D-dimer is a protein fragment that is formed when a blood clot that occurs during blood clotting dissolves. It is a marker of thrombus formation, since in this process, together with the occurrence of thrombi, their dissolution is triggered with the formation of D-dimers.
The main diagnostic value of the D-dimer is its high (98%) negative predictive value - normal levels make it possible to exclude thrombosis. Thanks to these diagnostic capabilities of the test, it is included in the algorithms for diagnosing such a fatal condition as pulmonary embolism (PE), allowing PE to be excluded in case of negative results.
When is the study scheduled?
For symptoms of deep vein thrombosis:
severe pain in the legs (leg),
severe edema of the legs (legs),
pallor of the skin in the area of thrombosis.
If pulmonary thromboembolism is suspected:
sudden shortness of breath
hemoptysis (blood in sputum),
sharp pain in the chest,
increased heart rate.
With DIC, when the following symptoms occur against the background of the underlying disease:
cyanosis of the skin,
severe pain in the muscles and abdomen,
pain in the region of the heart,
When monitoring anticoagulant therapy
What exactly is determined during the analysis?
The amount of D-dimer in blood plasma is determined by the method of immunochemiluminescence analysis.
What do the test results mean?
A normal (within the reference values) result of the D-dimer indicates that the person who passed this test most likely does not have an acute condition associated with increased formation and disintegration of fibrin thrombi. This indicator has a negative prognostic value: with a normal D-dimer, the probability of thrombosis is low, with an increased one, additional examination of the patient is required.
An elevated D-dimer does not always indicate the presence of thrombus formation, because a number of other factors can lead to an increase in the level of D-dimer in the blood:
recent surgery (early postoperative period)
The D-dimer is highly sensitive but lacks specificity and should only be used to rule out thrombosis and not to confirm the diagnosis.
A moderate increase in D-dimer concentration is often observed with:
injuries (not extensive),
normal pregnancy, especially in the later stages.
How to properly prepare for the study?
Eliminate fatty foods from the diet 24 hours before the study.
Eliminate physical and emotional stress 30 minutes before the study.
Do not smoke for 30 minutes prior to examination.
The D-dimer concentration may be elevated in the elderly as well as in patients with high rheumatoid factor levels in rheumatoid arthritis.
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