6533b857fe1ef96bd12b46b8

RESEARCH PRODUCT

Validation of the STA-Liatest DDi assay for exclusion of proximal deep vein thrombosis according to the latest Clinical and Laboratory Standards Institute/Food and Drug Administration guideline

Carlos AguilarAndrew RubinJeffrey A. KlinePascual Marco VeraColin G. KaideGilles PernodJohn LazarchickMelhem J. SharafuddinChristopher KabrhelSuman M. WasanJames GroceJeannine KassisEmmanuel De MaistreArmando D'angeloD. Mark CourtneyMichelangelo Sartori

subject

AdultMalemedicine.medical_specialtyDeep veinShort Communications030204 cardiovascular system & hematologySensitivity and SpecificityFibrin Fibrinogen Degradation ProductsSTA-Liatest DDi03 medical and health sciences0302 clinical medicineInternal medicineOutpatientsD-dimermedicineHumansProspective StudiesProspective cohort studyexclusiondeep venous thrombosisAgedVenous ThrombosisUnited States Food and Drug Administrationbusiness.industryImmunoturbidimetryHematologyGeneral MedicineGuidelineMiddle Agedmedicine.diseaseThrombosisUnited StatesPulmonary embolismClinical trialPre- and post-test probabilitymedicine.anatomical_structureD-dimerFemalebusiness030215 immunology

description

: Recommended strategy for venous thromboembolism (VTE) diagnosis includes the use of sensitive D-dimer (DDi) assays along with pretest probability (PTP) assessment. The Clinical and Laboratory Standards Institute (CLSI) recently issued a guideline (US FDA endorsed) on DDi in VTE exclusion. Such guideline specifies the ideal D-dimer assay characteristics and target population. Demonstrate STA-LiatestD-Di performance combined with a PTP score for proximal deep vein thrombosis (pDVT) exclusion in a CLSI compliant study. International, multicenter, prospective nonrandomized, noninterventional clinical outcome management study conducted in a standard-of-care setting. DDi was measured in DVT-suspected consecutive low/moderate PTP outpatients, without conditions possibly impacting DDi values independently of thrombosis presence (age >80, pregnancy, postoperative, cancer) using a 0.5 μg/ml (FEU) threshold for DVT exclusion. Results were used to determine test performance. One thousand two hundred and thirty-four patients (17 centers) signed informed consent. Nine hundred and eighty (mean age: 55) with valid results (494 negative DDi) completed the study (DVT prevalence: 8.7%). STA-LiatestD-Di performance exceeded CLSI/FDA requirements: sensitivity: 100% (95% CI 95.8-100%), NPV: 100% (95% CI 99.3-100%). STA-LiatestD-Di associated with PTP score showed excellent performance for pDVT exclusion, as recently demonstrated for pulmonary embolism. The assay allows safe VTE exclusion, avoiding unnecessary imaging tests.

https://doi.org/10.1097/mbc.0000000000000750