Clinical Relevance

During plasma coagulation soluble fibrin is generated. By degradation of cross-linked fibrin, characteristic products called D-dimers are released. Increased D-Dimer levels indicate the activation of coagulation and fibrinolysis processes and is mainly used to exclude venous thrombic events (VTE) as deep vein thrombosis of the leg (DVT) and pulmonary embolism (PE).

Diagnostic Value of D-Dimer

  • Determination of D-dimer can be used to exclude a suspected DVT or PE with levels below a specific cutoff value
  • Since neither a reference method nor reference material are available, clinical studies are mandatory for cutoff definition
  • Several studies support the use of a cutoff value of 0.5 FEU µg/L
  • If D-dimer levels are above the cutoff value imaging techniques as sonograhpy or phlebography are mandatory for a definitive diagnosis of VTE
  • Specificity for DVT is variable and patient population dependent; adjusted cutoffs were suggested for e.g. elderly patients or for individuals with cancer