A multicenter evaluation of a new quantitative highly sensitive D-dimer assay for exclusion of venous thromboembolism

Thromb Haemost. 2008 Sep;100(3):505-12. doi: 10.1160/th08-04-0202.

Abstract

D-dimer testing is widely applied for exclusion of deep-vein thrombosis (DVT) and pulmonary embolism (PE). We report on a multicenter performance evaluation of a new particle-enhanced immunoassay, Innovance D-Dimer. Innovance D-Dimer assay was performed in 1,543 frozen samples from outpatients suspected of DVT and/or PE enrolled in three management studies as well as in a routine clinical practice. Samples were assayed on BCS/BCS XP, BCT as well as Sysmex CA-7000, CA-1500 and CA-560 analyzers (cut-off on all analyzers: 0.5 mg/l). Stratus CS D-Dimer and Vidas D-Dimer Exclusion were used for comparison. The precision study indicated total coefficients of variation ranging from 2.1% to 8.4% depending on the analyzer and on the sample. Sensitivity and negative predictive values were above 99% and their lower 95% confidence interval were equal or above 97.4% and 98.6%, respectively. Specificity ranged from 38.2% to 40.4% and the respective lower 95% confidence intervals from 35.5% to 37.7%. Area under the curve was 0.90 for all assay systems except for Innovance D-Dimer with BCT (0.89). Two samples from patients with distal DVT tested negative with all assay systems. One patient with high pre-test clinical probability and proximal DVT tested negative with Vidas D-Dimer Exclusion. Our data indicate that the performances of Innovance D-Dimer, regardless of the analyzer, are similar to the reference methods, and that this assay can be used for the exclusion of venous thromboembolic disease.

Publication types

  • Multicenter Study

MeSH terms

  • Algorithms
  • Calibration
  • Chemistry, Clinical / methods
  • Dimerization
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Immunoassay / instrumentation
  • Immunoassay / methods*
  • Predictive Value of Tests
  • Probability
  • Regression Analysis
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Venous Thromboembolism / blood*
  • Venous Thromboembolism / diagnosis*

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D