scholarly journals D-dimer levels and acute pulmonary embolism development in COVID-19 patients

2021 ◽  
Vol 8 (1) ◽  
pp. 133-138
Author(s):  
Vural Ahmet ◽  
Kahraman Nedim
Keyword(s):  
Pulmonary Embolism ◽  
Ct Angiography ◽  
Acute Pulmonary Embolism ◽  
Community Hospital ◽  
Demographic Parameters ◽  
Ct Angiogram ◽  
Thorax Ct ◽  
D Dimer ◽  
Pulmonary Ct

Objective. To identify those who develop pulmonary embolism with Ddimer levels by evaluating pulmonary CT angiographies of patients who are followed up with suspicion of coronavirus disease 2019 (COVID-19). Methods. Patients who were followed up in a community hospital with suspicion of COVID-19 and underwent Pulmonary CT angiography examination were evaluated. Clinical and demographic parameters and DDimer values for patients with and without pulmonary embolism were evaluated in the pulmonary CT angiogram. Results. During the COVID-19 pandemic, Thorax CT examination was performed in our center for suspicion or follow-up of COVID-19 infection in 3396 patients. Pulmonary CT angiography was applied to 312 (9.2%) of these cases. Of these 312 patients, 141 were identified as COVID-19 patients. Acute pulmonary embolism was detected in 33 (23.4%) of 141 patients with COVID-19 and pulmonary CT angiogram. D-dimer levels (5964.97±4036.8 μg/L) of patients with COVID-19 infection and pulmonary embolism were significantly higher than D-dimer levels (972.4±1766.8 μg/L) of patients without pulmonary embolism. In patients with COVID-19 infection, a Ddimer value higher than 1013 μg/L was determined as a cut-off value with 100% sensitivity for the presence of pulmonary embolism. Conclusions. For those struggling with the COVID-19 pandemic, pulmonary embolism should be kept in mind if D-dimer values increase more than expected in the presence of respiratory distress that Thorax CT findings cannot explain.

Inappropriate Use of D-Dimer Assay and Pulmonary CT Angiography in the Evaluation of Suspected Acute Pulmonary Embolism

2011 ◽  
Vol 27 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Fang Yin ◽  
Thomas Wilson ◽  
Albert Della Fave ◽  
Moira Larsen ◽  
Jenni Yoon ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ct Angiography ◽  
Acute Pulmonary Embolism ◽  
Inappropriate Use ◽  
D Dimer ◽  
Pulmonary Ct

scholarly journals Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected with Pulmonary CT Angiography

Radiology ◽  
2020 ◽  
Vol 296 (3) ◽  
pp. E186-E188 ◽  
Author(s):  
Franck Grillet ◽  
Julien Behr ◽  
Paul Calame ◽  
Sébastien Aubry ◽  
Eric Delabrousse
Keyword(s):  
Pulmonary Embolism ◽  
Ct Angiography ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Ct

scholarly journals Joint analysis of D-dimer, N-terminal pro b-type natriuretic peptide, and cardiac troponin I on predicting acute pulmonary embolism relapse and mortality

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaoyu Liu ◽  
Liying Zheng ◽  
Jing Han ◽  
Lu Song ◽  
Hemei Geng ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Survival Rate ◽  
Adverse Events ◽  
Acute Pulmonary Embolism ◽  
Troponin I ◽  
All Cause Mortality ◽  
Long Term Prognosis ◽  
D Dimer

