Correlation Between Computer Tomography Angiography and D-Dimer Level for the Diagnosis of Pulmonary Embolism
Condition: D-Dimer as an Early Detector of Pulmonary Embolism
MeSH terms: Pulmonary Embolism; Embolism
Study type: Observational

Summary: 
      A blood sample was taken before starting the patients on any thrombolytic treatment. The
      positivity threshold for D-Dimer was above 250 ng/ml. CTPA was performed after performing
      blood sampling. Patients with confirmed pulmonary embolisms were admitted to ICU for
      continued monitoring of vitals, consciousness level, and signs of tissue perfusion. Signs of
      shock or hemodynamic instability should be observed regularly. Patients were managed in the
      ICU with anticoagulants by parenteral use. The most commonly used items were Heparin, either
      Unfractionated (UFH) or low-molecular-weight heparin (LMWH).D-dimer levels can leverage to
      detect PE. D-dimer levels can help in guiding the option of CTPA and the initiation of
      treatment for patients with suspected PE.
    

Detailed description: 
      A blood sample was taken before starting the patients on any thrombolytic treatment. The
      positivity threshold for D-Dimer was above 250 ng/ml. CTPA was performed after performing
      blood sampling. Patients with confirmed pulmonary embolisms were admitted to ICU for
      continued monitoring of vitals, consciousness level, and signs of tissue perfusion. Signs of
      shock or hemodynamic instability should be observed regularly. Patients were managed in the
      ICU with anticoagulants by parenteral use. The most commonly used items were Heparin, either
      Unfractionated (UFH) or low-molecular-weight heparin (LMWH).Presenting symptoms were mainly
      dyspnea, chest pain or discomfort, cough, and shortness of breath. Twenty-four patients of
      the total number of cases were positive for CTPA while four patients were negative for PE by
      CTPA. embolism was detected in the anterior, posterior, medial, and lateral basal segmental
      branches of the right lung, the lateral, posterior, and anterior basal segmental branches of
      the left lung, and the posterior segmental branch of the left lung. The D-dimer test and CTPA
      both provided similarly accurate PE diagnoses with no significant differences between them.
      There were 28 patients total, 3 of those patients had D-dimer levels below the cut-off value
      of 250 ng/ml, whereas the remaining 25 had D-dimer levels over the diagnostic threshold.
      Those with a positive CTPA diagnosis of PE had greater levels of D dimers than those with a
      negative CTPA diagnosis of PE. plasma D-dimer concentration did not correlate with the
      cross-sectional diameter of the blocked pulmonary vessel.D-dimer levels can leverage to
      detect PE. D-dimer levels can help in guiding the option of CTPA and the initiation of
      treatment for patients with suspected PE.
    

Intervention name(s): D-Dimer vs CTPA
Intervention type(s): Diagnostic Test
Intervention description(s): CTPA was performed after performing blood sampling using Siemens Somatom definition AS 24 slice scanners. Non-ionic water-soluble contrast Omnipaque 350 mg I/mg or Visipaque 320 mg I/mg was injected at 4 mm/s maximum dose 100 ml using a Medtron pressure injector.OR, A blood sample was taken before starting the patients on any thrombolytic treatment. The latex agglutination test was used to measure plasma D-dimer level; this was done using a Sysmex CA-7000 automatic coagulation unit. The positivity threshold was above 250 ng/ml.
Intervention MeSH terms: Fibrin fragment D
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        28 patients included, 14 patients female and 14 patients of male gender with an average age
        of 55.4 ±11.2 years. Presenting symptoms were mainly dyspnea, chest pain or, cough, and
        shortness of breath. Twenty-four patients of the total number of cases were positive for
        CTPA while four patients were negative for PE by CTPA. No allergy to the contrast was
        recorded during our study.
      
Keywords: D-Dimer, Pulmonary, Embolism, CTPA.