Fibrinopeptide A, Beta-Thromboglobulin, and Fibrin Degradation Products as Screening Test for the Diagnosis of Deep Vein Thrombosis

Abstract

In a group of 111 consecutive patients (mean age 65 years) with suspected deep venous thrombosis (DVT) phlebography demonstrated DVT in 51. In all patients blood tests for fibrinopeptide A (FPA), fibrin degradation products (FDP) and beta-thromboglobulin (beta-Tg) were carried out. There was a significant difference in FPA concentration between the group of patients with a positive and a negative phlebography. However, there was a wide variation of individual values in both groups. The difference in FPA concentration between the groups was not related to differences in predisposing diseases, age or sex. FDP and beta-Tg did not differ between the groups and, again, a wide variation of individual values was found in both groups. In our hands, none of these three methods reflecting activities in the hemostasis seems to be useful to diagnose DVT in clinical routine work.

Diagnostic Value of <i>D</i>-Dimer for Deep Venous Thrombosis in Outpatients

“…Other studies, using a semiquantitative 79-dimer latex agglutination assay, demon strated that DVT could not be excluded if only based on 79-dimer levels below the cut off point for test positivity [35][36][37], For merly developed assays for determination of fibrinopeptide A (FPA) and (3-TG in plasma have also been evaluated in the diagnosis of DVT [22][23][24] and have shown to be of little value in the diagnosis of DVT.…”

“…It has been demonstrated, however, that results obtained by these se rum-based assays are unreliable [21]. Other laboratory assays focused upon the assess ment of substances generated during throm bus formation, such as fibrinopeptide A and (3-thromboglobulin ((3-TG), but with disap pointing results [22][23][24], Assays have now become available for the detection of fibrin(ogen) degradation prod ucts in plasma [25][26][27][28][29][30], They can be divided in (semiquantitative) latex agglutination as says and (quantitative) enzyme immunoas says (EIA). These assays are based upon monoclonal antibodies with a well-defined specificity directed against epitopes of a cer tain fibrin(ogen) derivative and can be per formed in plasma samples.…”

D-Dimers, Thrombin Antithrombin III Complexes and Prothrombin Fragments 1 + 2: Diagnostic value in Clinically Suspected Deep Vein Thrombosis

“…In addition to these physical techniques, the usefulness of plasma markers reflecting an activation of haemostasis has been evaluated. Fibrinopeptide A assays or the determination of specific proteins relased during platelet activation (p-thromboglobulin, platelet factor 4) have been found of poor sensitivity and specificity for the diagnosis of DVT (2). At the present time, the most promising results have been obtained with the D-Dimer, a fragment of cross-linked fibrin digested by plasmin, provided that this fragment is measured with a sensitive enzyme-linked immunosorbent assay (ELISA) (3)(4)(5)(6)(7)(8)(9) More recently, 2 new assays have been set up to determine the prothrombin fragment L + 2 (F 1 + 2) and the thrombinantithrombin III complexes (TAT).…”

Is Quantitative Determination of Fibrin(ogen) Degradation Products and Thrombin-Antithrombin III Complexes Useful to Diagnose Deep Venous Thrombosis in Outpatients?

“…Other possible alternatives such as laboratory assays have also been investigated in the past for their potential as diagnostic aids. These laboratory tests were usually based on assessment of substances generated during thrombus formation, such as fibrinopeptide A or |3-thromboglobuline, or substances generated during lysis of the thrombus, such as plasmin-a2-antiplasmin complex and fibrin degradation products (5)(6)(7). Their contribu tion to the diagnosis of DVT, however, has been disappointing.…”