Elevated levels of soluble fibrin or D‐dimer indicate high risk of thrombosis

Abstract

Summary. Background: Fibrin‐related markers such as soluble fibrin (SF) and D‐dimer are considered useful for the diagnosis of thrombosis. However, the evidence for diagnosis of thrombosis by fibrin‐related markers is not well‐established. Objective: To evaluate the cutoff values of D‐dimer and SF in the diagnosis of thrombosis. Patients and Methods: Plasma concentrations of SF and D‐dimer were measured in 784 inpatients suspected of having thrombosis between 1 August 2003 and 31 December 2004, and then correlated with thrombosis. Results and Conclusions: Plasma concentrations of D‐dimer and SF were significantly higher in patients with disseminated intravascular coagulation (DIC), deep vein thrombosis (DVT) and cerebral thrombosis, compared with those in patients without thrombosis. When cutoff values of > 3.0 μg mL−1 for D‐dimer and > 6.0 μg mL−1 for SF were used for the diagnosis, more than 50% of patients (with the exception of liver transplant patients and postoperative patients) had thrombosis. Receiver operating characteristic analysis showed that SF was more useful than D‐dimer for the diagnosis of thrombosis (i.e. DVT and DIC). The cutoff value of D‐dimer (7.87 μg mL−1) was the same for DVT and DIC, while that of SF was slightly lower for DVT (7.05 μg mL−1) than for DIC (8.60 μg mL−1). Our findings suggest that high levels of plasma fibrin‐related markers reflect high risk for thrombosis.

D-dimer as a significant marker of deep vein thrombosis in patients with subclinical or overt Cushing’s syndrome

“…Elevated D-dimer levels are positively associated with the serum cortisol levels after LDDST, suggesting that relatively autonomous cortisol ificity, 91.7%). In the general Japanese population, the D-dimer cut-off value for DVT in detection was reported to be 7.87 μg/mL (measured using the same kit as in the current study) [26], suggesting that cutoff value was much lower in patients with soCS from the present study. The D-dimer cut-off values different among Japan, Europe, and North America because of the use of different measurement kits [27].…”

“…The D-dimer cut-off values different among Japan, Europe, and North America because of the use of different measurement kits [27]. A 2-fold D-dimer cut-off value has been recommended when comparing assays used in Japan with those used in Europe and North America [26], thus indicating that the cut-off value for DVT in patients with soCS might be ≥1.3 μg/mL as measured by an assay used in Europe and North America.…”

“…In the present study, we focused on D-dimer in patients with soCS because D-dimer measurement is rapid, simple, and inexpensive [17,26]. On the other hand, elevated D-dimer levels are not specific for DVT and can also be present in the settings of infection, inflammation, cancer, surgery, trauma, ischemic heart disease, and stroke [16].…”

The Evaluation of Fibrin-Related Markers for Diagnosing or Predicting Acute or Subclinical Venous Thromboembolism in Patients Undergoing Major Orthopedic Surgery

“…The cutoff values of D-dimer 3.4-5.2 mg/mL for the risk of VTE were similar to those of a previous report. 10 However, these cutoff values detected a risk of VTE in only 8.4% to 9.8% of cases.…”

“…Fibrin-related markers (FRMs) such as D-dimer, soluble fibrin (SF)/fibrin monomer complex (FMC), and fibrinogen and fibrin degradation products (FDPs) are useful markers for diagnosing thrombosis (TH), while FDPs are used in the diagnosis of disseminated intravascular coagulation (DIC) 8 and VTE. 9,10 A D-dimer assay is used as an initial screening test in the emergency department to exclude the diagnosis of PE. The purpose of this test, which has a high negative predictive value (NPV), is to provide a fast and cost-effective way to triage patients with VTE.…”