A multicenter evaluation of a new quantitative highly sensitive D-dimer assay for exclusion of venous thromboembolism
Philippe de Moerloose 1, Gualtiero Palareti 2, Carlos Aguilar 3, Cristina Legnani 2, Guido Reber 1, Dirk Peetz4
1 Angiology and Haemostasis Division, University Hospital of Geneva and Faculty of Medicine, Geneva Switzerland; 2 Angiology and Blood Coagulation, University Hospital of Bologna, Italy; 3 Department of Haematology, General Hospital Santa Barbara, Soria, Spain; 4 Institute for Clinical Chemistry and Laboratory Medicine, University of Mainz, Mainz, Germany
pulmonary embolism, Deep venous thrombosis, D-dimer
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 particleenhanced 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.