Comparison of diagnostic performance of three new fast D-dimer assays in the exclusion of deep vein thrombosis.

D-Dimer (DD), a soluble cross-linked fibrin degradation product, has been suggested as a reliable marker to rule out deep vein thrombosis (DVT) (1)(2)(3)(4). The disease can be ruled out in approximately one-third of outpatients suspected with DVT when the plasma concentration of DD is below an appropriate cutoff value (4). Measurement of plasma DD concentrations has been performed by two major methods: ELISA, which is highly sensitive but time-consuming; and latex agglutination, which is faster but less sensitive than ELISA (2)(4). SimpliRED, a latex assay, detects DD directly in whole blood, avoiding the plasma preparation step (5). However, this assay gives only qualitative results and adds an interindividual observation bias that may partly explain the discordant sensitivity values obtained by different investigators (3)(5)(6)(7). In the present study, we investigated the clinical utility of three new fast DD assays in the diagnosis of DVT. We compared 177 consecutive outpatients (117 women and 60 men) from the Montreal cohort in a bicentric prospective study (8). The mean age was 56 years (range, 19–87 years). The inclusion criteria were that subjects be ambulatory patients with a clinical suspicion of DVT and >16 years of age. The exclusion …

[1]  D. Slosman,et al.  Non-invasive diagnosis of venous thromboembolism in outpatients , 1999, The Lancet.

[2]  D. Anderson,et al.  SimpliRED D-dimer can reduce the diagnostic tests in suspected deep vein thrombosis , 1998, The Lancet.

[3]  N. Grenier,et al.  D-dimer Strategy in Thrombosis Exclusion , 1998, Thrombosis and Haemostasis.

[4]  F. Heinrich,et al.  Clinical evaluation of an immunoturbidimetric D-dimer assay in the diagnostic procedure of deep vein thrombosis and pulmonary embolism. , 1997, Thrombosis research.

[5]  P. Moerloose,et al.  D-dimer testing in suspected venous thromboembolism: an update. , 1997, QJM : monthly journal of the Association of Physicians.

[6]  J. Douketis,et al.  The use of D-dimer testing and impedance plethysmographic examination in patients with clinical indications of deep vein thrombosis. , 1997, Archives of internal medicine.

[7]  H. Wollersheim,et al.  Reliability of Five Rapid D-Dimer Assays Compared to ELISA in the Exclusion of Deep Venous Thrombosis , 1997, Thrombosis and Haemostasis.

[8]  J. Cambus,et al.  D-Dimer Test and Diagnosis of Deep Vein Thrombosis: A Comparative Study of 7 Assays , 1996, Thrombosis and Haemostasis.

[9]  I. Virgolini,et al.  Comparison of four rapid D-Dimer tests for diagnosis of pulmonary embolism. , 1996, Thrombosis research.

[10]  A. D’Angelo,et al.  Evaluation of a New Rapid Quantitative D-dimer Assay in Patients with Clinically Suspected Deep Vein Thrombosis , 1996, Thrombosis and Haemostasis.

[11]  P. de Moerloose,et al.  Contribution of a New, Rapid, Individual and Quantitative Automated D-Dimer ELISA to Exclude Pulmonary Embolism , 1996, Thrombosis and Haemostasis.

[12]  P. Moerloose,et al.  Plasma Measurement of D-Dimer as Diagnostic Aid in Suspected Venous Thromboembolism: An Overview , 1994, Thrombosis and Haemostasis.

[13]  Heaton Dc,et al.  Assessment of D dimer assays for the diagnosis of deep vein thrombosis. , 1987 .

[14]  J. Hanley,et al.  A method of comparing the areas under receiver operating characteristic curves derived from the same cases. , 1983, Radiology.