrome.
Authors:
David Shitrit; Ariella Bar-Gil Shitrit; Bernard Rudensky; Jaqueline Sulkes; Dan Tzviony
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of hematology     Volume:  76     ISSN:  0361-8609     ISO Abbreviation:  Am. J. Hematol.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-27     Completed Date:  2004-07-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7610369     Medline TA:  Am J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  121-5     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Wiley-Liss, Inc.
Affiliation:
Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel. davariel@zahav.net.il
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / blood,  chemically induced*,  radiography
Biological Markers / blood
Coronary Disease / blood,  diagnosis
Enzyme-Linked Immunosorbent Assay / methods
Female
Fibrin Fibrinogen Degradation Products / analysis*
Heart Catheterization*
Humans
Male
Middle Aged
Observer Variation
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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