Combination of D-dimer and amino-terminal pro-B-type natriuretic peptide testing for the evaluation of dyspneic patients with and without acute pulmonary embolism

Stacy E F Melanson, Michael Laposata, Carlos A. Camargo, Annabel A. Chen, Roderick Tung, Dan Krauser, Saif Anwaruddin, Aaron Baggish, Renee Cameron, Patrick Sluss, Kent B. Lewandrowski, Elizabeth Lee-Lewandrowski, James L. Januzzi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Context. - D-dimer concentration can be used to exclude a diagnosis of acute pulmonary embolism. However, clinicians frequently order unnecessary supplemental testing in patients with low concentrations of D-dimer. Elevations in natriuretic peptides have also been described in the setting of pulmonary embolism. Objective. - We investigated the integrative role of D-dimer with amino-terminal pro-B-type natriuretic peptide for the evaluation of patients with and without acute pulmonary embolism. Design. - Patients were selected for analysis from a previous study in which levels of D-dimer and amino-terminal pro-B-type natriuretic peptide were measured. The presence of pulmonary embolism was determined by computed tomographic angiography. Results.- The median levels of D-dimer were significantly higher in patients with acute pulmonary embolism. Similarly, the median levels of amino-terminal pro-B-type natriuretic peptide were higher in patients with pulmonary embolism. Conclusions. - The Roche Tina-quant D-Dimer immunoturbidimetric assay provides a high negative predictive value and can be used to exclude acute pulmonary embolism in patients with dyspnea. Measurement of amino-terminal pro-B-type natriuretic peptide in addition to D-dimer improves specificity for acute pulmonary embolism without sacrificing negative predictive value. A combination of both markers may offer reassurance for excluding acute pulmonary embolism, and thus avoid redundant, expensive confirmatory tests.

Original languageEnglish (US)
Pages (from-to)1326-1329
Number of pages4
JournalArchives of Pathology and Laboratory Medicine
Volume130
Issue number9
StatePublished - Sep 2006
Externally publishedYes

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Brain Natriuretic Peptide
Pulmonary Embolism
fibrin fragment D
Natriuretic Peptides
Dyspnea
Angiography

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Combination of D-dimer and amino-terminal pro-B-type natriuretic peptide testing for the evaluation of dyspneic patients with and without acute pulmonary embolism. / Melanson, Stacy E F; Laposata, Michael; Camargo, Carlos A.; Chen, Annabel A.; Tung, Roderick; Krauser, Dan; Anwaruddin, Saif; Baggish, Aaron; Cameron, Renee; Sluss, Patrick; Lewandrowski, Kent B.; Lee-Lewandrowski, Elizabeth; Januzzi, James L.

In: Archives of Pathology and Laboratory Medicine, Vol. 130, No. 9, 09.2006, p. 1326-1329.

Research output: Contribution to journalArticle

Melanson, SEF, Laposata, M, Camargo, CA, Chen, AA, Tung, R, Krauser, D, Anwaruddin, S, Baggish, A, Cameron, R, Sluss, P, Lewandrowski, KB, Lee-Lewandrowski, E & Januzzi, JL 2006, 'Combination of D-dimer and amino-terminal pro-B-type natriuretic peptide testing for the evaluation of dyspneic patients with and without acute pulmonary embolism', Archives of Pathology and Laboratory Medicine, vol. 130, no. 9, pp. 1326-1329.
Melanson, Stacy E F ; Laposata, Michael ; Camargo, Carlos A. ; Chen, Annabel A. ; Tung, Roderick ; Krauser, Dan ; Anwaruddin, Saif ; Baggish, Aaron ; Cameron, Renee ; Sluss, Patrick ; Lewandrowski, Kent B. ; Lee-Lewandrowski, Elizabeth ; Januzzi, James L. / Combination of D-dimer and amino-terminal pro-B-type natriuretic peptide testing for the evaluation of dyspneic patients with and without acute pulmonary embolism. In: Archives of Pathology and Laboratory Medicine. 2006 ; Vol. 130, No. 9. pp. 1326-1329.
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