Clinical Utility of D-Dimer for Rule-Out or Rule-In of Venous Thromboembolism in Syncope

J Cardiovasc Transl Res. 2023 Apr;16(2):427-429. doi: 10.1007/s12265-022-10306-0. Epub 2022 Aug 30.

Abstract

Fig. 1 Diagnostic performance of D-dimer using two different assays in patients presenting with syncope. A Left: Receiver-operating characteristic curves quantifying the diagnostic performance of Innovance® D-dimer (blue) and hs-Loci-Innovance® D-dimer (red) for the diagnosis of venous thromboembolism (VTE). Right: Clinical application of D-dimer using the 2-level Wells-score with age-adjusted1 or fixed cutoffs versus the YEARS-algorithm with probability-adjusted cut offs2. B Left: Specificity for different cufoffs of Innovance® D-dimer (blue) and hs-Loci-Innovance® D-dimer (red) for the diagnosis of venous thromboembolism (VTE). Right: Percentage of patients ruled-in and correctly identified VTE patients for different cutoffs of Innovance® D-dimer (blue) and hs-Loci-Innovance® D-dimer (red). 1In patients 50 years or younger, D-dimer concentration < 0.5 mg/l was considered negative. For patients older than 50 years, we used the formula: age in years divided by 100. 2YEARS-algorithm: assessment of only three items from the Wells-score (clinical signs of deep vein thrombosis, hemoptysis, pulmonary embolism the most likely diagnosis) and using a D-dimer test threshold of 0.5 mg/l in presence, and 1.0 mg/l in absence of one of the YEARS-items.

Keywords: Diagnostic testing; Pulmonary embolism; Syncope.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fibrin Fibrinogen Degradation Products
  • Humans
  • Infant
  • Pulmonary Embolism* / diagnosis
  • Syncope
  • Venous Thromboembolism* / diagnosis

Substances

  • fibrin fragment D
  • Fibrin Fibrinogen Degradation Products