Plasma D-dimer levels were significantly higher in patients with pulmonary embolism compared to those without (9.85 vs 2.82 µg/ml), with an optimal diagnostic threshold of 1.9 µg/ml.
Observational (n=32)
No
Does plasma D-dimer level accurately diagnose pulmonary embolism compared to CTPA in patients with suspected pulmonary embolism?
D-dimer testing provides high sensitivity but moderate specificity for diagnosing pulmonary embolism, supporting its use as a simple screening tool for exclusion.
Absolute Event Rate: 9.85% vs 2.82%
p-value: p=0.001
D-dimer levels correlate with the extent of pulmonary embolism (PE) on computed tomography pulmonary angiography (CTPA), but the use of D-dimer alone for screening and diagnosing PE remains controversial. This study compared the utility of plasma D-dimer levels for diagnosing PE with that of CTPA (gold standard). This was a retrospective analysis of 32 consecutive patients with suspected PE at the Affiliated Hospital of Yan'an University between OctoberC 2010 and March 2011. Blood was sampled before thrombolytic therapy was administered. D-dimer levels were measured using an automatic system. CTPA was used to diagnose PE and was performed within 48 h of blood sampling using a Siemens Somatom Sensation 64 computed tomography (CT) scanner. ROC curve analysis was performed to evaluate the diagnostic utility of D-dimer levels, with CTPA as the gold standard. Among the 32 patients, CTPA identified 26 patients with PE and 6 patients without obvious abnormality. Using a threshold value of 1.3 µg/ml for D-dimer level, the diagnosis of PE was achieved with a sensitivity of 96.2%, specificity of 50.0%, positive predictive value of 89.3%, negative predictive value of 75.0% and accuracy of 87.5%. D-dimer levels were significantly higher in patients positive for PE on CTPA than in those negative for PE on CTPA (9.85±7.14 vs. 2.82±2.65 µg/ml, P=0.001). Based on ROC curve analysis, the optimal threshold value for D-dimer level in the diagnosis of PE was 1.9 µg/ml. To conclude, D-dimer could be a simple, fast and inexpensive screening method for excluding a diagnosis of PE.
Gao et al. (Fri,) conducted a observational in Suspected pulmonary embolism (n=32). Plasma D-dimer testing vs. Computed tomography pulmonary angiography (CTPA) was evaluated on Plasma D-dimer level (µg/ml) (p=0.001). Plasma D-dimer levels were significantly higher in patients with pulmonary embolism compared to those without (9.85 vs 2.82 µg/ml), with an optimal diagnostic threshold of 1.9 µg/ml.
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