<scp>d</scp>-Dimer and Venous Thromboembolism
Authors: Grégoire Le Gal, Marc Righini, Henri Bounameaux
Journal: Annals of Internal Medicine (2004)

Letters21 September 2004d-Dimer and Venous ThromboembolismGrégoire Le Gal, MD, Marc Righini, MD, and Henri Bounameaux, MDGrégoire Le Gal, MDFrom Geneva University Hospital, 1211 Geneva 14, Switzerland.Search for more papers by this author, Marc Righini, MDFrom Geneva University Hospital, 1211 Geneva 14, Switzerland.Search for more papers by this author, and Henri Bounameaux, MDFrom Geneva University Hospital, 1211 Geneva 14, Switzerland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-6-200409210-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the excellent review by Stein and colleagues (1), the sensitivity of d-dimer testing for the diagnosis of DVT appears to be lower than previously reported, even for ELISAs. In fact, plasma concentration of d-dimer is at least partly related to the volume of the thrombus (2). Hence, d-dimer level may not be increased in patients with isolated distal DVT. Indeed, some of the studies included in Stein and colleagues' meta-analysis included distal as well as proximal thromboses. For example, in the study by Leroyer and associates (3), in which a qualitative rapid ELISA was used, sensitivity ...References1. Stein PD, Hull RD, Patel KC, Olson RE, Ghali WA, Brant R, et al . d-Dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med. 2004;140:589-602. [PMID: 15096330] LinkGoogle Scholar2. Galle C, Papazyan JP, Miron MJ, Slosman D, Bounameaux H, Perrier A. Prediction of pulmonary embolism extent by clinical findings, D-dimer level and deep vein thrombosis shown by ultrasound. Thromb Haemost. 2001;86:1156-60. [PMID: 11816700] CrossrefMedlineGoogle Scholar3. Leroyer C, Escoffre M, Le Moigne E, Grimaux M, Cagnioncle O, Oger E, et al . Diagnostic value of a new sensitive membrane based technique for instantaneous D-dimer evaluation in patients with clinically suspected deep venous thrombosis. Thromb Haemost. 1997;77:637-40. [PMID: 9134634] CrossrefMedlineGoogle Scholar4. Perrier A, Desmarais S, Miron MJ, de Moerloose P, Lepage R, Slosman D, et al . Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet. 1999;353:190-5. [PMID: 9923874] CrossrefMedlineGoogle Scholar5. Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, et al . Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003;349:1227-35. [PMID: 14507948] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Geneva University Hospital, 1211 Geneva 14, Switzerland. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee Alsod-Dimer for the Exclusion of Acute Venous Thrombosis and Pulmonary Embolism Paul D. Stein , Russell D. Hull , Kalpesh C. Patel , Ronald E. Olson , William A. Ghali , Rollin Brant , Rita K. Biel , Vinay Bharadia , and Neeraj K. Kalra d-Dimer and Venous Thromboembolism John T. Philbrick , Steven Heim , and Joel M. Schectman d-Dimer and Venous Thromboembolism Fabio Puglisi and Edda Federico d-Dimer and Venous Thromboembolism Russell D. Hull , William A. Ghali , Rollin F. Brant , and Paul D. Stein d-Dimer and Venous Thromboembolism Stephen J. Wolf Metrics Cited ByAppropriate Use of Venous Imaging and Analysis of the D-Dimer/Clinical Probability Testing Paradigm in the Diagnosis and Location of Deep Venous ThrombosisAppropriate Use of d-Dimer Testing Can Minimize Over-Utilization of Venous Duplex Ultrasound in a Contemporary High-Volume Hospital 21 September 2004Volume 141, Issue 6Page: 481-482KeywordsAnticoagulant therapyAttentionBlood plasmaD-dimerEnzyme linked immunosorbent assayPatientsQualitative studiesThrombosisVenous thromboembolism ePublished: 21 September 2004 Issue Published: 21 September 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...