Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis

Abstract Previous reports have investigated the impact of age on D-Dimer testing in elderly individuals with suspected deep vein thrombosis (DVT), but data on the age-related diagnostic value of D-dimer in a sample covering a broad age range are limited. The present study determined age-specifically...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jürgen H. Prochaska, Bernd Frank, Markus Nagler, Heidrun Lamparter, Gerhard Weißer, Andreas Schulz, Lisa Eggebrecht, Sebastian Göbel, Natalie Arnold, Marina Panova-Noeva, Iris Hermanns, Antonio Pinto, Stavros Konstantinides, Hugo ten Cate, Karl J Lackner, Thomas Münzel, Christine Espinola-Klein, Philipp S. Wild
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7d8eabf175fc4b579959a61339d0d0c8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7d8eabf175fc4b579959a61339d0d0c8
record_format	dspace
spelling	oai:doaj.org-article:7d8eabf175fc4b579959a61339d0d0c82021-12-02T15:06:10ZAge-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis10.1038/s41598-017-04843-x2045-2322https://doaj.org/article/7d8eabf175fc4b579959a61339d0d0c82017-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-04843-xhttps://doaj.org/toc/2045-2322Abstract Previous reports have investigated the impact of age on D-Dimer testing in elderly individuals with suspected deep vein thrombosis (DVT), but data on the age-related diagnostic value of D-dimer in a sample covering a broad age range are limited. The present study determined age-specifically the diagnostic accuracy of D-dimer and compared it to C-reactive protein (CRP), a marker of inflammation, in 500 patients with suspected DVT from the VTEval project (NCT02156401). Sensitivity of D-dimer was lower in patients < 60 years in comparison to patients ≥ 60 years (∆−16.8%), whereas specificity was 27.9% higher. Lowest levels of sensitivity were detected for female sex, unprovoked DVT, low thrombotic burden, and distal DVT. A fixed D-dimer threshold of 0.25 mg/L FEU resulted in elevated sensitivity for patients < 60 with a reduction of false negatives by 40.0% for proximal DVT and by 50.0% for distal DVT. In patients < 60 years, D-dimer and CRP demonstrated comparable diagnostic performance for both proximal and distal DVT (p > 0.05). In conclusion, these data outline a clinically-relevant limitation of D-dimer testing among younger patients with suspected DVT indicating a necessity for age-adapted cut-off values. Further research is required to decrypt the role of inflammation in the pathophysiology and diagnosis of venous thrombosis.Jürgen H. ProchaskaBernd FrankMarkus NaglerHeidrun LamparterGerhard WeißerAndreas SchulzLisa EggebrechtSebastian GöbelNatalie ArnoldMarina Panova-NoevaIris HermannsAntonio PintoStavros KonstantinidesHugo ten CateKarl J LacknerThomas MünzelChristine Espinola-KleinPhilipp S. WildNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-10 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jürgen H. Prochaska Bernd Frank Markus Nagler Heidrun Lamparter Gerhard Weißer Andreas Schulz Lisa Eggebrecht Sebastian Göbel Natalie Arnold Marina Panova-Noeva Iris Hermanns Antonio Pinto Stavros Konstantinides Hugo ten Cate Karl J Lackner Thomas Münzel Christine Espinola-Klein Philipp S. Wild Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
description	Abstract Previous reports have investigated the impact of age on D-Dimer testing in elderly individuals with suspected deep vein thrombosis (DVT), but data on the age-related diagnostic value of D-dimer in a sample covering a broad age range are limited. The present study determined age-specifically the diagnostic accuracy of D-dimer and compared it to C-reactive protein (CRP), a marker of inflammation, in 500 patients with suspected DVT from the VTEval project (NCT02156401). Sensitivity of D-dimer was lower in patients < 60 years in comparison to patients ≥ 60 years (∆−16.8%), whereas specificity was 27.9% higher. Lowest levels of sensitivity were detected for female sex, unprovoked DVT, low thrombotic burden, and distal DVT. A fixed D-dimer threshold of 0.25 mg/L FEU resulted in elevated sensitivity for patients < 60 with a reduction of false negatives by 40.0% for proximal DVT and by 50.0% for distal DVT. In patients < 60 years, D-dimer and CRP demonstrated comparable diagnostic performance for both proximal and distal DVT (p > 0.05). In conclusion, these data outline a clinically-relevant limitation of D-dimer testing among younger patients with suspected DVT indicating a necessity for age-adapted cut-off values. Further research is required to decrypt the role of inflammation in the pathophysiology and diagnosis of venous thrombosis.
format	article
author	Jürgen H. Prochaska Bernd Frank Markus Nagler Heidrun Lamparter Gerhard Weißer Andreas Schulz Lisa Eggebrecht Sebastian Göbel Natalie Arnold Marina Panova-Noeva Iris Hermanns Antonio Pinto Stavros Konstantinides Hugo ten Cate Karl J Lackner Thomas Münzel Christine Espinola-Klein Philipp S. Wild
author_facet	Jürgen H. Prochaska Bernd Frank Markus Nagler Heidrun Lamparter Gerhard Weißer Andreas Schulz Lisa Eggebrecht Sebastian Göbel Natalie Arnold Marina Panova-Noeva Iris Hermanns Antonio Pinto Stavros Konstantinides Hugo ten Cate Karl J Lackner Thomas Münzel Christine Espinola-Klein Philipp S. Wild
author_sort	Jürgen H. Prochaska
title	Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
title_short	Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
title_full	Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
title_fullStr	Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
title_full_unstemmed	Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
title_sort	age-related diagnostic value of d-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/7d8eabf175fc4b579959a61339d0d0c8
work_keys_str_mv	AT jurgenhprochaska agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT berndfrank agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT markusnagler agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT heidrunlamparter agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT gerhardweißer agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT andreasschulz agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT lisaeggebrecht agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT sebastiangobel agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT nataliearnold agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT marinapanovanoeva agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT irishermanns agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT antoniopinto agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT stavroskonstantinides agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT hugotencate agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT karljlackner agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT thomasmunzel agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT christineespinolaklein agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis AT philippswild agerelateddiagnosticvalueofddimertestingandtheroleofinflammationinpatientswithsuspecteddeepveinthrombosis
_version_	1718388591395078144

Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis

Ejemplares similares