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D-dimer (or D dimer) is a dimer that is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two D fragments of the fibrin protein joined by a cross-link , hence forming a protein dimer .
The purpose of the rule is to select the best method of investigation (e.g. D-dimer testing, CT angiography) for ruling in or ruling out the diagnosis of PE, and to improve the interpretation and accuracy of subsequent testing, based on a Bayesian framework for the probability of the diagnosis.
Principles of D-dimer testing. Fibrin degradation products (FDPs), also known as fibrin split products, are components of the blood produced by clot degeneration. [1] Clotting, also called coagulation, at the wound site produces a mass of fibrin threads called a net that remains in place until the cut is healed. As a cut heals, the clotting ...
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D-dimer is highly sensitive but not specific (specificity around 50%). In other words, a positive D-dimer is not synonymous with PE, but a negative D-dimer is, with a good degree of certainty, an indication of absence of a PE. [52] A low pretest probability is also valuable in ruling out PE. [53]
In people without a detectable thrombophilia, the cumulative risk of developing thrombosis by the age of 60 is about 12%. About 60% of people who are deficient in antithrombin will have experienced thrombosis at least once by age 60, as will about 50% of people with protein C deficiency and about a third of those with protein S deficiency.
Pregnancy is associated with an increase in fibrinogen and D-dimer levels, so this test is less useful. This should probably be mentioned in the diagnosis section. I've heard of age-adjusted D-dimer levels in the workup of PE, but I don't recall ever seeing that applied to DVT. Biosthmors 17:52, 25 May 2021 (UTC)
Findings may include low platelets, low fibrinogen, high INR, or high D-dimer. [2] Treatment is mainly directed towards the underlying condition. [2] [3] Other measures may include giving platelets, cryoprecipitate, or fresh frozen plasma. [2] Evidence to support these treatments, however, is poor. [2] Heparin may be useful in the slowly ...
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