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D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications.

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  • 1a CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory , Université Catholique de Louvain , Yvoir , Belgium.

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Summary

D-dimer testing aids in ruling out venous thromboembolism (VTE) and assessing recurrence risk. This review clarifies D-dimer definition, measurement variables, and clinical applications for improved patient care.

Keywords:
D-dimeranalyticalpostanalyticalpreanalyticalvenous thromboembolism

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Area of Science:

  • Hematology
  • Clinical Chemistry
  • Diagnostic Medicine

Background:

  • D-dimer is a fibrin degradation product reflecting coagulation and fibrinolysis.
  • It serves as a biomarker for activated coagulation and fibrinolysis.
  • Routinely used to exclude venous thromboembolism (VTE).

Purpose of the Study:

  • Revise the definition of D-dimer.
  • Discuss preanalytical variables impacting D-dimer measurement.
  • Review assay performance and postanalytical variables.
  • Explore D-dimer use in diverse clinical settings.

Main Methods:

  • Literature review of D-dimer definition and applications.
  • Analysis of preanalytical and postanalytical factors affecting D-dimer assays.
  • Comparison of D-dimer assay performance.
  • Evaluation of clinical utility across different patient populations.

Main Results:

  • D-dimer is a key biomarker for VTE diagnosis and recurrence risk assessment.
  • Preanalytical and postanalytical variables significantly influence D-dimer test results.
  • Assay performance varies, necessitating careful interpretation.
  • Age-adjusted cutoffs and different units impact clinical decisions.

Conclusions:

  • Accurate D-dimer measurement and interpretation are crucial for clinical decision-making.
  • Understanding influencing factors optimizes the use of D-dimer in VTE management.
  • D-dimer plays a vital role in diagnosing VTE, assessing recurrence, and guiding anticoagulation therapy.