Review of D‐dimer testing: Good, Bad, and Ugly

Linkins, Lori Ann; Lapner, Sarah Takach

doi:10.1111/ijlh.12665

Cited by 226 publications

(201 citation statements)

References 36 publications

(58 reference statements)

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“…However, any pathologic or non-pathologic process that increases fibrin production or breakdown also increases plasma D-dimer levels. [12] Examples include deep vein thrombosis/ pulmonary embolism, arterial thrombosis, disseminated intravascular coagulation, and conditions such as pregnancy, inflammation, cancer, chronic liver diseases, post trauma and surgery status, vasculitis. Among adults admitted to the emergency room, infections, instead of VTE/PE, are the most common reason for Ddimer elevation.…”

Section: Discussionmentioning

confidence: 99%

D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study

Yao

Cao

Wang

et al. 2020

Preprint

122

134

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Background: Over 240000 cases of coronavirus disease-19 (COVID-19) has been reported since Dec. 2019. We aim to assess the use of D-dimer as a biomarker for disease severity and clinical outcome in COVID-19 patients.Methods: We retrospectively analyzed the clinical, laboratory, and radiological characteristics of 248 consecutive cases of COVID-19 in Renmin Hospital of Wuhan University, Wuhan, China from Jan 28 to Mar 08, 2020. Correlations of D-dimer upon admission with clinical staging, radiological staging, and in-hospital mortality were analyzed. Receiver operating characteristics curve was used to determine the optimal cutoff level for D-dimer that discriminated those survivors versus non-survivors during hospitalization. Results: D-dimer elevation (≥0.50mg/L) was seen in 74.6% (185/248) of the patients. Pulmonary embolism and deep vein thrombosis were ruled out in patients with high probability of thrombosis. D-dimer levels significantly increased with increasing severity of COVID-19 as determined by clinical staging (Kendall's tau_b = 0.374, P=0.000) and chest CT staging (Kendall's tau_b = 0.378, P=0.000). In-hospital mortality rate was 6.9%. Median D-dimer level in non-survivors (n=17) was significantly higher than in survivors (n=231) [6.21 (3.79-16.01) mg/L versus 1.02 (0.47-2.66) mg/L, P=0.000]. D-dimer level of >2.14 mg/L predicted in-hospital mortality with a sensitivity of 88.2% and specificity of 71.3% (AUC 0.85; 95% CI=0.77-0.92).Conclusions: D-dimer is commonly elevated in patients with COVID-19. D-dimer levels correlate with disease severity and is a reliable prognostic marker for in-hospital mortality in patients admitted for COVID-19.

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Section: Discussionmentioning

confidence: 99%

D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study

Yao

Cao

Wang

et al. 2020

Preprint

122

134

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“…When brin laments are degraded by brinolytic enzymes during coagulation, plasma D-dimer is produced. Therefore, an increased D-dimer content in plasma indicates the occurrence of thrombosis and dissolution in vivo, and can therefore be used as an indicator of non-invasive thrombosis [23] . The results of the present study demonstrated that the plasma D-dimer level is an independent factor that affects the formation of DVT, which is similar to the results of Zhang et al [9] .…”

Section: Discussionmentioning

confidence: 99%

Study on the Risk Factors of Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture

Chang

Wang

et al. 2020

Preprint

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Abstract Background:The objective of this work is to discuss and analyze the related factors of lower extremity fracture complicated by deep vein thrombosis (DVT), and to help surgeons aptly prevent it.Methods:A retrospective analysis was conducted on the orthopedic inpatient records of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July 2014 to November 2018, and 11,891 patients with closed fractures of lower extremities were selected.By analyzing each patient's gender, age, presence or absence of diabetes and hypertension,preoperative plasma D-dimer level, and color Doppler ultrasound of the lower extremity vein, the pertinent factors of the patients with lower extremity fractures complicated by DVT were analyzed.Results: A total of 11,891 patients were selected, including 4462 with cases of peri-hip fractures, 754with cases of femoral shaft fractures, 1776 with cases of peri-knee fractures, 1961 with cases of tibiofibular fractures, and 2938 with cases of ankle fractures.Of these patients, 643 with DVT were detected, displaying a total incidence of 5.4%.All patients were categorized into either the DVT group or non-DVT group.The results demonstrate that there were statistically significant differences between the two groups in age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level (p<0.05), but there was no statistically significant difference in sex (p>0.05). Logistic multivariate analysis revealed that age, the presence of diabetes, and the preoperative plasma D-dimer level of patients were independent risk factors for lower extremity fracture complicated by DVT.Conclusion: Age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level were found to be correlated with the incidence of DVT. Moreover,age, the presence of diabetes, the preoperative fracture site, and the plasma D-dimer level were found to be independent risk factors.

