Diagnostic accuracy of D-Dimer testing for recurrent venous thromboembolism: A systematic review with meta-analysis
| Autor: | Antimo Papa, Mauro Maniscalco, Matteo Nicola Dario Di Minno, Alessandro Di Minno, Roberta Lupoli, Pasquale Ambrosino, Ilenia Calcaterra |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Absolute risk reduction Clinical prediction rule Odds ratio 030204 cardiovascular system & hematology medicine.disease Confidence interval Discontinuation Pulmonary embolism 03 medical and health sciences 0302 clinical medicine Meta-analysis Internal medicine D-dimer Internal Medicine Medicine 030212 general & internal medicine business |
| Zdroj: | European Journal of Internal Medicine. 89:39-47 |
| ISSN: | 0953-6205 |
| Popis: | Objective Venous thromboembolism (VTE) recurrence is a major concern after a first symptomatic episode, potentially impacting survival and healthcare needs in community, hospital and rehabilitation settings. We evaluated the association of D-Dimer positivity after oral anticoagulant therapy (OAT) discontinuation with VTE recurrence. Methods PubMed, Web of Science, Scopus and EMBASE databases were systematically searched. Differences were expressed as Odds Ratio (OR) with 95% confidence intervals (95%CI). Pooled sensitivity, specificity, positive (PLR) and negative likelihood ratio (NLR), and summary ROC (sROC) curve were calculated. Results Twenty-six articles on 10,725 VTE patients showed that the absolute risk of recurrence was 16.1% (95%CI: 13.2%-19.5%) among 4,049 patients with a positive D-Dimer and 7.4% (95%CI: 6.0%-9.0%) in 6,676 controls (OR: 2.1, 95%CI: 1.7-2.8, P Conclusions D-Dimer positivity after OAT may identify VTE patients at higher risk of recurrence, with a better diagnostic accuracy for provoked events. |
| Databáze: | OpenAIRE |
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