URINE TEST COULD HELP SPOT BLOOD CLOTS
A new study by researchers
from California and Canada indicates a simple urine test can indicate the
presence of venous thromboembolism, a blood clot that has broken free from its
point of origin and which travels through the bloodstream, eventually lodging
in a vein. The test evaluates the levels of fibrinopeptide B (FPB), a small
peptide that's released when a thrombosis forms and which is removed from the
body through urine
The results of the
study will be presented at the American Thoracic Society's 2014 International
Conference here.
Study lead author
Timothy Fernandes, M.D., M.P.H., said the study was developed based on the
results of a pilot trial that suggested that urine FPB levels could be used as
a screening tool for venous thromboembolism in patients at risks for clots.
"The urine FPB test offers advantages over other screening methods because
it doesn't require blood to be drawn and it can provide more accurate results
than the D-dimer test," Fernandes said.
The D-dimer test
looks for blood evidence of a protein fragment called D-dimer that is present
in the blood after a clot begins to break down. The FPB test has the potential
for greater specificity because it can reflect ongoing clot activity, while
D-dimer can only be measured once a clot has already become degraded.
"During our
study, we validated the sensitivity, specificity and likelihood ratios for
several diagnostic thresholds of urine FPB using stored urine samples from the
Fernandes said.
The researchers used
stored urine samples taken from 344 patients who participated in the Pulmonary
Embolism Diagnosis Study (PEDS), a multicenter study of 1,417 patients
considered likely to have an acute pulmonary embolism. For all urine samples,
the researchers measured the FPB concentration and evaluated the sensitivity
and specificity of the test at various cut-off points in relation to its
ability to predict the presence of venous thromboembolism.
What they found was
at concentrations of 2.5 ng/ml, urine FPB demonstrated sensitivity comparable
to previously published values for plasma latex and whole blood D-dimer levels,
but with greater specificity.
"The results of
our study indicate that urine FPB tests may be a useful complement to current
biomarkers such as D-dimer to measure for the presence and activity of venous
thromboembolism," Dr. Fernandes said. "As an addition to other types
of testing, FPB urine provides greater specificity and doesn't require a blood
draw, which can be a major boon to patients."
The patent for the
urine fibrinopeptide B test is held by the University of California Board of
Regents. Dr. Fernandes and his co-authors plan on developing a urine dipstick
test for FBP that could be quickly and widely applied.
Future studies are
planned to assess urine fibrinopeptide B in other settings where D-dimer is
used including use of urine fibrinopeptide after anticoagulation to determine
the risk of recurrent venous thromboembolism.
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