D-Dimer – A laboratory point of view Jovan P.

Jovan P. Antovic
Coagulation, Hematology, Clinical Chemistry, Laboratory, Karolinska University Hospital & Institute

D-dimer (D-D) is a marker of fibrin deposition and secondary fibrinolysis and, as such, an indirect marker of thrombotic activity. D-D testing is efficient in the exclusion of venous thromboembolism (VTE), but it also has some implications in the prediction of recurrent VTE, in the prediction and prognosis of arterial thrombotic events, diagnosis of disseminated intravascular coagulation, as well as the potential exclusion of aortic aneurism. In spite of excellent characteristics for the exclusion of VTE, D-D is high (false positive) even in the absence of thrombosis in different clinical conditions. Therefore the use of D-D in the elderly, pregnancy, malignancy, after surgery, etc has to be careful with the potential adjustment of the reference range. On the other hand, D-D assays standardization and absence of international calibrator standard are still a critical issue from the laboratory perspective and therefore clinicians need to be aware of the different performance characteristics of the available D-D assays. Finally the turnaround time for laboratory testing, which may significantly improve efficacy in emergency departments, has become very important. Thus the introduction of a rapid, easy to perform point of care (POC) D-D assay would be desirable and would help physicians to make safe and timely therapeutic decisions. This brief review discusses all those issues of potential importance for cardiologists.




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