Role of fibrin D-dimer testing in emergency medicine. Issue 4 (1st July 2003)

• Record Type: Journal Article
• Authors: Wakai, A; Gleeson, A; Winter, D
• Is Part Of: Emergency medicine journal. Volume 20:Issue 4(2003)
• Page Start: 319
• Page End: 325
• Publication Date: 2003-07-01
• Subjects: D-dimer; DD, D-dimer -- VTE, venous thromboembolism -- tPA, tissue plasminogen activator -- XL-Fg, crosslinked fibrin -- FDP, fibrin degradation product -- ELISA, enzyme linked immunosorbent assay -- HMW, high molecular weight -- LMW, low molecular weight -- FACT, Fibrin Assay Comparison Trial -- CT, computed tomography -- PE, pulmonary embolism -- DVT, deep vein thrombosis -- PTP, pretest probability -- CHD, coronary heart disease -- ACS, acute coronary syndrome -- MI, myocardial infarction; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emj.20.4.319
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Objectives: Systemic values of the fibrinolytic plasma marker fibrin D -dimer are raised in a variety of acute clinical conditions. D -dimer values can now be rapidly determined and used to aid diagnosis in emergency medicine. However, despite clinical guidelines, inappropriate and unnecessary measurement of D -dimer values is a significant clinical problem. An understanding of the pathophysiological basis and limitations of the value of D -dimer values may help reduce this problem. This review discusses the pathophysiology of the fibrinolytic system. The currently used assays, clinical indications, and limitations of D -dimer measurement are reviewed. Finally, the potential future clinical indications for measurement of D -dimer values in emergency medicine are discussed. Methods: Literature on D -dimer was identified from Medline, along with cross referencing from the reference lists of major articles on the subject Results and conclusions: Systemic D -dimer values aids diagnosis, and is potentially a prognostic indicator, in a variety of clinical conditions in emergency medicine. However, it has limited specificity in patients with comorbid conditions. Although, currently, there is no standard D -dimer assay, immunoturbidimetric assays are the most suitable for use in emergency medicine