Evaluation of soluble P-selectin as a marker for the diagnosis of deep venous thrombosis

Eduardo Ramacciotti, Susan Blackburn, Angela E. Hawley, Frank Vandy, Nicole Ballard-Lipka, Cathy Stabler, Nichole Baker, Kenneth E. Guire, John E. Rectenwald, Peter K. Henke, Daniel D. Myers, Thomas W. Wakefield

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

Objective: The combination of D-dimer and Wells score can exclude, but not confirm, the diagnosis of deep venous thrombosis (DVT). Since thrombosis and inflammation are interrelated, we evaluated the combination of soluble P-selectin (sPsel) with other inflammatory biomarkers for the diagnosis of DVT. Methods: Sixty-two positive and one hundred and sixteen patients with negative DVT, by duplex scan, were prospectively evaluated for sPsel, D-dimer, C-reactive protein (CRP), microparticles (MPs; total, leukocyte, and platelet-derived and tissue factor positive microparticles), and clinical Wells score. Results: Biomarkers and clinical scores that differentiated DVT positives from negatives were sPsel (87.3 vs 53.4 ng/mL, P <.0001), D-dimer (5.8 vs 2.1 mg/ L, P <.0001), CRP (2.1 vs 0.8 μg/mL, P <.0005), and Wells score (3.2 vs 2.0, P <.0001). For MP analysis, platelet-derived MPs were found to differentiate DVT from negatives. Using multivariable logistic regression, a combination of sPsel and Wells score could establish the diagnosis of DVT (cut point ≥90 ng/mL + Wells ≥2), with a specificity of 96% and positive predictive value (PPV) of 100%, and could exclude DVT diagnosis (cut point ≤60 ng/mL and Wells <2) with a sensitivity of 99%, a specificity of 33%, and a negative predictive value (NPV) of 96%. Conclusion: This study establishes a biomarker and clinical profile combination that can both confirm and exclude the diagnosis of DVT.

Original languageEnglish (US)
Pages (from-to)425-431
Number of pages7
JournalClinical and Applied Thrombosis/Hemostasis
Volume17
Issue number4
DOIs
StatePublished - Aug 1 2011

Keywords

  • deep venous thrombosis
  • thrombosis
  • venous thromboembolism

ASJC Scopus subject areas

  • Hematology

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    Ramacciotti, E., Blackburn, S., Hawley, A. E., Vandy, F., Ballard-Lipka, N., Stabler, C., Baker, N., Guire, K. E., Rectenwald, J. E., Henke, P. K., Myers, D. D., & Wakefield, T. W. (2011). Evaluation of soluble P-selectin as a marker for the diagnosis of deep venous thrombosis. Clinical and Applied Thrombosis/Hemostasis, 17(4), 425-431. https://doi.org/10.1177/1076029611405032