Markedly elevated plasma D-dimer and the prevalence of acute pulmonary embolus

Authors

  • Andrew W. Bowman Department of Radiology, Mayo Clinic Florida
  • Gretchen S. Johns Division of Laboratory Medicine and Pathology, Mayo Clinic Florida
  • Nolan Karstaedt Department of Radiology, Mayo Clinic Florida

Keywords:

Pulmonary embolus, D-dimer, CT

Abstract

Objective. To evaluate if increasingly elevated levels of plasma Ddimerare associated with higher prevalence of acute pulmonaryembolus (PE). Patients and Methods. A retrospective study wasconducted evaluating all PE protocol CT examinations performed inlow-to-intermediate risk emergency department and hospitalized patientsduring 2007. All PE protocol CT reports were reviewed for thepresence or absence of acute PE. Th e charts of all of these subjectswere then reviewed for quantitative plasma D-dimer values, measuredin mg/ml Fibrinogen Equivalent Units, drawn within one day prior tothe CT exam. Th e prevalence of acute PE at diff erent D-dimer thresholdresults was then evaluated using D-dimer groups as follows: < 1.0mg/ml, ≥ 1.0 but < 2.0 mg/ml, ≥ 2.0 but < 4.0 mg/ml, and ≥ 4.0 mg/ml. Results. 943 PE protocol CT exams were reviewed. 410 subjectshad D-dimer values drawn before their CT exams; 30 (7.3%) of thesewere positive for acute PE. As D-dimer values became increasingly elevated,the prevalence of acute PE increased accordingly. In particular,D-dimer elevation ≥4.0 mg/ml was almost 94% specifi c for acute PEby CT criteria. Conclusion. Increased elevation of plasma D-dimer isassociated with increased prevalence of acute PE in low-to-intermediaterisk patients.

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References

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Published

2011-11-08

How to Cite

Bowman, A. W., Johns, G. S., & Karstaedt, N. (2011). Markedly elevated plasma D-dimer and the prevalence of acute pulmonary embolus. Acta Medica Academica, 40(2), 152–158. Retrieved from https://ama.ba/index.php/ama/article/view/114

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Section

Clinical Science