In:
Clinical and Applied Thrombosis/Hemostasis, SAGE Publications, Vol. 17, No. 4 ( 2011-08), p. 425-431
Abstract:
Objective: The combination of D-dimer and Wells score can exclude, but not confirm, the diagnosis of deep venous thrombosis (DVT). Since thrombosis and inflammation are interrelated, we evaluated the combination of soluble P-selectin (sPsel) with other inflammatory biomarkers for the diagnosis of DVT. Methods: Sixty-two positive and one hundred and sixteen patients with negative DVT, by duplex scan, were prospectively evaluated for sPsel, D-dimer, C-reactive protein (CRP), microparticles (MPs; total, leukocyte, and platelet-derived and tissue factor positive microparticles), and clinical Wells score. Results: Biomarkers and clinical scores that differentiated DVT positives from negatives were sPsel (87.3 vs 53.4 ng/mL, P 〈 .0001), D-dimer (5.8 vs 2.1 mg/ L, P 〈 .0001), CRP (2.1 vs 0.8 μg/mL, P 〈 .0005), and Wells score (3.2 vs 2.0, P 〈 .0001). For MP analysis, platelet-derived MPs were found to differentiate DVT from negatives. Using multivariable logistic regression, a combination of sPsel and Wells score could establish the diagnosis of DVT (cut point ≥90 ng/mL + Wells ≥2), with a specificity of 96% and positive predictive value (PPV) of 100%, and could exclude DVT diagnosis (cut point ≤60 ng/mL and Wells 〈 2) with a sensitivity of 99%, a specificity of 33%, and a negative predictive value (NPV) of 96%. Conclusion: This study establishes a biomarker and clinical profile combination that can both confirm and exclude the diagnosis of DVT.
Type of Medium:
Online Resource
ISSN:
1076-0296
,
1938-2723
DOI:
10.1177/1076029611405032
Language:
English
Publisher:
SAGE Publications
Publication Date:
2011
detail.hit.zdb_id:
2230591-9