Key result
LDH and D-dimer levels did not significantly differentiate between patients with and without pulmonary thromboembolism detected by computed tomography pulmonary angiography (AUC 0.550).
Why the study?
Do D-dimer and LDH levels accurately predict pulmonary thromboembolism diagnosed by CTPA in patients with suspected PE?
Observational (n=62)
No
Do D-dimer and LDH levels accurately predict pulmonary thromboembolism diagnosed by CTPA in patients with suspected PE?
Effect estimate: AUC 0.550 (95% CI 0.364-0.736)
p-value: p=0.575
LDH and D-dimer tests using the latex agglutination method did not reliably exclude pulmonary thromboembolism without CT pulmonary angiography in this small cohort.
BACKGROUND: Pulmonary thromboembolism (PTE) is a common disease with a high mortality rate that is difficult to diagnose and treat. Because of the variety of clinical symptoms and signs, it is difficult to diagnose. Therefore, the diagnosis of PTE is mainly confirmed by imaging techniques. The aim of this study was to evaluate whether there is any corelation of the Wells rule, D-dimer and LDH values with computerized tomography pulmonary angiography (CTPA) findings in PTE diagnosis. MATERIAL/METHODS: A consecutive series of 62 patients, which included 31 males and 31 females, with high/moderate/low risk of embolism according to Wells pulmonary embolism score, selected from the emergency service and/or outpatient clinic, enrolled in this prospective study. The patients with clinical or laboratory findings of elevated D-dimer level or elevated lactate dehydrogenase (LDH) level were suspected of embolism and underwent tomography. RESULTS: PTE was detected in 26 patients (42%). A significant difference was not detected between tomography finding positive and negative embolisms in the patient group in terms of age or gender distribution (P=0.221 and P=0.416, respectively). No significant difference was detected between tomography finding positive and negative embolisms in the patient group in terms of elevated LDH or/and D-dimer levels (P=0.263 and P=1.000, respectively). The distribution of low-risk-factor patients in the non-embolism group, and the distribution of high-risk-factor patients in the embolism-positive group was statistically significantly high (P<0.001). There was no statistically significant difference between the groups (P=0.053). Correlation test showed no correlation between LDH and D-dimer levels. (r=0.214, P=0.180). CONCLUSIONS: In conclusion, when a patient presents with chest pain, our carrying out LDH and D-Dimer tests will not exclude PTE without CTPA. However, we suggest that LDH isoenzymes should be studied in further research.
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Fatma Dilek Gökharman (2015) conducted an observational in Suspected pulmonary thromboembolism (n=62). LDH and D-dimer testing vs. Computed tomography pulmonary angiography (CTPA) was evaluated on Differentiation between patients with and without pulmonary thromboembolism (AUC 0.550, 95% CI 0.364-0.736, p=0.575). LDH and D-dimer levels did not significantly differentiate between patients with and without pulmonary thromboembolism detected by computed tomography pulmonary angiography (AUC 0.550).
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