Widely Used Types and Clinical Applications of D-Dimer Assay

Abstract

D-dimers are formed by the breakdown of fibrinogen and fibrin during fibrinolysis. D-dimer analysis is critical for the diagnosis of deep vein thrombosis, pulmonary embolism, and disseminated intravascular coagulation. Modern assays for D-dimer are monoclonal antibody based. The enzyme-linked immunosorbent assay (ELISA) is the reference method for D-dimer analysis in the central clinical laboratory, but is time consuming to perform. Recently, a number of rapid, point-of-care D-dimer assays have been developed for acute care settings that utilize a variety of methodologies. In view of the diversity of D-dimer assays used in central laboratory and point-of-care settings, several caveats must be taken to assure the proper interpretation and clinical application of the results. These include consideration of preanalytical variables and interfering substances, as well as patient drug therapy and underlying disease. D-dimer assays should also be validated in clinical studies, have established cut-off values, and reported according to the reagent manufacturers recommendations.

Troponin I and <smlcap>D</smlcap>-Dimer for Discriminating Acute Pulmonary Thromboembolism from Myocardial Infarction

“…Latex-enhanced immunoturbidimetric assay is a cost-effective, rapid test that has analytical sensitivity comparable to conventional ELISA [9,10,11]. In this study, to measure D -dimer levels, a venous blood sample was placed into a test tube containing sodium citrate, and an immunoturbidimetric assay was performed using the Innovance D -dimer assay kit with a Sysmex CS 5100 analyzer (Siemens Medical Solutions, Malvern, Pa., USA).…”

Evaluation of D‐dimer levels in aqueous humor of rabbit eyes with and without induced intraocular fibrin and fibrinolytic treatment

“…Tissue plasminogen activator (t‐PA) is an enzyme, which is mainly produced by vascular endothelial cells . It converts plasminogen to plasmin and is the central protein in the fibrinolytic cascade .…”

“…It converts plasminogen to plasmin and is the central protein in the fibrinolytic cascade . Plasmin leads to lysis of fibrin clots into soluble degradation products like D‐dimers . While tissue plasminogen activator is physiologically found in many body tissues including the eye, the manufactured enzyme (alteplase) can be injected into the anterior chamber or vitreous to aid in fibrinolysis by converting plasminogen to plasmin within approximately 2 hours post‐injection .…”

“…As D‐dimers are the product of the degradation of cross‐linked fibrin, D‐dimer assays are commonly used to rule out venous thromboembolism for diagnostic and prognostic purposes in human patients with thromboembolic disease . D‐dimers are measurable in plasma of healthy people, presumably due to a certain degree of physiologic fibrinogen to fibrin conversion and further degradation to D‐dimers .…”

Assessment of regional fibrinolytic activity of tear fluid by determining the levels of D-dimer in patients with retinal vein occlusion

“…Современные исследования дают основа-ние полагать, что D-димер является уникаль-ным маркером деградации фибрина, и поэтому в последние годы определение его содержания в плазме крови становится важным диагности-ческим и прогностическим тестом диагностики и мониторинга тромбозов различной этиологии [4,21,22]. Концентрация D-димера позволяет судить как о тромбообразовании, так и о тром-болизисе независимо от локализации тромба, его объёма и причины образования.…”