Update of D-dimer testing

D-dimer concentrations are elevated in a variety of clinical situations with hypercoagulability, such as venous thromboembolism (VTE), disseminated intravascular coagulation (DIC), ischemic cardiopathy, stroke, acute aortic dissection, malignomas, pregnancy, after surgery, traumas, and burns. D-dimer testing has become an essential tool for the diagnosis of VTE and pulmonary embolism because of its high negative predictive value, especially when used in conjunction with a clinical pretest score. D-dimer testing can be used for the diagnosis of DIC and other thrombotic diseases. It is also helpful for risk stratification in coronary artery disease, in first and recurrent thrombotic events, and for the timing of the duration of oral anticoagulation after a first episode of VTE. The use of D-dimer testing is limited in certain clinical conditions in which elevated D-dimer concentrations render the test unsuitable for the detection of acute thrombotic events.