title: How to use D-dimer in acute cardiovascular care.
abstract: D-dimer testing is important to aid in the exclusion of venous thromboembolic events (VTEs), including deep venous thrombosis and pulmonary embolism, and it may be used to evaluate suspected aortic dissection. D-dimer is produced upon activation of the coagulation system with the generation and subsequent degradation of cross-linked fibrin by plasmin. Many different assays for D-dimer testing are currently used in routine care. However, these tests are neither standardized nor harmonized. Consequently, only clinically validated assays and assay specific decision limits should be used for routine testing. For the exclusion of pulmonary embolism/deep vein thrombosis, age-adjusted cut-offs are recommend. Clinicians must be aware of the validated use of their hospital's D-dimer assay to avoid inappropriate use of this biomarker in routine care.
authors.affiliation: 1 Department of Cardiology, University Heidelberg, Germany.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.affiliation: 2 Department of Internal Medicine III, Medical University Innsbruck, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Mair
authors.affiliation: 3 Cardiology, Uppsala University, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Christersson
authors.affiliation: 4 Clinical Chemistry, Uppsala University, Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Siegbahn
authors.affiliation: 5 Department of Medicine, Wilhelminen Hospital, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.affiliation: 6 Mayo Clinic, USA.
authors.forename: Allan S
authors.initials: AS
authors.lastname: Jaffe
authors.affiliation: 7 Emergency Medicine, Baylor College of Medicine, Texas.
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.affiliation: 8 Department of Laboratory Medicine, University Hospital, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.affiliation: 9 Department of Cardiology, Aarhus University Hospital, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Thygesen
authors.affiliation: 10 Division of Emergency Medicine, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Möckel
authors.affiliation: 11 Department of Cardiology, University Hospital Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
authors.affiliation: 12 Department of Medical Sciences, Uppsala University, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Lindahl
mesh_terms: D000465:Algorithms; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D019095:Point-of-Care Systems; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000378:metabolism; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: D-dimer; acute cardiovascular care; pulmonary embolism; thrombosis