J Thromb Haemost. Systematic review: d-dimer to predict recurrent disease after stopping anticoagulant therapy for unprovoked venous thromboembolism.
Ann Intern Med. D-dimer testing to select patients with a first unprovoked venous thromboembolism who can stop anticoagulant therapy: a cohort study. Rivaroxaban or aspirin for extended treatment of venous thromboembolism. N Engl J Med. Eur Heart J. The use of D-dimer with new cutoff can be useful in diagnosis of venous thromboembolism in pregnancy. Elevated D-dimers are also a marker of underlying malignancy and increased mortality in the absence of venous thromboembolism.
J Clin Pathol. J Intensive Care. Prediction of venous thromboembolism in cancer patients. D-dimer level and the risk for thrombosis in systemic lupus erythematosus. Clin J Am Soc Nephrol.
D-dimer in ruling out acute aortic dissection: a systematic review and prospective cohort study. D-dimer for the exclusion of cerebral venous thrombosis: a meta-analysis of low risk patients with isolated headache. BMC Neurol. D-dimer for venous thromboembolism diagnosis: 20 years later. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography.
Category: Hematology. Disclaimer May contain information that is not supported by performance and intended use claims of Radiometer's products. Chris Higgins has a master's degree in medical biochemistry and he has twenty years experience of work in clinical laboratories.
Join the webinar. Acute care testing handbook Get the acute care testing handbook Your practical guide to critical parameters in acute care testing. Download now. Scientific webinars Check out the list of webinars Radiometer and acutecaretesting. Go to webinars. Sign up for the Acute Care Testing newsletter Sign up. About this site. In the bloodstream, plasmin is rapidly and specifically neutralized by alphaantiplasmin, thereby restricting its fibrinogenolytic activity and localizes the fibrinolysis on the fibrin clot.
On the fibrin clot, plasmin degrades fibrin into various products ie, D-dimers. Antibodies specific for these products, which do not recognize fibrinogen, have been developed.
The presence of these various fibrin degradation products, among which D-dimer is the terminal product, is the proof that the fibrinolytic system is in action in response to coagulation activation. Elevated D-dimer levels are found in association with disseminated intravascular coagulation DIC , pulmonary embolism PE , deep vein thrombosis DVT , trauma, and bleeding. D-dimer may also be increased in association with pregnancy, liver disease, malignancy, inflammation, or a chronic hypercoagulable state.
D-dimer concentrations increase with age and, therefore, the specificity for DVT and PE exclusion decreases with age. For DVT or PE exclusion, in addition to clinical pretest probability, age-adjusted D-dimer cutoffs are suggested for patients older than 50 years of age.
Recent evidence suggests using clinical pretest probability and age-adjusted cutoffs to improve the performance of D-dimer testing in patients older than 50 years of age. A consequence of any test dichotomisation is loss of information that is hidden in the continuous spectrum of results. For D-dimer, the information conveyed by extremely elevated results may be particularly relevant.
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