D-dimer: An Overview of Hemostasis and Fibrinolysis, Assays, and Clinical Applications

John D Olson

Research output: Chapter in Book/Report/Conference proceedingChapter

43 Scopus citations

Abstract

D-dimer is the smallest fibrinolysis-specific degradation product found in the circulation. The origins, assays, and clinical use of D-dimer will be addressed. Hemostasis (platelet and vascular function, coagulation, fibrinolysis, hemostasis) is briefly reviewed. D-dimer assays are reviewed. The D-dimer is very sensitive to intravascular thrombus and may be markedly elevated in disseminated intravascular coagulation, acute aortic dissection, and pulmonary embolus. Because of its exquisite sensitivity, negative tests are useful in the exclusion venous thromboembolism. Elevations occur in normal pregnancy, rising two- to fourfold by delivery. D-dimer also rises with age, limiting its use in those >. 80 years old. There is a variable rise in D-dimer in active malignancy and indicates increased thrombosis risk in active disease. Elevated D-dimer following anticoagulation for a thrombotic event indicates increased risk of recurrent thrombosis. These and other issues are addressed.

Original languageEnglish (US)
Title of host publicationAdvances in Clinical Chemistry
PublisherAcademic Press Inc.
Pages1-46
Number of pages46
Volume69
ISBN (Print)9780128022658
DOIs
StatePublished - 2015

Publication series

NameAdvances in Clinical Chemistry
Volume69
ISSN (Print)00652423

Keywords

  • D-dimer
  • Deep venous thrombosis
  • Disseminated intravascular coagulation
  • Fibrinolysis
  • Pulmonary embolus

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Chemistry(all)

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