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D-Dimer and prothrombin fragment 1 + 2 in urine and plasma in patients with clinically suspected venous thromboembolism

Wexels, Fredrik; Seljeflot, Ingebjørg; Pripp, Are H.; Dahl, Ola E.

Blood Coagulation & Fibrinolysis: June 2016 - Volume 27 - Issue 4 - p 396–400
doi: 10.1097/MBC.0000000000000461

Increased levels of urine prothrombin fragment 1 + 2 was recently reported to be associated with imaging-verified venous thromboembolism. In this study we evaluated the relationship between plasma D-dimer and plasma and urine prothrombin fragment 1 + 2 in patients with suspected venous thromboembolism. Urine and blood samples were collected from patients with suspected pulmonary embolism or deep vein thrombosis. The samples were analysed with commercially available ELISA kits. The diagnosis of venous thromboembolism was verified with contrast-enhanced computer tomography of the pulmonary arteries or lower extremity deep vein compression ultrasound and venography as appropriate. Venous thromboembolism was diagnosed in 150 of 720 patients. Significantly higher levels of plasma D-dimer and prothrombin fragment 1 + 2 in plasma and urine were found in those with imaging-confirmed venous thromboembolism versus those without (P < 0.001). The correlation between the three biomarkers was statistically significant (range of r s values 0.45–0.65, P < 0.001). Plasma D-dimer had the highest diagnostic accuracy followed by prothrombin fragment 1 + 2 in plasma. Further development of ELISA analyses for urine testing of prothrombin fragment 1 + 2 may improve its diagnostic accuracy.

aDepartment of Radiology, Vestre Viken Hospital Trust, Drammen

bFaculty of Medicine, University of Oslo

cDepartment of Cardiology, Centre for Clinical Heart Research, Oslo University Hospital

dOslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo

eCentre of Medical Science, Education and Innovation, Innlandet Hospital Trust, Brumunddal, Norway

fThrombosis Research Institute, London, UK

Correspondence to Fredrik Wexels, Department of Radiology, Vestre Viken Hospital Trust, 3004 Drammen, Norway Tel: +47 32 80 37 02; e-mail:

Received 21 April, 2015

Revised 10 September, 2015

Accepted 26 September, 2015

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