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D-dimer Testing in Pulmonary Embolism with a Focus on Potential Pitfalls: A Narrative Review
Loris Wauthier1, Julien Favresse1,2, Michaël Hardy3
1Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium.
Abstract:
D-dimer is a multifaceted biomarker of concomitant activation of coagulation and fibrinolysis, which is routinely used for ruling out pulmonary embolism (PE) and/or deep vein thrombosis (DVT) combined with a clinical pretest probability assessment. The intended use of the tests depends largely on the assay used, and local guidance should be applied. D-dimer testing may suffer from diagnostic errors occurring throughout the pre-analytical, analytical, and post-analytical phases of the testing process. This review aims to provide an overview of D-dimer testing and its value in diagnosing PE and discusses the variables that may impact the quality of its laboratory assessment.
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