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The D-dimer assay

Eric D Johnson1, John C Schell2, George M Rodgers1

  • 1Division of Hematology and Hematologic Malignancies, University of Utah Health Sciences Center, Salt Lake City, Utah.

American Journal of Hematology
|April 5, 2019
PubMed

Insights

D-dimer testing is a valuable tool for diagnosing blood clots, particularly venous thromboembolism (VTE). While widely used to rule out VTE, its elevation in conditions like cancer requires careful interpretation.

Area of Science:

  • Biochemistry
  • Hematology
  • Medical Diagnostics

Background:

  • D-dimer is a fibrin degradation product reflecting fibrinolysis and fibrin turnover.
  • It serves as a marker for hemostatic abnormalities and intravascular thrombosis.
  • D-dimer indicates activation of coagulation and fibrinolysis in various clinical contexts.

Purpose of the Study:

  • To explore the utility of D-dimer as a biomarker in clinical scenarios.
  • To highlight its role in excluding venous thromboembolism (VTE).
  • To discuss its application in managing anticoagulation, disseminated intravascular coagulation, and bleeding/thrombotic risks.

Main Methods:

  • Review of existing literature and clinical investigations on D-dimer assays.
  • Analysis of D-dimer's performance in diagnosing and monitoring thrombotic conditions.
  • Evaluation of factors influencing D-dimer levels.

Main Results:

  • D-dimer is routinely used to exclude the diagnosis of VTE.
  • It is evaluated for optimizing anticoagulation duration in VTE patients.
  • D-dimer aids in diagnosing and monitoring disseminated intravascular coagulation and other high-risk conditions.

Conclusions:

  • D-dimer is a significant diagnostic marker for coagulation and fibrinolysis.
  • Its primary application is in the exclusion of VTE.
  • Limitations include non-specific elevation in age, pregnancy, cancer, and lack of standardization.

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