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Tissue plasminogen activator as a novel diagnostic aid in acute pulmonary embolism.
Flores, Julio; García-Avello, Angel; Alonso, Esther; Ruíz, Antonio; Navarrete, Olga; Alvarez, Concepción; Lozano, Cristina; Arribas, Ignacio.
Afiliación
  • Flores J; Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Neumología, Madrid, Spain.
  • García-Avello A; Hospital Universitario Ramón y Cajal, Servicio de Hematología y Hemoterapia, Madrid, Spain.
  • Alonso E; Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Neumología, Madrid, Spain.
  • Ruíz A; Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Neumología, Madrid, Spain.
  • Navarrete O; Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Neumología, Madrid, Spain.
  • Alvarez C; Hospital Universitario Príncipe de Asturias, Servicio de Radiodiagnóstico, Madrid, Spain.
  • Lozano C; Hospital Universitario Príncipe de Asturias, Servicio de Medicina Interna, Madrid, Spain.
  • Arribas I; Hospital Universitario Príncipe de Asturias, Universidad de Alcalá de Henares, Fundación para la Investigación Biomédica, Madrid, Spain.
Vasa ; 43(6): 450-8, 2014 Nov.
Article en En | MEDLINE | ID: mdl-25339163
BACKGROUND: We evaluated the diagnostic efficacy of tissue plasminogen activator (tPA), using an enzyme-linked immunosorbent assay (ELISA) and compared it with an ELISA D-dimer (VIDAS D-dimer) in acute pulmonary embolism (PE). PATIENTS AND METHODS: We studied 127 consecutive outpatients with clinically suspected PE. The diagnosis of PE was based on a clinical probability pretest for PE and a strict protocol of imaging studies. A plasma sample to measure the levels of tPA and D-dimer was obtained at enrollment. Diagnostic accuracy for tPA and D-dimer was determined by the area under the receiver operating characteristic (ROC) curve. Sensitivity, specificity, predictive values, and the diagnostic utility of tPA with a cutoff of 8.5 ng/mL and D-dimer with a cutoff of 500 ng/mL, were calculated for PE diagnosis. RESULTS: PE was confirmed in 41 patients (32 %). Areas under ROC curves were 0.86 for D-dimer and 0.71 for tPA. The sensitivity/negative predictive value for D-dimer using a cutoff of 500 ng/mL, and tPA using a cutoff of 8.5 ng/mL, were 95 % (95 % CI, 88-100 %)/95 % (95 % CI, 88-100 %) and 95 % (95 % CI, 88-100 %)/94 %), respectively. The diagnostic utility to exclude PE was 28.3 % (95 % CI, 21-37 %) for D-dimer and 24.4 % (95 % CI, 17-33 %) for tPA. CONCLUSIONS: The tPA with a cutoff of 8.5 ng/mL has a high sensitivity and negative predictive value for exclusion of PE, similar to those observed for the VIDAS D-dimer with a cutoff of 500 ng/mL, although the diagnostic utility was slightly higher for the D-dimer.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Activador de Tejido Plasminógeno Tipo de estudio: Diagnostic_studies / Evaluation_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Vasa Año: 2014 Tipo del documento: Article País de afiliación: España Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Activador de Tejido Plasminógeno Tipo de estudio: Diagnostic_studies / Evaluation_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Vasa Año: 2014 Tipo del documento: Article País de afiliación: España Pais de publicación: Suiza