Titre
Clinical usefulness of D-dimer testing in cancer patients with suspected pulmonary embolism
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Righini, M.
Auteure/Auteur
Le Gal, G.
Auteure/Auteur
De Lucia, S.
Auteure/Auteur
Roy, P. M.
Auteure/Auteur
Meyer, G.
Auteure/Auteur
Aujesky, D.
Auteure/Auteur
Bounameaux, H.
Auteure/Auteur
Perrier, A.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0340-6245
Statut éditorial
Publié
Date de publication
2006-04
Volume
95
Numéro
4
Première page
715
Dernière page/numéro d’article
9
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Apr
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Apr
Résumé
Limited data are available about the diagnostic value of D-dimer testing in cancer patients with clinically suspected pulmonary embolism (PE). Therefore, we evaluated i) the safety and clinical usefulness of an ELISA D-dimer test to rule out PE in cancer patients compared with non-cancer patients and ii) whether adopting a higher D-dimer cut-off value might increase the usefulness of D-dimer in cancer patients. We analysed data from two outcome studies which enrolled 1,721 consecutive patients presenting in the emergency department with clinically suspected PE. Presence of an active malignancy was abstracted from the database. All patients underwent a sequential diagnostic work-up including an ELISA D-dimer test and a 3-month followup. Sensitivity and predictive value (NPV) were 100% in both cancer and non-cancer patients. PE was ruled out by a negative D-dimer test in 494/1,554 (32%) patients without cancer, and in 18/164 (11%) patients with a malignancy. At cut-off values varying from 500 to 900 microg/l, the sensitivity was unchanged (100%, 95% CI: 93% to 100%) and the specificity increased from 16% (95% CI: 11% to 24%) to 30% (95% CI: 22% to 39%). The 3-month thromboembolic risk was 0% (95% CI: 0% to 18%) in cancer patients with a negative D-dimer test. ELISA D-dimer appears safe to rule out pulmonary embolism in cancer patients but it is negative in only one of ten patients at the usual cut-off value. Increasing the cut-off value of D-dimer in cancer patients might increase the test's clinical usefulness.
Sujets
PID Serval
serval:BIB_C2E8BDDE8F3F
PMID
Date de création
2008-01-25T12:38:17.195Z
Date de création dans IRIS
2025-05-21T00:17:54Z