Zeitschrift für Hämatologie und thromboembolische Erkrankungen
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Abstrakt

D-Dimer Specificity for the Diagnosis of Acute Symptomatic Pulmonary Embolism

Vicente Gomez, Javier de Miguel-Diez, Ana Karina Portillo, Rosa Nieto, Leticia Garcia3 and David Jimenez Castro

Introduction: D-dimer is present in elevated levels with different diseases. In this study we aimed to determine if a high D-dimer cut-off value might increase its specificity for the diagnosis of venous thromboembolism.

Materials and methods: Retrospective analysis was carried out on 136 patients with a D-dimer value ≥ 8000 ng/ml.

Results: 53 were diagnosed of VTE by objective methods (40%), and 65 were excluded from VTE diagnosis (49%). The final diagnoses for the patients excluded from VTE were: infections (n=23), cardiovascular diseases (n=14), fractures/traumas (n=12), disseminated malignancy (n=5), brain disease (n=5), and others (n=6). 30 patients died whilst hospitalized (23%). There were 6 deaths among the patients diagnosed with VTE (11%) and 20 among the patients excluded from VTE (31%) (p<0.01).

Conclusions: A D-dimer threshold >8000 ng/mL is not specific to diagnose VTE. Patients with a D-dimer value >8000 ng/mL have a significantly worse prognosis when VTE is excluded by objective methods.