D-dimer, P-selectin, and microparticles: Novel markers to predict deep venous thrombosis

John E. Rectenwald; Daniel D. Myers Jr; Angela E. Hawley; Christopher Longo; Peter K. Henke; Kenneth E. Guire; Alvin H. Schmaier; Thomas W. Wakefield

doi:10.1160/TH05-06-0426

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2005; 94(06): 1312-1317
DOI: 10.1160/TH05-06-0426

New Technologies and Diagnostic Tools

Schattauer GmbH

D-dimer, P-selectin, and microparticles: Novel markers to predict deep venous thrombosis

A pilot study

Authors

John E. Rectenwald

¹Departments of Surgery, Section of Vascular Surgery
Daniel D. Myers Jr

¹Departments of Surgery, Section of Vascular Surgery
Angela E. Hawley

¹Departments of Surgery, Section of Vascular Surgery
Christopher Longo

¹Departments of Surgery, Section of Vascular Surgery
Peter K. Henke

¹Departments of Surgery, Section of Vascular Surgery
Kenneth E. Guire

³School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
Alvin H. Schmaier

²Internal Medicine and Pathology
Thomas W. Wakefield

¹Departments of Surgery, Section of Vascular Surgery

Abstract

Summary

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 1 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.

Keywords

Deep venous thrombosis - D-dimer - P-selectin - microparticles - clinical study

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Referenzen

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