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Diagnostic possibilities of specific fibrin(ogen) degradation products in relation to venous thromboembolism.
MedLine Citation:
PMID:  23187785     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The exclusion of deep venous thrombosis (DVT) in the elderly is hampered by low specificity in clinical decision of D-dimer assays in older patients. To reduce false-positive results, we evaluated specific fibrin(ogen) degradation product assays for their contribution in the diagnosis of DVT. In a post-hoc study with outpatients suspected for DVT, we evaluated the elastase-specific fibrinogen (fibrinogen elastase degradation product, FgEDP) and D-E-specific fibrin (fibrin degradation product, FbDP) degradation product assays in relation to DVT. Results were combined with five D-dimer assays as ratio, with a specific focus on age-dependency. In 437 patients (DVT prevalence 39%), FgEDP correlated with D-dimer in DVT-negative patients (P < 0.001), but not in DVT-positive patients (P > 0.55). FbDP results correlated with D-dimer in both groups (P < 0.001). The values of the area under the curve of the receiver operating characteristic curve for both assays were lower than D-dimer. Using the ratios, only in the fourth age quartile D-dimer/FgEDP ratios had diagnostic value with lower number needed to test (1.8-12.7) as compared to D-dimer less than 500 μg/l alone (5.4-102). The D-dimer/FbDP ratios in DVT-negative elderly patients increased to a plateau by increasing D-dimer. In DVT-positive patients, these ratios were near constant for increasing values of D-dimer. In elderly patients, the D-dimer/FgEDP ratios may improve the number of patients in whom DVT could be excluded. The D-dimer/FbDP ratios showed differences in composition of fibrin degradation products between DVT-negative and DVT-positive patients and between young and old DVT-negative patients.
Authors:
Fred J L M Haas; Roger E G Schutgens; Douwe H Biesma; Ria H Laterveer; Cornelis Kluft
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-22
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  -     ISSN:  1473-5733     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment of Clinical Chemistry, St Antonius Hospital, Nieuwegein bDepartment of Haematology/van Creveldkliniek, University Medical Center Utrecht, Utrecht cDepartment of Internal Medicine, St Antonius Hospital, Nieuwegein dGood Biomarker Sciences, Leiden, the Netherlands.
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