THE IMPORTANCE OF D-DIMER FOR THE DIAGNOSIS OF VENOUS THROMBOSES IN CLINICAL CARDIOLOGY

Yu.A. Fedotkina, Ye.S. Kropacheva, A.B. Dobrovolsky, Ye.V. Titaeva, Ye.P. Panchenko
Laboratory for Clinical Problems of Atherothrombosis, A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Industrial Complex,
RF Ministry of Public Health,
Moscow, Russia

The aim of the study was to analyze the importance of the rapid assay for D-dimer in the diagnosis of venous thromboses (VT).

The study accrued 82 patients. There were 57 (70%) men and 25 (30%) women aged 16 to 86 years. Fifty-three patients were suspected of deep venous thrombosis (DVT) and 29 of pulmonary thromboembolism (PTE). In 49 of the 82 patients, the use of USD, isotope phlebography, x-ray and ventilation-perfusion scintigraphy of the lungs made it possible to verify the diagnosis of VT. In one case, it was verified on autopsy. In 33 patients, the suspicions were rejected. The blood assay for D-dimer was performed using the kit Roche/Diagnostika Stago. The method is based on agglutination of latex particles covered by monoclonal antibodies to D-dimer.

Among the 49 patients with a verified diagnosis of VT, D-dimer was positive in 44 (89.8%) and negative in 5 (11.4%) patients. In the group of the 33 patients, in whom the diagnosis of VT was rejected, D-dimer was negative in 26 (78.8%) and positive in 7 (21.8%) patients. Thus, the sensitivity of the assay for D-dimer constituted 89.8% and the specificity 78,8%.

The high sensitivity of the assay provides an opportunity of using D-dimer measurement as a screening method in patients suspected of VT. Negative D-dimer is helpful in excluding VT. If D-dimer is positive, the diagnosis should be confirmed by other methods.

KEY WORDS: deep venous thrombosis, pulmonary thromboembolism, D-dimer.

P. 21-26

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