Study finds ways to improve detection of blood clots i...( mbolism (PE) leads to death in nearly o...),Health

mbolism (PE) leads to death in nearly one-third of untreated cases, but therapies lower the death rate to between 3 percent and 8 percent. In nine out of 10 cases, PE begins as a clot in the deep veins of the leg, a condition known as deep vein thrombosis (DVT). The clot breaks free from the vein and travels to the lung, where it can block an artery. Commonly used treatments for both PE and DVT include anti-clotting medications and injections of clot-busting agents.

"There are many effective ways to prevent and treat blood-clotting diseases," noted NHLBI Director Elizabeth G. Nabel, MD. "Pulmonary embolism is underdiagnosed and therefore often untreated. If detected early, however, blood clots can often be prevented from causing permanent damage or death."

In PIOPED II, researchers compared the accuracy of three ways to diagnose blood clots in 824 patients suspected of having pulmonary embolism: chest CT angiogram alone, chest CT angiogram with venous-phase imaging (leg CT), and chest CT angiogram with an objective clinical assessment known as the Wells Score. The Wells Score is a validated tool to determine the likelihood that a patient has PE based on characteristics such as signs and symptoms, heart rate, and risk factors. A high score indicates that a patient has a high probability of having PE. To determine their accuracy, the tests were compared with the participants' composite results from other validated diagnostic tests for PE.

Overall, the sensitivity (the ability to detect clots) of the combined chest CT and leg CT was 90 percent, compared to 83 percent sensitivity of the chest CT angiogram alone. The specificity (the ability to rule out the presence of clots) of the chest CT alone compared to the chest CT and leg CT combined was similar (about 95 percent). A high clinical probability combined with positive chest CT correctly indicated PE in 96 percent of participants. However, in patients with a high clinical probability, a ne
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Contact: NHLBI Communications Office
NHLBI_news@nhlbi.nih.gov
301-496-4236
NIH/National Heart, Lung, and Blood Institute
31-May-2006

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