LABORATORY ASSAYS AND DUPLEX SCANNING OUTCOMES AFTER SYMPTOMATIC DEEP-VEIN THROMBOSIS - PRELIMINARY-RESULTS

Purpose: The purpose of this article was to assess a number of hematol ogic and fibrinolytic assays at the time of diagnosis of deep vein thr ombosis (DVT) and at several intervals over a period of 6 months after ward and to correlate these results with the results of serial duplex scanning. Methods: Thirty-five patients (average age 61, range 18 to 8 2) with acute symptomatic DVT confirmed by duplex scanning were includ ed. On diagnosis, blood was drawn, and plasma levels of tissue-type pl asminogen activator (t-PA), plasminogen activator inhibitor (PAI), D-d imer (DD), and tissue factor pathway inhibitor (TFPI) were determined. Duplex scanning and all laboratory assays were repeated 1 week, 1 mon th, 3 months, and 6 months thereafter. Results: The rate of DVT comple te resolution 6 months after diagnosis was 57%. Whereas plasma levels of PAI were similar throughout the 6-month follow-up period, t-PA incr eased significantly 1 week after diagnosis and decreased thereafter. B oth DD and TFPI levels decreased significantly after diagnosis compare d with presentation values. Comparing these assay levels between patie nts with complete resolution versus partial or no resolution, PAI leve ls were significantly higher during the first week in patients with po or outcome. Plasma levels of t-PA were higher in cases with good outco me, and DD levels were higher in patients with poor outcome. TFPI leve ls were similar in both outcome groups. Conclusions: Patients with com plete DVT resolution on duplex scanning at 6 months had significantly lower levels of PAI on presentation and after 1 week than did those wi th incomplete lysis, Although differences were not significant, t-PA l evels were higher and DD lower in patients with good outcome. Our resu lts suggest that certain plasma fibrinolytic assays might correlate wi th the outcome of DVT, as assessed by duplex ultrasonography.