Summary
This study was performed to determine the accuracy of D-Dimer fibrin derivatives,
thrombin-antithrombin III (TAT) complexes and prothrombin fragments 1 + 2 (F 1 + 2)
determinations for the diagnosis of deep vein thrombosis (DVT). One hundred and sixteen
consecutive patients referred to the angiology unit of our hospital for a clinically
suspected DVT were investigated. They were submitted to mercury strain gauge plethysmography
and to ultrasonic duplex scanning examination; in cases of inconclusive results or
of proximal DVT (n = 35), an ascending phlebography was performed. After these investigations
were completed, the diagnosis of DVT was confirmed in 34 and excluded in 82. One half
of the patients were already under anticoagulant therapy at the time of investigation.
The 3 biological markers were assayed using commercially available ELISA techniques
and the D-Dimer was also assayed with a fast latex method. The normal distribution
of these markers was established in 40 healthy blood donors. The most accurate assay
for the diagnosis of DVT was the D-Dimer ELISA which had both a high sensitivity (94%)
and a high negative predictive value (95%). The D-Dirner latex, TAT complexes and
F 1 + 2 were far less sensitive and provided negative predictive values which ranged
between 78 and 85%. In spite of positive and significant correlations between the
levels of ihe 3 markers, their association did not improve their overall accuracy
for detecting D\/L Therefore, with the exception of the D-Dimer ELISA, these markers
were of little value for the diagnosis of DVT in this specific population.
