COMPARISON OF NEW RAPID METHODS FOR D-DIMER MEASUREMENT TO EXCLUDE DEEP-VEIN THROMBOSIS IN SYMPTOMATIC OUTPATIENTS

Eighty-seven outpatients consecutively admitted to the emergency unit of our hospital with clinically suspected first deep vein thrombosis ( DVT) of a leg had D-dimer levels measured by the following recently in troduced fast methods: VIDAS (bioMerieux), LPIA (Mitsubishi), Nephelot ex (Biopool), Nycocard (Nycomed) and Instant.I.A. (Diagnostica Stago). A latex agglutination test (Minutex, Biopool) was also performed and a classical ELISA (Gold EIA, Agen) used as reference. Venography was p erformed in all patients, with DVT diagnosed in 42 (37 proximal). All the new methods can be adopted in emergency situations, since they are suited for individual tests, are rapid and the reagents ready to use. All the methods proved to have a good interassay reproducibility. The new D-dimer and latex agglutination tests showed negative (88-96%) an d positive (63-81%) predictive values similar to those of ELISA (92% a nd 71%, respectively), though the still Ride confidence intervals sugg est larger patient population series be investigated. As regards clini cal application, the use of these tests to rule out DVT should be test ed in prospective clinical follow-up trials a here anticoagulation is withheld in subjects with negative non-invasive reliable vascular test s and normal D-dimer levels.