help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by QUINN, D. A.
Right arrow Articles by HALES, C. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by QUINN, D. A.
Right arrow Articles by HALES, C. A.

Am. J. Respir. Crit. Care Med., Volume 159, Number 5, May 1999, 1445-1449

D-Dimers in the Diagnosis of Pulmonary Embolism

DEBORAH A. QUINN, ROBERT B. FOGEL, CYNTHIA D. SMITH, MICHAEL LAPOSATA, B. TAYLOR THOMPSON, STEPHEN M. JOHNSON, ARTHUR C. WALTMAN, and CHARLES A. HALES

Pulmonary/Critical Care Unit, Department of Pathology, Division of Clinical Laboratories, and Vascular Radiology Division, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts

The aim of this study was to determine if the absence of circulating D-dimers, as determined by latex agglutination assays, can correctly exclude the presence of pulmonary embolism using pulmonary angiography as the diagnostic endpoint. Blood samples were obtained prospectively at the time of angiography for suspicion of acute pulmonary embolism. Plasma was assayed for D-dimer by five different latex agglutination assays. Angiographic evidence of pulmonary emboli was found in 34% (35/ 103) of patients. The latex agglutination assays had sensitivities of 97 to 100% and specificities of 19 to 29%. The negative predictive value was 94 to 100%. However, a negative D-dimer was rare in patients with recent surgery, malignancy, or total bilirubin > 34 µmol/L (> 2 mg/dl). In 31 patients suspected of pulmonary emboli but without these confounding factors, the five D-dimer assays were negative in 46 to 55% of patients with normal pulmonary angiograms. The negative predictive value in these patients was 100% by all five latex agglutination assays tested. The latex agglutination assays for D-dimer, when the pulmonary angiogram is used as the diagnostic endpoint and in the absence of recent surgery, malignancy, or liver disease, appears to be a clinically useful test in the diagnosis of acute pulmonary embolism.




This article has been cited by other articles:


Home page
 ACCP Crit Care Med Brd RevHome page
R. P. Dellinger
Venous Thromboembolic Disease
ACCP Crit Care Med Brd Rev, January 1, 2009; 20(0): 197 - 212.
[Full Text] [PDF]

Home page
 RadiologyHome page
V. King, A. A. Vaze, C. S. Moskowitz, L. J. Smith, and M. S. Ginsberg
D-Dimer Assay to Exclude Pulmonary Embolism in High-Risk Oncologic Population: Correlation with CT Pulmonary Angiography in an Urgent Care Setting
Radiology, June 1, 2008; 247(3): 854 - 861.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
M. S. Parker, F. K. Hui, M. A. Camacho, J. K. Chung, D. W. Broga, and N. N. Sethi
Female Breast Radiation Exposure During CT Pulmonary Angiography
Am. J. Roentgenol., November 1, 2005; 185(5): 1228 - 1233.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
P.-M. Roy, I. Colombet, P. Durieux, G. Chatellier, H. Sors, and G. Meyer
Systematic review and meta-analysis of strategies for the diagnosis of suspected pulmonary embolism
BMJ, July 30, 2005; 331(7511): 259.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
P. D. Stein, R. D. Hull, K. C. Patel, R. E. Olson, W. A. Ghali, R. Brant, R. K. Biel, V. Bharadia, and N. K. Kalra
D-Dimer for the Exclusion of Acute Venous Thrombosis and Pulmonary Embolism: A Systematic Review
Ann Intern Med, April 20, 2004; 140(8): 589 - 602.
[Abstract] [Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
D. A. Froehling, P. L. Elkin, S. J. Swensen, J. A. Heit, V. S. Pankratz, and J. H. Ryu
Sensitivity and Specificity of the Semiquantitative Latex Agglutination D-Dimer Assay for the Diagnosis of Acute Pulmonary Embolism as Defined by Computed Tomographic Angiography
Mayo Clin. Proc., February 1, 2004; 79(2): 164 - 168.
[Abstract] [PDF]

Home page
 Mayo Clin Proc.Home page
S. D. Frost, D. J. Brotman, and F. A. Michota
Rational Use of D-Dimer Measurement to Exclude Acute Venous Thromboembolic Disease
Mayo Clin. Proc., November 1, 2003; 78(11): 1385 - 1391.
[Abstract] [PDF]

Home page
 Clin. Chem.Home page
J. E. Schrecengost, R. D. LeGallo, J. C. Boyd, K. G.M. Moons, S. L. Gonias, C. E. Rose Jr, and D. E. Bruns
Comparison of Diagnostic Accuracies in Outpatients and Hospitalized Patients of D-Dimer Testing for the Evaluation of Suspected Pulmonary Embolism
Clin. Chem., September 1, 2003; 49(9): 1483 - 1490.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Shitrit, D. Bendayan, A. Bar-Gil-Shitrit, M. Huerta, B. Rudensky, G. Fink, and M. R. Kramer
Significance of a Plasma D-dimer Test in Patients With Primary Pulmonary Hypertension
Chest, November 1, 2002; 122(5): 1674 - 1678.
[Abstract] [Full Text] [PDF]

Home page
 JWatch GeneralHome page
More on D-Dimer for Pulmonary Embolism
Journal Watch (General), June 4, 1999; 1999(604): 1 - 1.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1999 American Thoracic Society