Role of the Peripheral Intravenous Catheter in False‐positive D‐dimer Testing

Heffner, Alan C.; Kline, Jeffrey A.

doi:10.1111/j.1553-2712.2001.tb01272.x

Cited by 9 publications

(4 citation statements)

References 13 publications

(12 reference statements)

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“…We emphasize that the derived cutoffs are for hypothetical purposes only and are not meant to be used in clinical practice without further research. From previous reports in the literature in which D-dimer was measured in healthy persons with similar exclusion criteria, we expected that 85% of healthy women would have a D-dimer concentration Ͻ0.50 mg/L (18 ). We used the inferential approach described by Arkin and Wachtel (19 ) to set the sample size to narrow the 95% confidence limits around this 80% proportion to less than approximately Ϯ15% at all trimesters.…”

Section: Sample Sizementioning

confidence: 99%

D-Dimer Concentrations in Normal Pregnancy: New Diagnostic Thresholds Are Needed

Kline¹,

2005

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Section: Sample Sizementioning

confidence: 99%

D-Dimer Concentrations in Normal Pregnancy: New Diagnostic Thresholds Are Needed

Kline¹,

2005

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“…Increases of D-dimer are expected in this group of patients as even the insertion of an antecubital line can result in elevations of this marker. 5 Also notable was the fact that patients with dual ICD-10 codes behaved mostly as patients with cardiac assist devices which may be due to the fact that they were adequately anticoagulated. In a previous analysis of cardiac assist devices in our institution, D-dimers were elevated when measured at baseline, during routine visits after the device had been in place, and when patients had a thrombotic event.…”

Section: Discussionmentioning

confidence: 99%

“… 2 Importantly, D-dimer values above the reference range can be seen in a variety of situations not necessarily related to activation of the coagulation system, including advanced age 3 , 4 and in the presence of intravenous catheters. 5 This stresses the importance of the test’s negative predictive value, as D-dimer results within the reference range allow clinicians to rule-out certain conditions such as disseminated intravascular coagulation (DIC), pulmonary embolism, or deep vein thrombosis. Fibrin monomers are another analyte frequently offered by clinical laboratories.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Coagulation and Hemostasis Biomarkers in a Subset of Patients With Chronic Cardiovascular Disease

Miller

Maier

Duncan

et al. 2021

Clin Appl Thromb Hemost

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Measurement of a single marker of coagulation may not provide a complete picture of hemostasis activation and fibrinolysis in patients with chronic cardiovascular diseases. We assessed retrospective orders of a panel which included prothrombin fragment 1.2 (PF1.2), thrombin: antithrombin complexes, fibrin monomers, and D-dimers in patients with heart assist devices, cardiomyopathies, atrial fibrillation and intracardiac thrombosis (based on ordering ICD-10 codes). During 1 year there were 117 panels from 81 patients. Fifty-six (69%) patients had heart assist devices, cardiomyopathy was present in 17 patients (21%) and 29 patients (36%) had more than 1 condition. PF1.2 was most frequently elevated in patients with cardiomyopathy (61.1%) compared to those with cardiac assist devices (15.7%; P = 0.0002). D-dimer elevation was more frequent in patients with cardiac assist devices (98.8%) compared to those patients with cardiomyopathy (83.3%; P = 0.014). Patients with cardiomyopathy show increases of PF1.2 suggesting thrombin generation. In contrast, elevations of D-dimers without increase in other coagulation markers in patients with cardiac assist devices likely reflect the presence of the intravascular device and not necessarily evidence of hemostatic activation.

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“…It remains to be determined if these elevations result from nonspecific interactions between oritavancin and assay components. The D dimer elevations noted in some participants plausibly represent false-positive readings owing to their transient nature, their occurrence early in the course of therapy, and the observation that insertion of an intravenous catheter alone has been shown to be associated with false-positive D dimer results (9,10). Nevertheless, a conservative approach was taken such that the maximum time to resolution of the elevations in D dimer levels (72 h) is indicated to inform clinicians of the potential for D dimer assay interference.…”

Section: Discussionmentioning

confidence: 99%

Effects of Oritavancin on Coagulation Tests in the Clinical Laboratory

Belley

Robson

Francis³

et al. 2017

Antimicrob Agents Chemother

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Previous studies have shown that some lipoglycopeptide and lipopeptide antimicrobial agents may cause falsely elevated values for some phospholipiddependent coagulation tests. The effect of oritavancin, a lipoglycopeptide antibiotic, on coagulation test results was explored using pooled human plasma samples spiked with drug and in a clinical study after an infusion of a single 1,200-mg intravenous dose of oritavancin in normal healthy volunteers. Pooled plasma with oritavancin added ex vivo showed concentration-dependent prolongation of prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (aPTT), and dilute Russell viper venom time (DRVVT) test results. In contrast, oritavancin had no effect on the activated protein C resistance assay, chromogenic antifactor Xa assay (anti-FXa), thrombin time, and an immunoassay for the laboratory diagnosis of heparin-induced thrombocytopenia. In participants that received a single dose of oritavancin, elevations in PT/INR result, aPTT, DRVVT, activated clotting time, and silica clotting time occurred, with the maximum times to resolution of test interference determined to be 12, 120, 72, 24, and 18 h, respectively. The anti-FXa assay was unaffected, whereas transient elevations in D dimer levels were observed in 30% of participants, with a maximum time to resolution of 72 h. Although oritavancin has no impact on the coagulation system in vivo, a single dose of oritavancin can produce falsely elevated values of some coagulation tests used to monitor hemostasis. The interference of oritavancin on affected tests is transient, and the test results revert to normal ranges within specified times after dosing.

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Role of the Peripheral Intravenous Catheter in False‐positive D‐dimer Testing

Cited by 9 publications

References 13 publications

D-Dimer Concentrations in Normal Pregnancy: New Diagnostic Thresholds Are Needed

D-Dimer Concentrations in Normal Pregnancy: New Diagnostic Thresholds Are Needed

Assessment of Coagulation and Hemostasis Biomarkers in a Subset of Patients With Chronic Cardiovascular Disease

Effects of Oritavancin on Coagulation Tests in the Clinical Laboratory

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