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Determinants of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography.

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  • Additional Information
    • Source:
      Publisher: College of American Pathologists Country of Publication: United States NLM ID: 7607091 Publication Model: Print Cited Medium: Print ISSN: 0003-9985 (Print) Linking ISSN: 00039985 NLM ISO Abbreviation: Arch. Pathol. Lab. Med. Subsets: Core Clinical (AIM); MEDLINE
    • Publication Information:
      Publication: Northfield, Ill. : College of American Pathologists
      Original Publication: Chicago, American Medical Assn.
    • Subject Terms:
      Fibrin Fibrinogen Degradation Products/*analysis ; Pulmonary Embolism/*diagnostic imaging; Aged ; Angiography ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity
    • Abstract:
      Background: The reported operating characteristics of the plasma fibrin D-dimer level for the diagnosis of acute pulmonary embolism vary widely.
      Objective: To determine the sensitivity, specificity, predictive value, and clinical utility of the D-dimer for the diagnosis of pulmonary embolism, and to describe the effect of D-dimer assay method (enzyme-linked immunosorbent assay [ELISA], latex agglutination, membrane ELISA) and discriminate level, patient location at onset, comorbid disease, duration and intensity of concurrent heparin administration, and duration of symptoms on these operating characteristics.
      Design: Prospective laboratory investigation.
      Setting: Community and tertiary care teaching hospital.
      Patients: Consecutive patients with suspected acute pulmonary embolism referred for pulmonary angiography from April 1993 through March 1996.
      Measurements: Baseline characteristics, the duration and intensity of heparin anticoagulation, the time interval between symptom onset and plasma D-dimer testing, pulmonary angiography, and the D-dimer level on the day of pulmonary angiography.
      Results: Of 105 consenting patients, 33 (31%) had a positive pulmonary angiogram. The D-dimer sensitivity/ negative predictive value for the ELISA, latex agglutination (American Bioproducts Co/Diagnostica Stago and Biopool International), and membrane ELISA were 100%/100%, 94%/94%, 100%/100%, and 97%/96%, respectively, at a discriminate level of 250 microg/L or less. The clinical utility, defined as the prevalence of a negative test, ranged from 17% to 33%. D-dimer sensitivity was unaffected by patient location at onset, comorbid disease, or heparin therapy but was inversely related to the duration of symptoms.
      Conclusions: The sensitivity of the plasma fibrin D-dimer for the diagnosis of pulmonary embolism depends on the assay method, the assay-specific discriminate level, and the duration of symptoms. At the appropriate discriminate level, the plasma D-dimer is a sensitive but nonspecific test for the diagnosis of pulmonary embolism.
    • Accession Number:
      0 (Fibrin Fibrinogen Degradation Products)
      0 (fibrin fragment D)
    • Publication Date:
      Date Created: 19990323 Date Completed: 19990507 Latest Revision: 20161124
    • Publication Date:
      20200827
    • Accession Number:
      10086512
  • Citations
    • ABNT:
      HEIT, J. A. et al. Determinants of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography. Archives of pathology & laboratory medicine, [s. l.], v. 123, n. 3, p. 235–240, 1999. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=10086512. Acesso em: 25 set. 2020.
    • AMA:
      Heit JA, Minor TA, Andrews JC, Larson DR, Li H, Nichols WL. Determinants of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography. Archives of pathology & laboratory medicine. 1999;123(3):235-240. Accessed September 25, 2020. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=10086512
    • APA:
      Heit, J. A., Minor, T. A., Andrews, J. C., Larson, D. R., Li, H., & Nichols, W. L. (1999). Determinants of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography. Archives of Pathology & Laboratory Medicine, 123(3), 235–240.
    • Chicago/Turabian: Author-Date:
      Heit, J A, T A Minor, J C Andrews, D R Larson, H Li, and W L Nichols. 1999. “Determinants of Plasma Fibrin D-Dimer Sensitivity for Acute Pulmonary Embolism as Defined by Pulmonary Angiography.” Archives of Pathology & Laboratory Medicine 123 (3): 235–40. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=10086512.
    • Harvard:
      Heit, J. A. et al. (1999) ‘Determinants of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography’, Archives of pathology & laboratory medicine, 123(3), pp. 235–240. Available at: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=10086512 (Accessed: 25 September 2020).
    • Harvard: Australian:
      Heit, JA, Minor, TA, Andrews, JC, Larson, DR, Li, H & Nichols, WL 1999, ‘Determinants of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography’, Archives of pathology & laboratory medicine, vol. 123, no. 3, pp. 235–240, viewed 25 September 2020, .
    • MLA:
      Heit, J. A., et al. “Determinants of Plasma Fibrin D-Dimer Sensitivity for Acute Pulmonary Embolism as Defined by Pulmonary Angiography.” Archives of Pathology & Laboratory Medicine, vol. 123, no. 3, Mar. 1999, pp. 235–240. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=10086512.
    • Chicago/Turabian: Humanities:
      Heit, J A, T A Minor, J C Andrews, D R Larson, H Li, and W L Nichols. “Determinants of Plasma Fibrin D-Dimer Sensitivity for Acute Pulmonary Embolism as Defined by Pulmonary Angiography.” Archives of Pathology & Laboratory Medicine 123, no. 3 (March 1999): 235–40. http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=10086512.
    • Vancouver/ICMJE:
      Heit JA, Minor TA, Andrews JC, Larson DR, Li H, Nichols WL. Determinants of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography. Archives of pathology & laboratory medicine [Internet]. 1999 Mar [cited 2020 Sep 25];123(3):235–40. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=10086512