D-Dimer testing: the role of the clinical laboratory in the diagnosis of pulmonary embolism

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Abstract
Pulmonary embolism is a common, yet often unsuspected and unrecognised disease associated with a high mortality. New, objective, “user friendly” and cost effective diagnostic strategies are being explored. D-Dimers, the fibrinolytic degradation products of crosslinked fibrin, have emerged as the most useful of the procoagulant activity and ongoing fibrinolysis markers. D-Dimer measurements are very sensitive in excluding a diagnosis of pulmonary embolism in the setting of normal values, a low clinical suspicion, and non-diagnostic lung scans. Several assays have been developed and are reviewed.