D-Dimers in diagnosis and prevention of venous thrombosis: recent advances and their practical implications.
Pol Arch Intern Med
; 133(11)2023 11 29.
Article
em En
| MEDLINE
| ID: mdl-37965939
ABSTRACT
DDimers derive from degradation of crosslinked fibrin by plasmin, and thus their level is a marker of coagulation and fibrinolytic system activation. Guidelines recommend that Ddimers are determined if the pretest probability (PTP) is low or intermediate, to exclude venous thromboembolism (VTE), either deep vein thrombosis or pulmonary embolism, and to avoid imaging tests. If the PTP is high or Ddimer level is above the suggested thresholds, imaging is recommended. DDimer assays offer high sensitivity and low specificity, as Ddimer levels can be above the threshold in several other conditions than thrombosis, and they increase with age. As a result, there have been several proposals to improve the diagnostic accuracy of Ddimer levels by adjusting the cutoffs according to patient characteristics, such as age, PTP, pregnancy, renal function, or cancer. DDimer levels can also predict clinical severity of COVID19, and escalated anticoagulation based on Ddimer levels can be associated with a lower risk of mortality in patients with severe COVID19. Finally, Ddimer levels have been incorporated in prediction models for recurrent VTE to help identify patients who may benefit from prolonged anticoagulation.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
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2_ODS3
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4_TD
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6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Embolia Pulmonar
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Trombose Venosa
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Tromboembolia Venosa
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COVID-19
Limite:
Humans
Idioma:
En
Revista:
Pol Arch Intern Med
Ano de publicação:
2023
Tipo de documento:
Article