Determinants of ELISA D‐dimer sensitivity for unstable angina pectoris as defined by coronary catheterization

Shitrit, David; Shitrit, Ariella Bar-Gil; Rudensky, Bernard; Sulkes, Jaqueline; Tzviony, Dan

doi:10.1002/ajh.20074

Cited by 10 publications

(6 citation statements)

References 22 publications

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“…Because of the variability in the average D-dimer and fibrin monomer levels related to the choice of biologic assay used, the cutpoint values in the present study may differ from those in studies using other assay systems [28].…”

Section: Limitationsmentioning

confidence: 55%

The prognostic utility of D-dimer and fibrin monomer at long-term follow-up after hospitalization with coronary chest pain

Brügger-Andersen¹,

Pönitz²,

Staines³

et al. 2008

Blood Coagulation &Amp; Fibrinolysis

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D-dimer and fibrin monomer both reflect a prothrombotic potential. There are limited data available comparing these two markers of activated coagulation in a prospective manner in an unselected patient population presenting to the emergency department with chest pain. In addition, their role in risk stratification in patients with acute coronary syndrome is still under evaluation. Therefore, we wanted to assess the prognostic value of these markers with respect to long-term all-cause mortality in 871 patients admitted to the emergency department. Blood samples were obtained immediately following admission. After a follow-up period of 24 months, 123 patients had died. In the univariate analysis, both D-dimer and fibrin monomer predicted all-cause mortality within 2 years with an odds ratio of 7.78 (95% confidence interval, 3.95-15.33) and 4.19 (95% confidence interval, 2.42-7.28), respectively, in the highest quartile (Q4) compared with the lowest quartile (Q1). However, in the multivariable logistic regression model for death within 2 years, the odds ratio of D-dimer and fibrin monomer was 1.80 (95% confidence interval, 0.81 to 3.97) and 1.04 (95% confidence interval, 0.53 to 2.04) in Q4 compared with Q1, respectively, and added no prognostic information above and beyond age, known coronary heart disease, B-type natriuretic peptide and the index diagnoses of ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction and unstable angina pectoris. In an unselected patient population hospitalized with chest pain and potential acute coronary syndrome, neither D-dimer nor fibrin monomer provided complementary prognostic information to established risk determinants during long-term follow-up.

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Section: Limitationsmentioning

confidence: 55%

The prognostic utility of D-dimer and fibrin monomer at long-term follow-up after hospitalization with coronary chest pain

Brügger-Andersen¹,

Pönitz²,

Staines³

et al. 2008

Blood Coagulation &Amp; Fibrinolysis

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show abstract

“…D-dimer may be elevated in patients with unstable angina 39. Some observed elevations of D-dimer in patients with myocardial infarction40, although others observed elevations of D-dimer infrequently among conventionally treated patients 41.…”

Section: D-dimermentioning

confidence: 99%

Diagnosis of Pulmonary Embolism in the Coronary Care Unit

Stein¹,

Sostman²,

Hull³

et al. 2009

The American Journal of Cardiology

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The clinical diagnosis of pulmonary embolism (PE) is difficult in the coronary care unit (CCU) because many findings of PE are similar to acute coronary syndrome and heart failure. Immobilization of only 1 or 2 days may predispose to PE. Heart failure and acute myocardial infarction add to the risk. Dyspnea may be absent or occur only with exertion. The onset of dyspnea may occur over seconds to days. Orthopnea occurs with PE as well as heart failure. When the clinical probability and results of objective testing are discordant, the post-test probability of PE may be neither sufficiently high nor sufficiently low to permit therapeutic decisions. Objective scoring systems for clinical assessment have not been developed for patients in a CCU. D-dimer is likely to be of little value for exclusion of PE in the CCU, because elevations occur with heart failure, unstable angina, and myocardial infarction. Computed tomographic (CT) pulmonary angiography with venous phase imaging of the low pelvic and proximal leg veins (CT venography) are recommended for imaging. Scintigraphy in women

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“…In a cohort of 54 patients who were diagnosed with unstable angina and underwent coronary angiography, D-dimer levels (cutoff 270ng/ml) predicted significant coronary disease on angiography with sensitivity 70%, specificity 50%, PPV 86%, NPV 72%. By lowering the cut-off to 200ng/ml sensitivity increased to 95% but specificity dropped to 20% (189).…”

Section: D-dimermentioning

confidence: 99%

Biomarkers of Atherosclerosis and Acute Coronary Syndromes - A Clinical Perspective

Body¹,

Slevin²,

McDowell³

2012

Traditional and Novel Risk Factors in Atherothrombosis

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Determinants of ELISA D‐dimer sensitivity for unstable angina pectoris as defined by coronary catheterization

Cited by 10 publications

References 22 publications

The prognostic utility of D-dimer and fibrin monomer at long-term follow-up after hospitalization with coronary chest pain

The prognostic utility of D-dimer and fibrin monomer at long-term follow-up after hospitalization with coronary chest pain

Diagnosis of Pulmonary Embolism in the Coronary Care Unit

Biomarkers of Atherosclerosis and Acute Coronary Syndromes - A Clinical Perspective

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