D-dimer Testing in Pulmonary Embolism with a Focus on Potential Pitfalls: A Narrative Review
Loris Wauthier,
Julien Favresse,
Michaël Hardy,
Jonathan Douxfils,
Grégoire Le Gal,
Pierre-Marie Roy,
Nick van Es,
Cihan Ay,
Hugo ten Cate,
Thierry Vander Borght,
Michaël V. Dupont,
Thomas Lecompte,
Giuseppe Lippi,
François Mullier
Affiliations
Loris Wauthier
Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium
Julien Favresse
Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium
Michaël Hardy
Namur Thrombosis and Hemostasis Center (NTHC), CHU UCL Namur, Université Catholique de Louvain, 5530 Yvoir, Belgium
Jonathan Douxfils
Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS), University of Namur, 5000 Namur, Belgium
Grégoire Le Gal
Department of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
Pierre-Marie Roy
Department of Emergency Medicine, CHU Angers, Institut MITOVASC, Equipe CARME, UMR CNRS 6015-INSERM 1083, UNIV Angers, F-CRIN INNOVTE, 49000 Angers, France
Nick van Es
Amsterdam Cardiovascular Sciences, Pulmonary Hypertension & Thrombosis, Amsterdam UMC Location Universiteit van Amsterdam, 1105 Amsterdam, The Netherlands
Cihan Ay
Clinicial Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
Hugo ten Cate
Department of Internal Medicine and Thrombosis Expertise Center, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
Thierry Vander Borght
Department of Nuclear Medicine, CHU UCL Namur, 5530 Yvoir, Belgium
Michaël V. Dupont
Department of Radiology, CHU UCL Namur, 5530 Yvoir, Belgium
Thomas Lecompte
Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS), University of Namur, 5000 Namur, Belgium
Giuseppe Lippi
Section of Clinical Biochemistry, University Hospital of Verona, 37134 Verona, Italy
François Mullier
Namur Thrombosis and Hemostasis Center (NTHC), CHU UCL Namur, Université Catholique de Louvain, 5530 Yvoir, Belgium
D-dimer is a multifaceted biomarker of concomitant activation of coagulation and fibrinolysis, which is routinely used for ruling out pulmonary embolism (PE) and/or deep vein thrombosis (DVT) combined with a clinical pretest probability assessment. The intended use of the tests depends largely on the assay used, and local guidance should be applied. D-dimer testing may suffer from diagnostic errors occurring throughout the pre-analytical, analytical, and post-analytical phases of the testing process. This review aims to provide an overview of D-dimer testing and its value in diagnosing PE and discusses the variables that may impact the quality of its laboratory assessment.
