Biomarkers for the diagnosis of venous thromboembolism: D-dimer, thrombin generation, procoagulant phospholipid and soluble P-selectin

BackgroundThe diagnostic algorithm for venous thromboembolism (VTE) currently involves a composite of pre-test probability, D-dimer and imaging. Other laboratory tests, however, may assist in the identification of patients with VTE.AimTo assess the accuracy of different coagulation tests (D-dimer, t...

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Veröffentlicht in:Journal of clinical pathology 2018-11, Vol.71 (11), p.1015-1022
Hauptverfasser: Riva, Nicoletta, Vella, Kevin, Hickey, Kieron, Bertù, Lorenza, Zammit, Daniel, Spiteri, Silvana, Kitchen, Steve, Makris, Michael, Ageno, Walter, Gatt, Alex
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Sprache:eng
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Zusammenfassung:BackgroundThe diagnostic algorithm for venous thromboembolism (VTE) currently involves a composite of pre-test probability, D-dimer and imaging. Other laboratory tests, however, may assist in the identification of patients with VTE.AimTo assess the accuracy of different coagulation tests (D-dimer, thrombin generation, phospholipid-dependent (PPL) clotting time, soluble P-selectin (sP-selectin)) as biomarkers of acute VTE.MethodsRandom samples arriving at the Coagulation Laboratory at Mater Dei Hospital (Msida, Malta) from the Accident and Emergency Department with a request for D-dimer measurement were collected between August 2015 and February 2016. The following tests were performed: Innovance D-dimer (Siemens Healthcare Diagnostics), HemosIL D-dimer HS (Instrumentation Laboratory), thrombin generation (using the calibrated automated thrombogram), STA Procoag PPL (Diagnostica Stago) and sP-selectin (Affymetrix; eBioscience). VTE was objectively confirmed by compression ultrasonography, CT pulmonary angiography or ventilation/perfusion lung scan.Results100 samples were collected (33 with VTE). A strong positive linear correlation was found between the two D-dimer tests (r=0.97, p
ISSN:0021-9746
1472-4146
DOI:10.1136/jclinpath-2018-205293