Abstract
D-dimer is a soluble fibrin degradation product, which is formed by the breakdown of cross-linked fibrin monomers, previously created under thrombin activity, formed as a result of hemostatic activation. The degradation of cross-linked fibrin occurs as part of the activation of the fibrinolysis system, whose task is to remove the created coagulum and ensure the patency of the blood vessel. This process takes place under the influence of the most important fibrinolytic enzyme, plasmin. D-dimer can, therefore be considered a biomarker of coagulation activation and fibrinolysis, and is routinely used to rule out venous thromboembolism (VTE). D-dimer is increasingly used to assess the risk of VTE recurrence and to help define the optimal duration of anticoagulant therapy in the treatment of patients with VTE, to diagnose disseminated intravascular coagulation (DIC), to screen medical patients at increased risk of VTE. In particular, the use of D-dimer, which is sometimes unjustifiably high, should be emphasized, as part of the monitoring and treatment of patients with COVID-19 infection. This review article aims to: (1) define the origin and role of D-dimer in the hemostatic system, (2) the method of performing the analysis, the selection of adequate tests and interpretation in accordance with the consideration of possible preanalytical variables that affect the measurement of D-dimer; (3) consideration of its application in specific clinical settings or diseases.
Publisher
Centre for Evaluation in Education and Science (CEON/CEES)
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