Dimerized plasmin fragment D as a potential biomarker to predict successful catheter-directed thrombolysis therapy in acute deep vein thrombosis
Journal
Phlebology
Journal Volume
30
Journal Issue
9
Pages
620-626
Date Issued
2015
Author(s)
Abstract
Objectives The value of dimerized plasmin fragment D in the clinical monitoring during the catheter-directed thrombolysis in patients with acute deep vein thrombosis is not known. Methods Dimerized plasmin fragment D levels in 24 patients with acute deep vein thrombosis undergoing catheter-directed thrombolysis were prospectively evaluated. The plasma dimerized plasmin fragment D level was measured serially before and at every 12 h during catheter-directed thrombolysis for 24 h. Technical success was defined as restoration of patency and flow with less than 50% residual thrombus by surveillance rotational venography. Results Technical success was achieved in 79.2% (19 of 24) of the treated limbs after catheter-directed thrombolysis. In univariate analysis, there was significant elevation of the dimerized plasmin fragment D at 12th h after starting the catheter-directed thrombolysis (P < 0.05) in patients with less than 50% residual thrombus stenosis. The optimal cut-off value of dimerized plasmin fragment D to predict successful catheter-directed thrombolysis was determined as 18.4 ?g/ml at the 12th h after starting the catheter-directed thrombolysis with sensitivity 0.8 and specificity 0.8 (P = 0.03). It was further validated in multivariate logistic regression analysis (odds ratio: 14.38; 95% CI: 1.22–169.20; P = 0.03). Conclusions Catheter-directed thrombolysis is safe and effective for restoration of blood flow in patients with acute deep vein thrombosis. Dimerized plasmin fragment D value greater than 18.4 ?g/ml at the 12th h after starting catheter-directed thrombolysis had a high predictive rate of greater than 50% lysis at the end of catheter-directed thrombolysis. ? 2014, ? The Author(s) 2014.
SDGs
Other Subjects
biological marker; D dimer; fibrinogen; urokinase; biological marker; fibrin degradation product; fibrin fragment D; fibrinogen D fragment; acute disease; adult; aged; Article; bleeding; blood clot lysis; catheter directed thrombolysis therapy; clinical article; clinical effectiveness; deep vein thrombosis; disease surveillance; female; human; lung embolism; male; mortality; observational study; outcome assessment; patient monitoring; patient safety; phlebography; predictive value; priority journal; prospective study; receiver operating characteristic; reference value; residual thrombus stenosis; rotational venography; sensitivity and specificity; stenosis; time series analysis; validation process; vascular patency; vascular stent; vein blood flow; acute disease; blood; catheterization; chemistry; dimerization; Doppler ultrasonography; fibrinolytic therapy; middle aged; multivariate analysis; odds ratio; procedures; thrombosis; Venous Thrombosis; very elderly; Acute Disease; Adult; Aged; Aged, 80 and over; Biomarkers; Catheterization; Dimerization; Female; Fibrin Fibrinogen Degradation Products; Humans; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Phlebography; Prospective Studies; ROC Curve; Sensitivity and Specificity; Thrombolytic Therapy; Thrombosis; Ultrasonography, Doppler; Venous Thrombosis
Publisher
SAGE Publications Ltd
Type
journal article