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What is D-Dimer?
Blood clots primarily help prevent bleeding caused by injuries. If injury to blood vessels occurs, a cascade of events starts, forming a gel-like structure made up of fibrin filaments. These fibrin filaments attach to each other with the help of D domains. This structure helps attract and fix platelets forming the clot/thrombus1,2.
As the healing process starts, this structure degrades, resulting in the circulating fibrin degradation products (FDP). D-Dimer, one of the types of FDP, is normally not present in the circulation, and thus its detection indicates the formation of clots.
D- Dimer is one of the tests that have gained significant importance lately. It is one of the reliable ways to predict the risk of clot formation. However, blood coagulation is widely engaged in many biological events in human body, so elevated D-Dimer can be caused by various reasons. Here are some common reasons of abnormal D-Dimer level.
Elevated D-Dimer: Diseases & symptoms
D-Dimer is often employed as screening test for deep vein thrombosis (DVT). The test is important because, in many cases, there are no symptoms of DVT. DVT may occur due to surgery, trauma, long periods of bed rest, cancer, and other reasons. In addition, some individuals may develop symptoms like swelling of ankles, thighs, or other parts of the body where DVT has occurred4.
One of the more severe conditions requiring early thrombus detection is pulmonary embolism (PE). PE may occur due to clot formation in the lungs’ blood vessels. This blockage of blood flow to the parts of the lungs may cause a pulmonary infarction, resulting in the death of part of lung tissues. PE produces symptoms like chest pain, dizziness, and fainting5.
PE often occurs when the DVT is dislodged from its site. Thus, PE is often a complication of DVT. Ultimately, early detection of DVT may help prevent PE.
Another and perhaps even more important use of the D-Dimer test is the early detection of disseminated intravascular coagulopathy (DIC). It is a life-threatening complication of severe infections. DIC causes the formation of small clots throughout the body, which causes widespread organ damage. It often occurs due to dysfunction of clot formation pathways caused by severe inflammation. D-Dimer may help in the early detection of DIC. The early initiation of therapy could be lifesaving6.
Here it is vital to understand that D-Dimer does not help diagnose these conditions. However, its absence helps exclude the specific conditions. Further, it may help in the early detection of DVT or DIC in high-risk individuals.
Examination/Treatment
If DVT is considered, there would be a need to determine the location of thrombus formation. It is generally done with the help of non-invasive vascular scans. Other tests could be checking the local tissue perfusion.
If D-Dimer is detected, blood thinning agents may help prevent clot formation. For decades drugs like warfarin have remained the mainstay of such a treatment. However, newer agents like rivaroxaban and apixaban are now preferred over warfarin due to better safety profiles7.
Importance of D-Dimer in COVID-19 prognosis
D-Dimer has gained significant importance in the ongoing COVID-19 pandemic because COVID-19 often causes hyper inflammation called a cytokine storm. This cytokine storm often leads to DIC, resulting in fatal outcomes8.
Elevated D-Dimer test in COVID-19 patients at the time of hospital admission is often associated with greater mortality9. Besides, the D-Dimer test is one of the most vital tests in severe cases of COVID-19. Moreover, its detection may help make the right therapeutic decisions, helping reduce COVID-19 related mortality.
Wondfo D-Dimer Rapid Quantitative Test
Wondfo D-Dimer Rapid quantitative test provides a fast and reliable way to know about the levels of D-Dimer. It gives results in merely 5 minutes so that life-saving therapy can be initiated at the earliest. Furthermore, considering that the test is rapid, it allows almost real-time monitoring of the patient’s status.
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