Acosta Stefan, Blaser Annika Reintam, Nuzzo Alexandre, Soltanzadeh-Naderi Yasmin, Starkopf Joel, Forbes Alastair, Murruste Marko, Tamme Kadri, Voomets Anna-Liisa, Koitmäe Merli, Bala Miklosh, Bodnar Zsolt, Casian Dumitru, Demetrashvili Zaza, Biloslavo Alan, Muñoz-Cruzado Virginia Dúran, Hess Benjamin, Kase Karri, Kirov Mikhail, Lindner Matthias, Loudet Cecilia I, Damaskos Dimitrios, Björck Martin
Department of Clinical Sciences, Malmö, Lund University, Sweden.
Institute of Clinical Medicine, University of Tartu, Estonia.
Biomark Insights. 2024 Nov 26;19:11772719241296631. doi: 10.1177/11772719241296631. eCollection 2024.
Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.
The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).
Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period.
Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95% confidence intervals (CI).
D-dimer was not significantly higher in MVT (n = 73) compared to non-AMI (n = 287) patients (median 7.0 mg/L vs 4.5 mg/L, = .092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95% CI 0.011-0.84; = .034) and elevated D-dimer (OR 2.59/one SD increment, 95% CI 1.07-6.28; = .034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95% CI 0.49-0.78).
Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition.
NCT05218863 (registered 19.01.2022).
急性肠系膜静脉血栓形成（MVT）在急诊科很少被怀疑为主要诊断，且住院死亡率仍高于20%。
本研究旨在找出急性MVT患者与疑似但确诊没有任何类型急性肠系膜缺血（AMI）的对照组之间在临床和实验室指标上的差异。
数据取自急性肠系膜缺血（AMESI）研究。这项来自32个地点的国际多中心前瞻性病例对照研究在10个月期间收集了疑似AMI患者的数据。
在多变量逻辑回归分析中评估与急性MVT相关的独立因素，并以比值比（OR）及95%置信区间（CI）表示。
与非AMI患者（n = 287）相比，MVT患者（n = 73）的D-二聚体水平无显著升高（中位数分别为7.0mg/L和4.5mg/L，P = 0.092）。在多变量逻辑回归分析中，将体重指数、动脉粥样硬化疾病、静脉血栓栓塞病史、CRP和D-二聚体作为协变量纳入后，无动脉粥样硬化疾病（OR 0.096，95%CI 0.011 - 0.84；P = 0.034）和D-二聚体升高（OR 2.59/标准差增加量，95%CI 1.07 - 6.28；P = 0.034）与MVT相关。在受试者工作特征分析中，通过曲线下面积评估，D-二聚体对MVT的鉴别能力为0.63（95%CI 0.49 - 0.78）。
D-二聚体升高与MVT相关，但D-二聚体的鉴别能力较差。迫切需要为这种情况找到一种更准确的血浆生物标志物。
NCT05218863（于2022年1月19日注册）
