During the process of degradation of fibrin clot under the influence of plasmin there will be generated fragments containing D-dimer. D-dimers are thus considered a marker of the over coagulation state and endogenous fibrinolysis, increased levels being recorded in patients affected by thrombosis.
D-dimers are more specific to fibrinolysis than fibrin degradation products and byproducts which also detects direct proteolysis of the fibronogen (fibrinogenolysis) products.
-the test has negative predictive value for lower limb deep vein thrombosis and pulmonary thromboembolism in that a negative result in patients suspected of these conditions exclude their presence at a rate of> 90%. D-dimer plasma levels progressively increase during pregnancy and have a poor predictive value in excluding the diagnosis of deep vein thrombosis after 20 weeks gestation. During labor D-dimers usually increase a lot, then decrease rapidly 3 days post-partum and slowly return to normal after about 4 weeks. D-dimer is a sensitive marker for disseminated intravascular coagulation (DIC) and is recommended for confirmation / refutation of a suspected diagnosis, estimation of potential risk in patients with existing CID and for monitoring the initial therapy .
-test may be useful for monitoring the degree of clot lysis during thrombolytic therapy;
-Determining D-dimer is a useful analysis in the investigation of patients with suspected acute aortic dissection.
-a single determination of D-dimer has an important predictive value in terms of survival in the next 2 years for patients with chronic atrial fibrillation. It can also help in choosing a more sustained therapy in patients with elevated baseline levels of DD.
-it has been found that DD is an independent risk factor for cardiovascular mortality that can be used to stratify into risk groups those patients with heart failure.
D-dimers with other thrombotic factors may be potential risk factors for coronary artery disease.
-DD Were identified as markers for thrombophilia also be useful in the investigation of patients subclinical primary or secondary with unexplained infertility and thrombophilia.
-DD shows high levels in breast cancer patients according to tumor stage, lymph node metastasis is useful in identifying patients with operable breast cancer.
After bleeding , the blood will be immediately put in the centrifuge to separate plasma and will be interpreted very fast. If this is not possible, the plasma can be stored at -20 ° C.
Normal values - <0.5 mg / mL FEU.
Increases in D-dimers are associated with: CID (secondary fibrinolysis); arterial or venous thrombosis; renal or hepatic impairment; pulmonary embolism; preeclampsia; myocardial infarction; tumors; inflammation; severe infections; tissue plasminogen activator therapy. Elevated DD can be found in normal pregnancy, estrogen therapy, oral contraceptives, the elderly, trauma and stress after surgery.