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Fibrin Split Products in Acute Pulmonary Embolism

FRANK D. RICKMAN, M.D.; ROBERT HANDIN, M.D.; JOHN P. HOWE, M.D.; JOSEPH S. ALPERT, M.D.; LEWIS DEXTER, M.D.; and JAMES E. DALEN, M.D.
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▸Requests for reprints should be addressed to James E. Dalen, M.D., Peter Bent Brigham Hospital, 721 Huntington Ave., Boston, MA 02115.


Boston, Massachusetts


Ann Intern Med. 1973;79(5):664-668. doi:10.7326/0003-4819-79-5-664
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The concentration of fibrin split products (FSP) was measured, by using a modification of the staphylococcal clumping test, in 46 patients who had pulmonary angiography for suspected acute pulmonary embolism and in 12 normal control subjects. The concentration was significantly higher in 19 patients with angiographically documented pulmonary embolism (mean FSP, 158 µg/ml) than in 22 patients without (mean, 8 µg/ml; P < 0.001)—in 18 of the 19 patients the concentration was > 10 µg/ml; in 19 of the 22 patients without pulmonary embolism it was 10 µg/ml or less. The levels were highest in patients with acute symptoms (<3 days) and in those with significant increases in total pulmonary resistance, as measured at cardiac catheterization. Fibrin split products concentration seems to be increased (>10 µg/ml) in most patients with acute pulmonary embolism. We had only one false-negative finding; however, the specificity of an elevation of this variable in acute pulmonary embolism needs further assessment.

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