D-dimer Testing in Pulmonary Embolism with a Focus on Potential Pitfalls: A Narrative Review
Loris Wauthier, Julien Favresse, Michaël Hardy, Jonathan Douxfils, Grégoire Le Gal, Pierre‐Marie Roy, Nick van Es, Cihan Ay, Hugo Ten Cate, Thierry Vander Borght, Michaël Dupont, Thomas Lecompte, Giuseppe Lippi, François Mullier
Abstract
D-dimer is a multifaceted biomarker of concomitant activation of coagulation and fibrinolysis, which is routinely used for ruling out pulmonary embolism (PE) and/or deep vein thrombosis (DVT) combined with a clinical pretest probability assessment. The intended use of the tests depends largely on the assay used, and local guidance should be applied. D-dimer testing may suffer from diagnostic errors occurring throughout the pre-analytical, analytical, and post-analytical phases of the testing process. This review aims to provide an overview of D-dimer testing and its value in diagnosing PE and discusses the variables that may impact the quality of its laboratory assessment.