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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
John E. Rectenwald
1   Departments of Surgery, Section of Vascular Surgery
,
Daniel D. Myers Jr
1   Departments of Surgery, Section of Vascular Surgery
,
Angela E. Hawley
1   Departments of Surgery, Section of Vascular Surgery
,
Christopher Longo
1   Departments of Surgery, Section of Vascular Surgery
,
Peter K. Henke
1   Departments of Surgery, Section of Vascular Surgery
,
Kenneth E. Guire
3   School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
,
Alvin H. Schmaier
2   Internal Medicine and Pathology
,
Thomas W. Wakefield
1   Departments of Surgery, Section of Vascular Surgery
› Author AffiliationsGrant support: Supported by grant HL70766 from the National Institutes of Health to T.W.W and HL52779 and HL57346 to A.H.S. Presented in part at The 46th Annual American Society of Hematology Meeting and Exposition, San Diego, CA. December 6, 2004.
Further Information

Publication History

Received 16 June 2005

Accepted after resubmission 30 September 2005

Publication Date:
07 December 2017 (online)

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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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