AbstractPrevious studies on the adverse events of acute pulmonary embolism (APE) were mostly limited to single marker, and short follow-up duration, from hospitalization to up to 30 days. We aimed to predict the long-term prognosis of patients with APE by joint assessment of D-dimer, N-Terminal Pro-Brain Natriuretic Peptide (NT-ProBNP), and troponin I (cTnI). Newly diagnosed patients of APE from January 2011 to December 2015 were recruited from three hospitals. Medical information of the patients was collected retrospectively by reviewing medical records. Adverse events (APE recurrence and all-cause mortality) of all enrolled patients were followed up via telephone. D-dimer > 0.50 mg/L, NT-ProBNP > 500 pg/mL, and cTnI > 0.40 ng/mL were defined as the abnormal. Kaplan–Meier curve was used to compare the cumulative survival rate between patients with different numbers of abnormal markers. Cox proportional hazard regression model was used to further test the association between numbers of abnormal markers and long-term prognosis of patients with APE after adjusting for potential confounding. During follow-up, APE recurrence and all-cause mortality happened in 78 (30.1%) patients. The proportion of APE recurrence and death in one abnormal marker, two abnormal markers, and three abnormal markers groups were 7.69%, 28.21%, and 64.10% respectively. Patients with three abnormal markers had the lowest survival rate than those with one or two abnormal markers (Log-rank test, P < 0.001). After adjustment, patients with two or three abnormal markers had a significantly higher risk of the total adverse event compared to those with one abnormal marker. The hazard ratios (95% confidence interval) were 6.27 (3.24, 12.12) and 10.7 (4.1, 28.0), respectively. Separate analyses for APE recurrence and all-cause death found similar results. A joint test of abnormal D-dimer, NT-ProBNP, and cTnI in APE patients could better predict the long-term risk of APE recurrence and all-cause mortality.

scholarly journals The Rate of Resolution of Clot Burden Measured by Pulmonary CT Angiography in Patients With Acute Pulmonary Embolism

2013 ◽  
Vol 200 (4) ◽  
pp. 791-797 ◽  
Author(s):  
Ayaz Aghayev ◽  
Alessandro Furlan ◽  
Amol Patil ◽  
Serter Gumus ◽  
Kyung Nyeo Jeon ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ct Angiography ◽  
Acute Pulmonary Embolism ◽  
Clot Burden ◽  
Pulmonary Ct

scholarly journals Acute Pulmonary Embolism in Patients with COVID-19 at CT Angiography and Relationship to d-Dimer Levels

Radiology ◽  
2020 ◽  
Vol 296 (3) ◽  
pp. E189-E191 ◽  
Author(s):  
Ian Léonard-Lorant ◽  
Xavier Delabranche ◽  
François Séverac ◽  
Julie Helms ◽  
Coralie Pauzet ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ct Angiography ◽  
Acute Pulmonary Embolism ◽  
D Dimer

State-of-the-Art Pulmonary CT Angiography for Acute Pulmonary Embolism

2017 ◽  
Vol 208 (3) ◽  
pp. 495-504 ◽  
Author(s):  
Moritz H. Albrecht ◽  
Matthew W. Bickford ◽  
John W. Nance ◽  
Longjiang Zhang ◽  
Carlo N. De Cecco ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ct Angiography ◽  
Acute Pulmonary Embolism ◽  
State Of The Art ◽  
Pulmonary Ct

scholarly journals Characteristics of Acute Pulmonary Embolism in Patients With COVID-19 Associated Pneumonia From the City of Wuhan

2020 ◽  
Vol 26 ◽  
pp. 107602962093677 ◽  
Author(s):  
Jianpu Chen ◽  
Xiang Wang ◽  
Shutong Zhang ◽  
Bin Lin ◽  
Xiaoqing Wu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Laboratory Data ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Imaging Characteristics ◽  
Right Middle Lobe ◽  
The Right ◽  
D Dimer

The aim of this study was to describe clinical, imaging, and laboratory features of acute pulmonary embolism (APE) in patients with COVID-19 associated pneumonia. Patients with COVID-19 associated pneumonia who underwent a computed tomography pulmonary artery (CTPA) scan for suspected APE were retrospectively studied. Laboratory data and CTPA images were collected. Imaging characteristics were analyzed descriptively. Laboratory data were analyzed and compared between patients with and without APE. A series of 25 COVID-19 patients who underwent CTPA between January 2020 and February 2020 were enrolled. The median D-dimer level founded in these 25 patients was 6.06 μg/mL (interquartile range [IQR] 1.90-14.31 μg/mL). Ten (40%) patients with APE had a significantly higher level of D-dimer (median, 11.07 μg/mL; IQR, 7.12-21.66 vs median, 2.44 μg/mL; IQR, 1.68-8.34, respectively, P = .003), compared with the 15 (60%) patients without APE. No significant differences in other laboratory data were found between patients with and without APE. Among the 10 patients with APE, 6 (60%) had a bilateral pulmonary embolism, while 4 had a unilateral embolism. The thrombus-prone sites were the right lower lobe (70%), the left upper lobe (60%), both upper lobe (40%) and the right middle lobe (20%). The thrombus was partially or completely absorbed after anticoagulant therapy in 3 patients who underwent a follow-up CTPA. Patients with COVID-19 associated pneumonia have a risk of developing APE during the disease. When the D-dimer level abnormally increases in patients with COVID-19 pneumonia, CTPA should be performed to detect and assess the severity of APE.

