VPB0133 - Evaluation of D-dimer Concentrations Measured With Three Methods in Patients With COVID-19

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Co-Author(s)

MC

Marco Capecchi, MD

MD
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
Milan, Lombardia, Italy

Presenting Author(s)

ES

Erica Scalambrino, MA

Collaboratore Professionale di Ricerca
Fondazione IRCCS Cà Grand Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center
Milano, Lombardia, Italy

Co-Author(s)

MC

Marigrazia Clerici

Collaboratore Professionale di Ricerca
Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia e Trhombosis Center, Milan, Italy
Milano, Lombardia, Italy
ST

Sophie Testa

Medical Doctor
Azienda Ospedaliera Istituti Ospitalieri di Cremona, Centro Emostasi e Trombosi
Cremona, Lombardia, Italy
CD

Claudia Dellanoce

MSc in biology
Azienda Ospedaliera Istituti Ospitalieri di Cremona, Centro Emostasi e Trombosi
Cremona, Lombardia, Italy
Flora Peyvandi, MD, PhD

Professor of Internal Medicine; Director of the Angelo Bianchi Bonomi Hemophilia & Thrombosis Center
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
Milan, Lombardia, Italy
AT

Armando Tripodi

Professor
Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia e Trhombosis Center, Milan, Italy
Milano, Lombardia, Italy

Background: COVID-19 is associated with an increased risk of venous thrombosis, even when patients are on standard-dose antithrombotic prophylaxis. Hence, the identification of biomarkers of thrombosis helps tailoring dosage of antithrombotic prophylaxis. D-dimer has been extensively employed as a biomarker and cut-off values at hospital admission have been proposed to stratify the risk of thrombosis and make decision on prophylaxis. However, D-dimer measurement is not standardized, and it is unknown if the cut-off values used for decision making can be used interchangeably between methods.

Aims: To assess for concordance of results obtained with different commercially available laboratory methods measuring D-dimer.

Methods: Plasma samples collected from COVID-19 patients at the Hospital of Cremona were evaluated for D-dimer with three widely used immunoturbidimetric methods (Liatest D-di, Stago, Asnieres, France; D-dimer HS 500, Werfen, Orangeburg, NY; Innovance D-dimer, Siemens, Marburg, Germany).

Results: A total of 87 COVID-19 patients [54 male and 33 female, median age of 73 years (range 28-98)] were enrolled in the study. No significant differences were found between mean D-dimer concentrations obtained with the three methods even when stratifying D-dimer levels in 4 groups ( < 1000, 1000-2000, 2000-5000, >5000 ng/mL) (Figure 1). The three methods showed substantial result agreement [Stago-vs-Werfen and Siemens-vs-Stago (Cohen’s kappa coefficient of 0.760 and 0.699, respectively)] to an almost perfect agreement [Siemens-vs-Werfen (Cohen’s kappa coefficient of 0.811)], with a p-value < 0.001. Results from the three methods showed a good linear correlation (Rho=0.94) (Figure 2).

Conclusion(s): The relatively good concordance of D-dimer results among the three investigated methods indicates that D-dimer cut-off values could be used interchangeably regardless of the method used for testing. The results pave the way to clinical trials aimed to assess the value of D-dimer as a biomarker to make decision on the intensity of antithrombotic prophylaxis in COVID-19 patients.