The Role of the D-Dimer in the Diagnosis of Venous Thromboembolism

Classic enzyme-linked immunosorbent assay (ELISA) D-dimer assays are sensitive in screening for thromboembolic disease; however, they are cumbersome and time consuming to perform, which limits their routine use. Latex agglutination assays are easier to perform, but they are not as sensitive as the ELISA assays. New D-dimer assays incorporating novel technologies can be performed rapidly with a sensitivity approaching that of classic ELISA assays. D-dimer assays are uniformly sensitive in detecting thromboembolic disease in different patient populations; however, low specificity limits the clinical utility of D-dimer measurements in medical inpatients and postoperative patients. Increasingly, these measurements are being incorporated into diagnostic algorithms for venous thromboembolism and are reducing the need for invasive diagnostic studies.