This article is more than 5 years old. Information may no longer be current.
D-dimer thresholds reduced need for CT pulmonary angiography
Click Here to Manage Email Alerts
The use of selective D-dimer thresholds reduced the need for CT pulmonary angiography in patients with suspected pulmonary embolism, but the approach was associated with increased failure rate, according to study results.
Researchers performed a post-hoc analysis that included 2,213 consecutive patients from two cohort studies with suspected PE. Patients were managed according to current standards.
PE was ruled out in cases of unlikely probability (Wells rule ≤4 points) and D-dimer level <0.5 mg/mL-1). All other patients underwent CT pulmonary angiography.
Follow-up was 3 months.
Using standard approaches, PE was excluded without CT pulmonary angiography in 26% of patients, with a 3-month venous thromboembolism incidence of 0.88% (95% CI, 0.29-2.1).
Using selective D-dimer thresholds, PE was excluded without CT pulmonary angiography in 36% of patients, with a 3-month VTE incidence of 2.1% (95% CI, 1.2-3.4).
“Applying selective D-dimer thresholds reduces the need for CT pulmonary angiography by 11 percentage points but is associated with an increased failure rate,” the researchers wrote. “Prospective studies should evaluate the safety and net clinical benefit of this approach.”
Click Here to Manage Email Alerts