Key result
STA-Liatest D-dimer assay safely rules out PE in 28% of outpatients.
Why the study?
Various D-dimer assays have different sensitivities and specificities to detect thrombosis, necessitating evaluation of STA-Liatest D-Di performance in out-patients with suspected PE.
Does the STA-Liatest D-dimer assay reliably rule out pulmonary embolism in out-patients with suspected PE?
Cohort (n=432)
No
Does the STA-Liatest D-dimer assay reliably rule out pulmonary embolism in out-patients with suspected PE?
The STA-Liatest D-dimer assay is a highly sensitive test that can safely rule out pulmonary embolism in out-patients with low or intermediate clinical probability.
May support STA-Liatest integration into outpatient PE algorithms; leaves open need for broader prospective validation.
Several studies have shown that D-dimer can reliably rule out pulmonary embolism (PE) in out-patients. However, various assays have different sensitivities and specificities to detect thrombosis. Our aim was to evaluate the performance of STA-Liatest D-Di in out-patients referred for suspected PE in a prospective outcome study. 495 consecutive patients referred to Østfold Hospital Trust-Fredrikstad, Norway for suspected PE between February 2002 and December 2003, were recruited in a study evaluating a decision-based algorithm combining clinical probability (CP), D-dimer, and multi-slice computer tomography (MSCT). D-dimer was performed as a first step test. No further testing was carried out in patients with D-dimer < or =0.4 mg/l and low/intermediate CP. The remaining patients proceeded to MSCT. All patients were followed up for 3 months to assess the 3-month thromboembolic risk. The final cohort consisted of 432 patients. PE was diagnosed in 102 (23%) patients. At a D-dimer cut-off point of 0.4 mg/l the tests had the highest sensitivity (100%) and specificity (36%). It safely ruled out PE in 120 (28%) patients. Kappa-coefficients for comparisons versus VIDAS and Asserachrom showed good concordance. STA-Liatest is a reliable and effective assay that can safely rule out PE in out-patients with a performance comparable with that of enzyme-linked immunosorbent assay-based d-dimer levels.
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Ghanima et al. (2005) conducted a cohort in Suspected pulmonary embolism (n=432). STA-Liatest D-dimer assay was evaluated on Pulmonary embolism. The STA-Liatest D-dimer assay at a 0.4 mg/l cut-off demonstrated 100% sensitivity and 36% specificity, safely ruling out pulmonary embolism in 28% of out-patients.
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