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“…факторов является возраст [19]. Логично предположить, что и отрезные границы для уровня D-димера, определя-ющие высокий риск развития ТО, могут оказаться неоди-наковыми у лиц разного возраста.…”

Section: оценка риска развития тромботических осложнений у больных ибunclassified

Prognostic significance of DAPT scale and D-Dimer level in patients treated with elective PCI

Комаров¹,

Новикова²,

Dobrovolsky³

et al. 2018

Kardio. vestn.

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1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия; 2 ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», Москва, Россия Цель исследования. Изучить взаимосвязь балльной оценки по шкале DAPT и коагулологического показателя -D-димера с развитием тромботических и геморрагических осложнений (ГО) на фоне двухкомпонентной антитромбоцитарной терапии (ДАТТ) и после ее прекращения у больных, подвергнутых плановым процедурам чрескожного коронарного вмешательства (ЧКВ). Материал и методы. В исследование (2012-2013 гг.) были включены 188 больных со стабильной формой ишемической болезни ИБС, подвергнутых плановым ЧКВ и получающих ДАТТ на протяжении 6-12 мес после вмешательства. Ретроспективно рассчитана балльная оценка по шкале DAPТ. Определение D-димера в образцах венозной крови проводилось методом иммуноферментного анализа накануне ЧКВ. Медиана периода проспективного наблюдения составила 651 день, минимальный период -23 дня, максимальный -1476 дней. Регистрировались тромботические осложнения (ТО): сердечно-сосудистая смерть, острый коронарный синдром, ишемический инсульт, транзиторная ишемическая атака, тромбоз периферических артерий, тромбоэмболия легочной артерии. ГО оценивали по классификации BARC (Bleeding Academic Research consortium, 2011). Результаты. За период наблюдения частота тромботических исходов и кровотечений (2-5-й тип по классификации BARC) составила 15,4 и 12,2% соответственно. Из всех больных, включенных в исследование, у 100 (53,2%) получена высокая оценка по шкале DAPT (≥2 баллов), у 88 (46,8%) -низкая (<2 баллов). Высокая оценка по шкале DAPT (≥2 баллов) ассоциировалась с увеличением шанса развития ТО в 3,12 раза (95% доверительный интервал 1,1-8,3; p=0,01). Уровень D-димера имел экспоненциальную зависимость от возраста обследованных больных. Высокий уровень D-димера (≥292 нг/мл для лиц моложе 65 лет, ≥610 нг/мл для лиц старше 65 лет) был связан с развитием ТО, риск которого увеличивался в 2,6 раза (95% ДИ от 1,0 до 6,9; р=0,04) после прекращения ДАТТ. Заключение. Пациенты со стабильной ИБС, подвергаемые ЧКВ, характеризуются высокой частотой развития ТО (15,4% за 2 года наблюдения). Предикторами ТО, возникающих после прекращения ДАТТ, являются высокая оценка по шкале DAPT (≥2 баллов) и высокий уровень D-димера. Aim. To study the association between DAPT score, haemostatic factor -D-dimer and prognosis of thrombotic and bleeding events in patients with stable coronary artery disease (CAD), receiving dual antiplatelet therapy (DAPT) after elective percutaneous coronary intervention (PCI). Маterial and methods. The study (2012-2013 years) included 188 patients with stable CAD after elective PCI on DAPT for 6-12 months after the procedure. Individual DAPT score was calculated in patients retrospectively. D-dimer level was assessed by ELISA method the day before PCI. The median of follow-up period was 651 days (min -23 days and max -1476 days). Registered thrombotic events: cardiovascular death, acute coronary syndrome, stroke/transien...

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Review of D‐dimer testing: Good, Bad, and Ugly

Cited by 226 publications

References 36 publications

D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study

D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study

Study on the Risk Factors of Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture

Prognostic significance of DAPT scale and D-Dimer level in patients treated with elective PCI

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