Investigation of two different human d-dimer assays in the horse.
Authors: Honoré Marie Louise, Pihl Tina H, Busk-Anderson Tanne M, Flintrup Laura L, Nielsen Lise N
Journal: BMC veterinary research
Summary
# Editorial Summary: D-dimer Assay Evaluation in Horses D-dimer measurement offers valuable prognostic information in critically ill horses suspected of thrombotic disease, yet veterinarians currently lack equine-specific assays and lack published evidence on how well human assays perform in equine plasma. Researchers compared two human d-dimer assays (STAGO STA-Liatest D-di+ and NycoCard D-dimer) across four horse populations: healthy controls, horses with mild systemic inflammation secondary to gastrointestinal disease (low SAA), horses with marked systemic inflammation from gastrointestinal disease (high SAA), and horses with non-strangulating intestinal infarction caused by *Strongylus vulgaris* (NSII). Beyond assessing analytical performance through precision testing, linearity, and method-comparison statistics, the researchers examined whether each assay could discriminate between disease states. Both assays successfully identified elevated d-dimer concentrations in horses with NSII and high-SAA disease, though the two methods showed limited agreement with each other, suggesting they may not be interchangeable for serial monitoring. These findings are significant for equine practitioners: whilst human d-dimer assays appear potentially useful for identifying thrombotic complications in acute colic cases, the choice of assay matters considerably, and clinicians should maintain consistency within their diagnostic pathway rather than switching between methods.
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Practical Takeaways
- •D-dimer can be used as a prognostic marker in critically ill horses, but practitioners should understand that current assays are human-derived and their reliability in horses varies
- •Elevation of d-dimer correlates with systemic inflammation and thrombotic disease severity; clinicians should consider which assay is being used when interpreting results
- •Until equine-specific d-dimer assays are available, understanding the limitations and comparative performance of human assays is essential for appropriate clinical interpretation in horses with colic and systemic disease
Key Findings
- •Two human d-dimer assays (STAGO STA-Liatest D-di+ and NycoCard D-dimer) were evaluated for applicability in horses with varying disease states
- •D-dimer concentrations differed significantly across clinical groups: healthy horses, mild inflammation (low SAA), strong inflammation (high SAA), and thrombotic disease (NSII)
- •Assay agreement and performance characteristics were assessed using intra/inter-assay coefficients of variation, linearity, and correlation methods to determine which human assay performs best in equine patients