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D-Dimer levels in DVT, pulmonary embolism, stroke and pregnancy, DIC, infection

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    By Katherine Kozlowski, Medical Author and Contributor to Vein News and www.VeinsVeinsVeins.com 

    What is the D-Dimer? 

    D-dimers are fibrin degradation products.

    Are D-Dimer levels increased in venous thrombosis? 

    There is a lot of scientific information that shows that D-Dimer levels are increased in conditions such as venous thrombosis. Other vascular conditions in which D-Dimer levels are increased are pulmonary embolism, stroke, and disseminated intravascular coagulation (DIC). 

    What is the sensitivity of the D-Dimer test? 

    The sensitivity of the most commonly used quantitative assay is approximately 95%.

    What is sensitivity (a statistical term)? 

    A highly sensitive test means that there are few false negative results and therefore fewer cases of the disease are missed.

    What is the negative predictive value of the D-Dimer test? 

    The D-Dimer test has a negative predictive value exceeding 99 %.

    What is a negative predictive value (a statistical term)? 

    The negative predictive value is the probability that patients with a negative screening test, like the D-Dimer test, truly don't have the disease (e.g. DVT or pulmonary embolism). 

    Can the D-Dimer test be a false negative? 

    False-negative (normal D-Dimer measurement) can still occur, particularly in patients treated with anticoagulants, with calf DVT, or with symptoms lasting for longer than 2-3 weeks.

    What is a false negative test result?

    A false negative test result (e.g. negative D-Dimer test), which incorrectly indicates that a particular condition (e.g. DVT or pulmonary embolism), is absent. 

    Are there limitations to the D-Dimer test? 

    D dimer testing is limited by its low specificity, 35% - 50%. 

    What is specificity (statistical term)? 

    The specificity of a test is also called the True Negative Rate. It is the proportion of people without the disease who will have a negative result. This means that the specificity of a test refers to how well a test identified patients who do not have a disease (e.g DVT or pulmonary embolism).

    What are some conditions that yield increased D- Dimer levels?


    Heart failure




    Infection (e.g. Covid-19)


    Reference:  Kakos SK, Gohel M, Baekgaard N, Bauersachs R, Bellmunt-Montoya S, Black SA, ten Care-Hoek AJ, Elalamy I, Enzmann FK, Geroulakos G, Gottsater A, Hunt BJ, Mansiha A, Nicolaides AN, Sandset PM, Stansby G et al. European Society of for Vascular Surgery (ESVS)Clinical Practice Guidelines on the Management of Venous Thrombosis.  European Journal Vascular Endovascular Surgery 2021; 61: 9-62.