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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 .
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 ...
The diagnosis of hyperfibrinolysis is made indirectly with immunochemical methods which detect the elevation of biomarkers such as D-Dimer (cross-linked fibrin degradation products), fibrinogen split products (FSP), complexes of plasmin and alpha-2-antiplasmin (PAP).
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FDPs compete with thrombin, and thus slow down clot formation by preventing the conversion of fibrinogen to fibrin. This effect can be seen in the thrombin clotting time (TCT) test, which is prolonged in a person that has active fibrinolysis. Antibody-antigen technology can measure FDPs and a specific FDP, the D-dimer. This is more specific ...
A D-dimer test can also be used to assist with excluding the diagnosis or to signal a need for further testing. [5] Diagnosis is most commonly confirmed by ultrasound of the suspected veins. [5] VTE becomes much more common with age. The condition is rare in children, but occurs in almost 1% of those ≥ age 85 annually. [3]
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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]