Background. Fibrin monomer (FM) or 'soluble fibrin' is generated in the initial step of converting fibrinogen to fibrin by thrombin. Quantitation of FM reflects prior action of thrombin on fibrinogen and may be useful in assessing early activation of coagulation. Because of its biological characteristics, fibrin monomer offers more potential advantages than fibrin degradation products as a marker of thrombin activity. Study objective. To determine the clinical utility of a novel whole blood assay for soluble fibrin in patients with clinically suspected deep vein thrombosis (DVT) or pulmonary embolism (PE). Design. Prospective cohort. Setting. Tertiary-care referral centres, University affiliated Hospitals. Patients. Two hundred and forty-five unselected patients, 91 with clinically suspected DVT and 154 patients with suspected PE, were enrolled in the study. Intervention. At presentation, all patients had blood taken for assay of plasma soluble FM. Subsequently objective testing was performed to determine the presence or absence of DVT or PE. According to results of the objective tests, patients were classified as DVT-positive (n = 32), DVT-negative (n = 59), PE-positive (n = 23), or PE-negative (n = 131). Measurements and Results. In order to determine whether clinically useful cut-offs for the detection or exclusion of DVT and PE could be ascertained, receiver operating curves were calculated. Conclusions. This study demonstrates that the soluble fibrin assay has potential in patients with clinically suspected DVT and PE; plasma levels below 1.3 μg/mL exclude DVT and PE reliably. Plasma levels above 4 μg/mL diagnose DVT in patients with and without comorbid conditions; FM levels above 3.5 μg/mL diagnose PE in patients without comorbid conditions, while plasma levels above 7 μg/mL rule in venous thromboembolism (VTE) diagnosis in all other patients.
|Translated title of the contribution||The role of fibrin monomers in patients with suspected acute venous thrombosis|
|Number of pages||7|
|Journal||Trasfusione del Sangue|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Immunology and Allergy