Key result
High-sensitivity D-dimer testing can rule out pulmonary embolism in approximately 30% of suspected non-high risk cases, and negative tests identify patients with low risk of recurrence.
Why the study?
Does high sensitive D-dimer testing rule out pulmonary embolism in suspected non-high risk patients and estimate risk of recurrence after anticoagulant withdrawal?
Does high sensitive D-dimer testing rule out pulmonary embolism in suspected non-high risk patients and estimate risk of recurrence after anticoagulant withdrawal?
High sensitive D-dimer testing is a crucial tool for ruling out non-high risk pulmonary embolism and assessing recurrence risk after anticoagulant withdrawal, though its specificity is limited in certain populations.
May inform PE diagnostic strategies; leaves open need for prospective validation of recurrence estimates.
D-dimer level estimation, specific fibrin degradation product, is a permanent part of diagnostic strategies of pulmonary embolism (PE). Approximately 30% of a suspected non-high risk PE can be ruled out with high sensitive D-dimer test when pre-test clinical probability is non-high. Recent guidelines underline that only very sensitive DD assays can be used. The main limitation of DD tests is relatively low specificity especially in hospitalized population, in elder patients, with cancer and in pregnancy. New indication for DD test mentioned in current guidelines is estimation of risk of recurrence after withdrawal of anticoagulant. Negative DD test identify patients with low risk of recurrence.
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Anna Fijałkowska (2009) conducted a review in Pulmonary embolism. D-dimer testing was evaluated. High-sensitivity D-dimer testing can rule out pulmonary embolism in approximately 30% of suspected non-high risk cases, and negative tests identify patients with low risk of recurrence.
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