scholarly journals Safety and Efficiency of the YEARS Diagnostic Algorithm for Pregnant Patients with Clinically Suspected Acute Pulmonary Embolism —the Artemis Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 419-419
Author(s):  
Liselotte M. Van Der Pol ◽  
Cecile Tromeur ◽  
Ingrid Bistervels ◽  
Thomas van Bemmel ◽  
Francis Couturaud ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pregnant Women ◽  
Failure Rate ◽  
Acute Pulmonary Embolism ◽  
Diagnostic Algorithm ◽  
Ct Scanning ◽  
Ct Scans ◽  
Acute Pe ◽  
D Dimer

Abstract Background Acute pulmonary embolism (PE) is the leading cause of maternal mortality in Western countries, accounting for 20 to 30% of all maternal deaths. Therefore, the threshold to test for PE during pregnancy is low. Because evidence regarding the safety of ruling out PE with clinical decision rules and D-dimer tests in pregnant women is unavailable, all women with a suspected PE need to undergo an imaging test, with potential harm to patient and fetus by exposure to ionizing radiation. In the present international, multicenter, prospective management study, we evaluated the safety and efficiency of the YEARS diagnostic algorithm for ruling out PE in pregnant patients with clinically suspected PE (Netherlands Trial Registry number 5913). YEARS is a simple diagnostic algorithm designed to reduce the number of required computed tomography (CT) scans in the diagnostic work-up of PE in non-pregnant patients, and was recently shown to be as safe as conventional algorithms but associated with a significant absolute 14% reduction in the number of CT scans (van der Hulle et al., Lancet 2017). Methods The Artemis study was performed in 11 Dutch hospitals, 8 French hospitals and 1 Irish hospital. Consecutive pregnant patients with suspected acute PE were included. Exclusion criteria were treatment with therapeutically dosed anticoagulants >24 hours or contraindications for CT. The YEARS algorithm was slightly adjusted for application during pregnancy (figure 1): in patients with signs of deep vein thrombosis (DVT), compression ultrasonography was obligatory before CT scanning was considered. In patients with proven DVT, anticoagulant treatment was initiated and no further diagnostic tests were undertaken. In patients with no YEARS items (Figure 1), a D-dimer threshold of <1.0 µg/ml was sufficient to rule out PE. In the remaining patients D-dimer threshold was <0.5 µg/mL. CT scanning was only performed in patients with a D-dimer level above the threshold. Anticoagulant therapy was withheld if PE was excluded. The primary safety endpoint was the occurrence of symptomatic venous thromboembolism during 3 months of follow-up, the primary efficiency endpoint was the proportion of patients in whom CTPA could be avoided. All safety endpoints were adjudicated by an independent committee. Assuming a 1.0% diagnostic failure rate and defining a maximum acceptable failure rate of 2.7%, a total study population of 472 patients was required (one-sided alpha 0.05, beta 80%). Results and conclusion: The last patient was included in May 2018. At baseline, 48% of pregnant women with suspected acute PE had no YEARS item and a D-dimer threshold of 1.0 µg/mL was applied. A total of 42% had a D-dimer level below the relevant threshold and were managed without CT scanning. Follow-up and endpoint adjudication was not completed at the abstract submission deadline; full study results will be presented at the ASH meeting. Disclosures Couturaud: Pfizer: Research Funding; Bayer: Honoraria, Other: Travel Support; AstraZeneca: Honoraria; Actelion: Other: Travel Support; Intermune: Other: Travel Support; Leo Pharma: Other: Travel Support; Daiichi Sankyo: Other: Travel Support.

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