Combination of D-Dimer and Amino-Terminal Pro-B-Type Natriuretic Peptide Testing for the Evaluation of Dyspneic Patients With and Without Acute Pulmonary Embolism

2006 ◽  
Vol 130 (9) ◽  
pp. 1326-1329
Author(s):  
Stacy E. F. Melanson ◽  
Michael Laposata ◽  
Carlos A. Camargo, Jr ◽  
Annabel A. Chen ◽  
Roderick Tung ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Amino Terminal ◽  
Tomographic Angiography ◽  
D Dimer

Abstract Context.—D-dimer concentration can be used to exclude a diagnosis of acute pulmonary embolism. However, clinicians frequently order unnecessary supplemental testing in patients with low concentrations of D-dimer. Elevations in natriuretic peptides have also been described in the setting of pulmonary embolism. Objective.—We investigated the integrative role of D-dimer with amino-terminal pro-B-type natriuretic peptide for the evaluation of patients with and without acute pulmonary embolism. Design.—Patients were selected for analysis from a previous study in which levels of D-dimer and amino-terminal pro-B-type natriuretic peptide were measured. The presence of pulmonary embolism was determined by computed tomographic angiography. Results.—The median levels of D-dimer were significantly higher in patients with acute pulmonary embolism. Similarly, the median levels of amino-terminal pro-B-type natriuretic peptide were higher in patients with pulmonary embolism. Conclusions.—The Roche Tina-quant D-Dimer immunoturbidimetric assay provides a high negative predictive value and can be used to exclude acute pulmonary embolism in patients with dyspnea. Measurement of amino-terminal pro-B-type natriuretic peptide in addition to D-dimer improves specificity for acute pulmonary embolism without sacrificing negative predictive value. A combination of both markers may offer reassurance for excluding acute pulmonary embolism, and thus avoid redundant, expensive confirmatory tests.

Evaluation of a Quantitative D-Dimer Latex Immunoassay for Acute Pulmonary Embolism Diagnosed by Computed Tomographic Angiography

2007 ◽  
Vol 82 (5) ◽  
pp. 556-560 ◽  
Author(s):  
David A. Froehling ◽  
Paul R. Daniels ◽  
Stephen J. Swensen ◽  
John A. Heit ◽  
Jayawant N. Mandrekar ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
D Dimer

Tissue plasminogen activator as a novel diagnostic aid in acute pulmonary embolism

VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 450-458 ◽  
Author(s):  
Julio Flores ◽  
Ángel García-Avello ◽  
Esther Alonso ◽  
Antonio Ruíz ◽  
Olga Navarrete ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Predictive Value ◽  
Acute Pulmonary Embolism ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diagnostic Utility ◽  
Tissue Plasminogen ◽  
D Dimer

Background: We evaluated the diagnostic efficacy of tissue plasminogen activator (tPA), using an enzyme-linked immunosorbent assay (ELISA) and compared it with an ELISA D-dimer (VIDAS D-dimer) in acute pulmonary embolism (PE). Patients and methods: We studied 127 consecutive outpatients with clinically suspected PE. The diagnosis of PE was based on a clinical probability pretest for PE and a strict protocol of imaging studies. A plasma sample to measure the levels of tPA and D-dimer was obtained at enrollment. Diagnostic accuracy for tPA and D-dimer was determined by the area under the receiver operating characteristic (ROC) curve. Sensitivity, specificity, predictive values, and the diagnostic utility of tPA with a cutoff of 8.5 ng/mL and D-dimer with a cutoff of 500 ng/mL, were calculated for PE diagnosis. Results: PE was confirmed in 41 patients (32 %). Areas under ROC curves were 0.86 for D-dimer and 0.71 for tPA. The sensitivity/negative predictive value for D-dimer using a cutoff of 500 ng/mL, and tPA using a cutoff of 8.5 ng/mL, were 95 % (95 % CI, 88–100 %)/95 % (95 % CI, 88–100 %) and 95 % (95 % CI, 88–100 %)/94 %), respectively. The diagnostic utility to exclude PE was 28.3 % (95 % CI, 21–37 %) for D-dimer and 24.4 % (95 % CI, 17–33 %) for tPA. Conclusions: The tPA with a cutoff of 8.5 ng/mL has a high sensitivity and negative predictive value for exclusion of PE, similar to those observed for the VIDAS D-dimer with a cutoff of 500 ng/mL, although the diagnostic utility was slightly higher for the D-dimer.

Dose Reduction in Computed Tomographic Angiography of Pregnant Patients With Suspected Acute Pulmonary Embolism

2009 ◽  
Vol 33 (6) ◽  
pp. 961-966 ◽  
Author(s):  
Diana Litmanovich ◽  
Phillip M. Boiselle ◽  
Alexander A. Bankier ◽  
Milliam L. Kataoka ◽  
Oleg Pianykh ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Dose Reduction ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography

scholarly journals Diagnostic Validity of 3D-Computed Tomographic Angiography in Spontaneous Subarachnoid Haemorrhage

2019 ◽  
Vol 5 (1) ◽  
pp. 47-52
Author(s):  
Nur Mohammad ◽  
Jalal Uddin Mohammad Rumi ◽  
Sadia Jabeen Khan ◽  
Kalim Uddin ◽  
Patoary Mohammed Faruque
Keyword(s):  
Intracranial Aneurysm ◽  
Positive Predictive Value ◽  
Subarachnoid Haemorrhage ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Intracranial Aneurysms ◽  
Computed Tomographic Angiography ◽  
Diagnostic Validity ◽  
Computed Tomographic ◽  
Tomographic Angiography

Background: Diagnostic validity of different tests for the detection of spontaneous subarachnoid haemorrhage is an important issue. Objectives: The purpose of the present study was to validate 3D-Computed tomographic angiography in spontaneous subarachnoid haemorrhage. Methodology: This cross-sectional study was carried out in the Department of Neurosurgery and Cath Lab of DMCH in collaboration with private diagnostic centre from September 2013 to February 2015 for a period of six (06) months. Adult patients diagnosed as a case of spontaneous SAH based on clinical features and confirmed by plain CT evidence of subarachnoid blood were included as study population. Patients having current history of trauma, poor clinical grade and agitated patient, patient with renal insufficiency, known allergy to iodinated contrast agent and patients who were not willing participate in the study were excluded from this study. Then both CT angiography and DSA were performed to detect cause of bleeding and to make a treatment planning. In this study DSA was considered as reference standard for evaluation of CTA. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CTA were calculated per patient basis and per aneurysmal basis. Result: A total number of 37 patients presented with spontaneous subarachnoid haemorrhage were recruited for this study. The mean age of patients was 58.53±7.54 years. Sensitivity and specificity in depicting intracranial aneurysms were, 93.75% and 100% respectively on a per-patient basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 94.59% accuracy in detection of intracranial aneurysm. Sensitivity and specificity in depicting intracranial aneurysms were 94.74% and 100% respectively on a per-aneurysm basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 95.35% accuracy in detection of intracranial aneurysm. Conclusion: In conclusion CTA has high detection capacity of aneurysm among spontaneous subarachnoid haemorrhage patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 47-52

Computed Tomographic Angiography in Acute Pulmonary Embolism

2008 ◽  
Vol 32 (3) ◽  
pp. 438-443 ◽  
Author(s):  
Ehab M. Kamel ◽  
Sabine Schmidt ◽  
Francesco Doenz ◽  
Ghazal Adler-Etechami ◽  
Pierre Schnyder ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography
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