This site is intended for healthcare professionals
General Practice Notebook
Medical search

D-dimer

FREE subscriptions for doctors and students... click here
You have 3 open access pages.

D-dimers are specific degradation products of cross-linked fibrin that are released when the endogenous fibrinolytic system attacks the fibrin matrix of fresh venous thromboemboli.

The absence of a raised concentration of D-dimer implies that there is no fresh thromboembolic material undergoing dissolution in the deep veins or in the pulmonary arterial tree.

There is evidence that a normal D-dimer assay result was useful for ruling out pulmonary embolism (PE) in patients with a low pretest probability of PE or a nondiagnostic V/Q scan. A d-dimer below a certain cut point rules out PE with a high predictive value, at least in patients with a low or moderate clinical probability (4)

Conditions in which there may be a raised D-dimer include:

  • pulmonary embolism
  • deep vein thrombosis
  • disseminated intravascular coagulation
  • postoperatively

More detailed information concerning other causes and factors affecting D-dimer levels is included in the linked item.

Notes:

  • D-dimer levels and prediction of recurrent VTE
    • a systematic review was undertaken (5)
      • patients who had completed at least 3 months of anticoagulation for a first episode of unprovoked (idiopathic) VTE and after approximately 2 years of follow-up, a negative D-dimer result was associated with a 3.5% annual risk for recurrent disease, whereas a positive D-dimer result was associated with an 8.9% annual risk for recurrence

Reference:

  1. Evidence Based Medicine (1999); 4 (3): 90.
  2. Moser K (1994). Diagnosing pulmonary embolism. BMJ (309): 1525-6.
  3. Ann Emerg Med 2002 Aug;40(2):133-44
  4. Evidence Based Medicine (2002); 8(1):29.
  5. Verhovsek M et al. D-dimer to predict recurrent disease after stopping anticoagulant therapy for unprovoked venous thromboembolism.Ann Intern Med. 2008 Oct 7;149(7):481-90

Links:

General Practice Notebook
General Practice Notebook
The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2016 Oxbridge Solutions LtdĀ®. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions LtdĀ® receives funding from advertising but maintains editorial independence. GPnotebook stores small data files on your computer called cookies so that we can recognise you and provide you with the best service. If you do not want to receive cookies please do not use GPnotebook.