2019 Volume 3 Issue 1 Pages 26-30
Background: D-dimer (DD) is useful for excluding diagnosis of venous thromboembolism (VTE) because of high sensitivity and high negative predictive value. Recently, soluble fibrin (SF) has been introduced for clinical use to examine coagulation status. However, the significance of SF in screening or diagnosis for VTE is uncertain. Thus, we examined DD and SF levels in incident VTE patients with ultrasonographic examination in their lower extremities. Subjects and Methods: We have conducted simultaneous measurement of DD and SF in 141 inpatients in our hospital between December 2013 and November 2014. Among them, we further selected 46 patients who were examined by lower extremity ultrasonography 1 month before or after the measurement of DD and SF. Incident VTE was diagnosed based on acute or subacute symptoms, the presence of thrombus in compression ultrasonography, and/or results from contrast-enhanced CT. Results: Incident VTE was found in 18 patients. SF levels were similar in VTE (+) and VTE (-) groups, while DD levels were significantly higher in VTE (+) group than those of VTE (-) group (17.7±30.4 μg/mL vs 5.1±5.2 μg/mL, p<0.05). When patients were classified based on surgical intervention, no significant difference in SF or DD levels was observed in peri-operative patients. However, DD levels in non-operative patients tended to be higher in VTE (+) group, compared to VTE (-) group. No such tendency was observed in SF levels. Conclusion: Measurement of DD but not SF may be beneficial for screening of incident VTE, especially in non-operative inpatients. Further study is necessary to determine the significance of DD and/or SF testing in VTE screening, diagnosis, and treatment in peri-operative patients.
