D-Dimer testing: the role of the clinical laboratory in the diagnosis of pulmonary embolism

Mavromatis, Blanche H.; Kessler, Craig M.

doi:10.1136/jcp.54.9.664

Cited by 21 publications

(13 citation statements)

References 34 publications

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“…No significant differences were found in PTR during pregnancy, but were seen in APTTR corroborating a general trend in reduction reported previously [8]. There was also confirmation that fibrinogen levels increased as pregnancy continued [9,10].…”

supporting

confidence: 78%

Establishing a normal range for d‐dimer levels through pregnancy to aid in the diagnosis of pulmonary embolism and deep vein thrombosis

Morse

2004

Journal of Thrombosis and Haemostasis

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supporting

confidence: 78%

Establishing a normal range for d‐dimer levels through pregnancy to aid in the diagnosis of pulmonary embolism and deep vein thrombosis

Morse

2004

Journal of Thrombosis and Haemostasis

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“…Most importantly, in patients who are considered to be clinically unlikely to have a DVT and who have a negative D‐dimer, the diagnosis of DVT is safely excluded, indicating an absence of false‐negative results using the D‐dimer test in such patients. Similar findings have also been found in studies examining the usefulness of the D‐dimer test in human patients with pulmonary thromboembolism (PTE) 17,18 . Recently, D‐dimer testing has been examined in various thromboembolic diseases in dogs, primarily dogs with PTE, with a negative test being considered a strong indicator of the absence of a thromboembolic disease.…”

Section: Introductionsupporting

confidence: 70%

“…This included dogs with neoplasia, liver disease, renal failure and post‐surgery 19–21 . For these reasons, the recommended cut‐off value for a positive D‐dimer using this assay has been suggested to be at >500 ng/mL in dogs as well as in humans 15,18,19,23 …”

Section: Discussionmentioning

confidence: 99%

Use of the D‐dimer assay for diagnosing thrombosis in cases of canine cutaneous vasculitis

Rosser

2009

Veterinary Dermatology

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The objectives of this study were to measure D-dimer concentrations and assess their value in diagnosis of thrombosis in three groups of dogs; (i) dogs with cutaneous vasculitis without histopathological evidence of thrombosis; (ii) dogs with cutaneous vasculitis with histopathological evidence of thrombosis; and (iii) pruritic dogs with erythematous skin and underlying allergic skin disease. D-dimer test results were reported as negative at <250 ng/mL, and positive at > or =250 ng/mL. Ten dogs with a diagnosis of atopic dermatitis and/or cutaneous adverse food reaction were enrolled in the study, and the D-dimer results were <250 ng/mL (eight dogs) and 250-500 ng/mL (two dogs). Twenty-six dogs with a diagnosis of cutaneous vasculitis had blood samples submitted for D-dimer analysis at the time of the initial submission of skin biopsies and results were: 15 had cutaneous vessel thrombi present with a D-dimer of >500-1000 ng/mL (14 dogs) and >1000 ng/mL (one dog); 11 dogs had no histological evidence of thrombi with a D-dimer of <250 ng/mL (four dogs), 250-500 ng/mL (three dogs) and >500-1000 ng/mL (four dogs). However, two of four dogs with a D-dimer of >500-1000 ng/mL without histological evidence of thrombi developed necrotic skin lesions over the next 24-48 h. In conclusion, a D-dimer >500 ng/mL is strong evidence to support the current presence or subsequent development of cutaneous vessel thrombosis, and a D-dimer of <500 ng/mL correlates well with the absence of cutaneous vessel thrombi and necrotic skin lesions. No dogs with histopathological evidence of thrombi had a false-negative D-dimer.

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“…In fact, some individuals in whom inflammation is already causing hypercoagulability, as expressed by high D-dimer levels, will have values below 200 ng/mL. Since other studies have used cut-off thresholds that are even higher than the threshold used in our study, the amount of misclassification is probably even higher (2, 8–10). Consistent with results from previous studies, we found that the level of D-dimer as well as the prevalence of elevated D-dimer increases with age (2, 4, 10, 11).…”

Section: Discussionmentioning

confidence: 74%

Correlates of D-dimer in older persons

et al. 2010

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Background and aims D-dimer is a marker of active fibrinolysis. Understanding how age-related factors affect D-dimer levels may help the interpretation of high D-dimer levels in older individuals. Methods 776 Baltimore Longitudinal Study on Aging (BLSA) participants (mean age 68.4±13.9 yrs) were divided into three groups according to baseline D-dimer levels >200 ng/mL; 100–200 ng/mL and <100 ng/mL. Results D-dimer level increased with age (p<0.0001). Using polychotomous logistic regression models, we found that age, cholesterol, triglycerides, creatinine, erythrocyte sedimentation rate, hemoglobin and body mass index were independently associated with D-dimer level. Conclusions Rising levels of D-dimer with age can be explained in part by the high prevalence of pro-inflammatory conditions and increasing burden of lipid abnormalities, anemia and obesity. These factors compromise the specificity of D-dimer levels as a diagnostic aid to thrombosis in older individuals.

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D-Dimer testing: the role of the clinical laboratory in the diagnosis of pulmonary embolism

Cited by 21 publications

References 34 publications

Establishing a normal range for d‐dimer levels through pregnancy to aid in the diagnosis of pulmonary embolism and deep vein thrombosis

Establishing a normal range for d‐dimer levels through pregnancy to aid in the diagnosis of pulmonary embolism and deep vein thrombosis

Use of the D‐dimer assay for diagnosing thrombosis in cases of canine cutaneous vasculitis

Correlates of D-dimer in older persons

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