D-dimer: Difference between revisions
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In [[medicine]], '''D-dimer''' is a [[fibrin degradation product]] after [[coagulation]]. | In [[medicine]], '''D-dimer''' is a [[fibrin degradation product]] after [[coagulation]]. | ||
[[Immunologic test]]s for d-dimer are generally use [[immunoassay]]s such as [[enzyme-linked immunosorbent assay]] or [[serologic test]]s such as [[agglutination test]]s. The [[immunoassay]] (more specifically, [[enzyme-linked immunosorbent assay]]) tend to be more [[sensitivity and specificity|sensitive]] while [[agglutination test]]s (such as the SimpliRED) tend to be more [[sensitivity and specificity|specific]].<ref name="pmid15096330">{{cite journal |author=Stein PD, Hull RD, Patel KC, ''et al.'' |title=D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review |journal=Ann. Intern. Med. |volume=140 |issue=8 |pages=589–602 |year=2004 |month=April |pmid=15096330 |doi= |url=http://www.annals.org/cgi/content/full/140/8/589 |issn=}}</ref> | [[Immunologic test]]s for d-dimer are generally use [[immunoassay]]s such as [[enzyme-linked immunosorbent assay]] or [[serologic test]]s such as [[agglutination test]]s. The [[immunoassay]]s (more specifically, [[enzyme-linked immunosorbent assay]]) tend to be more [[sensitivity and specificity|sensitive]] while [[agglutination test]]s (such as the SimpliRED) tend to be more [[sensitivity and specificity|specific]].<ref name="pmid15096330">{{cite journal |author=Stein PD, Hull RD, Patel KC, ''et al.'' |title=D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review |journal=Ann. Intern. Med. |volume=140 |issue=8 |pages=589–602 |year=2004 |month=April |pmid=15096330 |doi= |url=http://www.annals.org/cgi/content/full/140/8/589 |issn=}}</ref> | ||
{| class="wikitable" align="right" | |||
|+ D-dimer tests<ref name="pmid15096330"/> | |||
! !! [[sensitivity and specificity|sensitivity]]!! [[sensitivity and specificity|specificity]] | |||
|- | |||
| colspan="3" align="center"|[[Immunoassay]]s | |||
|- | |||
| [[Enzyme-linked immunosorbent assay|Elisa]]<br> VIDAS™|| 96%<br>96%<ref name="pmid17155963"/>|| 51%<br>44%<ref name="pmid17155963"/> | |||
|- | |||
| colspan="3" align="center"|[[Agglutination test]]s | |||
|- | |||
| [[Latex fixation test|Latex agglutination]]<br> Tinaquant™||94%<br>82%<ref name="pmid17155963"/>|| 50%<br>82%<ref name="pmid17155963"/> | |||
|- | |||
| Whole blood [[hemagglutination test]]<br> SimpliRED™|| 83%<br>86%<ref name="pmid17155963"/>|| 64%<br>70%<ref name="pmid17155963"/> | |||
|} | |||
==Using D-dimer to determine duration of anticoagulation treatment== | ==Using D-dimer to determine duration of anticoagulation treatment== | ||
Revision as of 10:17, 14 August 2009
In medicine, D-dimer is a fibrin degradation product after coagulation.
Immunologic tests for d-dimer are generally use immunoassays such as enzyme-linked immunosorbent assay or serologic tests such as agglutination tests. The immunoassays (more specifically, enzyme-linked immunosorbent assay) tend to be more sensitive while agglutination tests (such as the SimpliRED) tend to be more specific.[1]
| sensitivity | specificity | |
|---|---|---|
| Immunoassays | ||
| Elisa VIDAS™ |
96% 96%[2] |
51% 44%[2] |
| Agglutination tests | ||
| Latex agglutination Tinaquant™ |
94% 82%[2] |
50% 82%[2] |
| Whole blood hemagglutination test SimpliRED™ |
83% 86%[2] |
64% 70%[2] |
Using D-dimer to determine duration of anticoagulation treatment
An abnormal D-dimer level at the end of treatment might signal the need for continued anticoagulation with warfarin among patients with embolism and thrombosis such as a first unprovoked pulmonary embolism. If the D-dimer is abnormal, anticoaguation should be continued, if the D-dimer is normal, the duration of treatment is uncertain.[3] In an observation study that collected the D-dimer before stopping anticoagulation, the D-dimer was not as predictive.[4]
Screening for deep venous thrombosis
References
- ↑ 1.0 1.1 Stein PD, Hull RD, Patel KC, et al. (April 2004). "D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review". Ann. Intern. Med. 140 (8): 589–602. PMID 15096330. [e]
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Cite error: Invalid
<ref>tag; no text was provided for refs namedpmid17155963 - ↑ Palareti G, Cosmi B, Legnani C, et al (2006). "D-dimer testing to determine the duration of anticoagulation therapy". N. Engl. J. Med. 355 (17): 1780-9. DOI:10.1056/NEJMoa054444. PMID 17065639. Research Blogging.
- ↑ Rodger MA, Kahn SR, Wells PS, Anderson DA, Chagnon I, Le Gal G, et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ. 2008 Aug 26;179(5):417-426.