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Clinical Utility of D-Dimer for Rule-Out or Rule-In of Venous Thromboembolism in Syncope

2022; Springer Science+Business Media; Volume: 16; Issue: 2 Linguagem: Inglês

10.1007/s12265-022-10306-0

1937-5395

Patrick Badertscher, Jeanne du Fay de Lavallaz, Angelika Hammerer‐Lercher, Christian Mueller, Tobias Zimmermann, Pedro López‐Ayala, Thomas Nestelberger, Danielle Menosi Gualandro, Òscar Miró, Dagmar I. Keller, Francisco Javier Martín‐Sánchez, Franz Bürgler, Martin Than, Velina Widmer, Michael Christ, Louise Cullen, Salvatore Di Somma, W. Frank Peacock, Nicolas Geigy, Michael Kühne, Michael Freese, Emilio Salgado, Gemma Martínez‐Nadal, Carolina Isabel Fuenzalida Inostroza, Juan Pablo Costabel, José Bustamante Mandrión, Imke Poepping, Katharina Rentsch, Arnold von Eckardstein, Andreas Buser, Jaimi Greenslade, Jens Lohrmann,

Atrial Fibrillation Management and Outcomes

Fig. 1 Diagnostic performance of D-dimer using two different assays in patients presenting with syncope. A Left: Receiver-operating characteristic curves quantifying the diagnostic performance of Innovance® D-dimer (blue) and hs-Loci-Innovance® D-dimer (red) for the diagnosis of venous thromboembolism (VTE). Right: Clinical application of D-dimer using the 2-level Wells-score with age-adjusted1 or fixed cutoffs versus the YEARS-algorithm with probability-adjusted cut offs2. B Left: Specificity for different cufoffs of Innovance® D-dimer (blue) and hs-Loci-Innovance® D-dimer (red) for the diagnosis of venous thromboembolism (VTE). Right: Percentage of patients ruled-in and correctly identified VTE patients for different cutoffs of Innovance® D-dimer (blue) and hs-Loci-Innovance® D-dimer (red). 1In patients 50 years or younger, D-dimer concentration < 0.5 mg/l was considered negative. For patients older than 50 years, we used the formula: age in years divided by 100. 2YEARS-algorithm: assessment of only three items from the Wells-score (clinical signs of deep vein thrombosis, hemoptysis, pulmonary embolism the most likely diagnosis) and using a D-dimer test threshold of 0.5 mg/l in presence, and 1.0 mg/l in absence of one of the YEARS-items.