D-dimer in diagnosis of acute thromboses of lower-limb deep veins

Nazarenko G.I., Koungurtsev V.V., Anokhin N.V., Yugova T.M., Koungurtsev E.V., Repnikova T.R.

Medical Centre of the Bank of Russia Moscow, Russia

Analysed herein is a potential role the D-dimer plays in diagnosis of acute venous thromboses of the lower limbs.

The D-dimer blood plasma levels were determined in a total of 195 patients with either suspected or known acute thrombosis of the lower-limb deep veins. The D-dimer concentration was measured by the immunoturbidimetric method. Acute venous thrombosis (AVT) was either confirmed or negated by means of ultrasonographic scanning. Of the 195 patients examined, thrombosis in the system of the inferior vena cava was detected in 161 subjects, whereas in the remaining 34 cases the tentative diagnosis was not confirmed. Amongst the patients with established AVT, the D-dimer level was elevated in 156 (96.9%). Of the 34 patients with unconfirmed AVT, the test for the presence of D-dimer was negative in 20 (58.8%) patients and positive in 14 (41.2%) subjects. Hence, the sensitivity of the test under study amounted to 96.9%, while its specificity did not exceed 58.8%. A direct correlation between the incidence of AVT and the D-dimer level was revealed. Given high sensitivity of the D-dimer in AVT, this test should be used in a suspicion for or a high risk of phiebothrombosis in order to reliably exclude the diagnosis if the result proves negative.

KEY WORDS: thromboembolism, D-dimer.

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