TY - JOUR
T1 - D-dimer, P-selectin, and microparticles
T2 - Novel markers to predict deep venous thrombosis: A pilot study
AU - Rectenwald, John E.
AU - Myers, Daniel D.
AU - Hawley, Angela E.
AU - Longo, Christopher
AU - Henke, Peter K.
AU - Guire, Kenneth E.
AU - Schmaier, Alvin H.
AU - Wakefield, Thomas W.
PY - 2005/12
Y1 - 2005/12
N2 - Current plasma markers for diagnosis of deep venous thrombosis (DVT) allow for exclusion of the diagnosis, but lack adequate specificity to establish the diagnosis. Thus, a prospective study was performed to determine the sensitivity and specificity of plasma assays for D-dimer, soluble P-selectin (P-selectin), and total microparticles in patients with documented DVT by duplex ultrasound. Three groups of individuals were examined: 30 normals; 22 positive for DVT on duplex ultrasound (Group 2); and 21 symptomatic, but negative on duplex ultrasound for DVT (Group 3). Group I individuals had D-dimer values of 1.53±0.12 mg/l and P-selectin values of 0.34±0.05 ng/mg total protein. Group 2 vs. Group 3 individuals had D-dimer values of 7.57±2.03 vs. 3.19±0.79 mg/l, p=0.02; P-selectin values of 0.98±0.11 vs. 0.55±0.08 ng/mg total protein, p<0.01; and microparticle values of 129±17% vs. 99±12% of control, p=ns. Using a logistic regression model with dichotomous variables, we determined a sensitivity of 73%, specificity of 81%, and accuracy of 77% when combining D-dimer, soluble P-selectin, and total microparticles to differentiate Group 2 from Group 3 patients. Logistic regression using continuous variables yielded similar results (p=0.05). This study demonstrates that plasma markers for DVT can be developed and achieve moderate sensitivity and specificity in diagnosing DVT. However for clinical applicability, the sensitivity/specificity will need to be improved. These studies also suggest the importance of soluble P-selectin in assessing DVT in humans.
AB - Current plasma markers for diagnosis of deep venous thrombosis (DVT) allow for exclusion of the diagnosis, but lack adequate specificity to establish the diagnosis. Thus, a prospective study was performed to determine the sensitivity and specificity of plasma assays for D-dimer, soluble P-selectin (P-selectin), and total microparticles in patients with documented DVT by duplex ultrasound. Three groups of individuals were examined: 30 normals; 22 positive for DVT on duplex ultrasound (Group 2); and 21 symptomatic, but negative on duplex ultrasound for DVT (Group 3). Group I individuals had D-dimer values of 1.53±0.12 mg/l and P-selectin values of 0.34±0.05 ng/mg total protein. Group 2 vs. Group 3 individuals had D-dimer values of 7.57±2.03 vs. 3.19±0.79 mg/l, p=0.02; P-selectin values of 0.98±0.11 vs. 0.55±0.08 ng/mg total protein, p<0.01; and microparticle values of 129±17% vs. 99±12% of control, p=ns. Using a logistic regression model with dichotomous variables, we determined a sensitivity of 73%, specificity of 81%, and accuracy of 77% when combining D-dimer, soluble P-selectin, and total microparticles to differentiate Group 2 from Group 3 patients. Logistic regression using continuous variables yielded similar results (p=0.05). This study demonstrates that plasma markers for DVT can be developed and achieve moderate sensitivity and specificity in diagnosing DVT. However for clinical applicability, the sensitivity/specificity will need to be improved. These studies also suggest the importance of soluble P-selectin in assessing DVT in humans.
KW - Clinical study
KW - D-dimer
KW - Deep venous thrombosis
KW - Microparticles
KW - P-selectin
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UR - http://www.scopus.com/inward/citedby.url?scp=29244461392&partnerID=8YFLogxK
U2 - 10.1160/TH05-06-0426
DO - 10.1160/TH05-06-0426
M3 - Article
C2 - 16411411
AN - SCOPUS:29244461392
SN - 0340-6245
VL - 94
SP - 1312
EP - 1317
JO - Thrombosis and Haemostasis
JF - Thrombosis and Haemostasis
IS - 6
ER -