D-dimer in diagnosis and treatment of pulmonary embolism

Abstract

D-dimer level estimation, specific fibrin degradation product, is a permanent part of diagnostic strategies of pulmonary embolism (PE). Approximately 30% of a suspected non-high risk PE can be ruled out with high sensitive D-dimer test when pre-test clinical probability is non-high. Recent guidelines underline that only very sensitive DD assays can be used. The main limitation of DD tests is relatively low specificity especially in hospitalized population, in elder patients, with cancer and in pregnancy. New indication for DD test mentioned in current guidelines is estimation of risk of recurrence after withdrawal of anticoagulant. Negative DD test identify patients with low risk of recurrence.