D-dimer
proteinD-dimer indicates active coagulation and thrombus formation during acute coronary events.
Pathway placement
Cascade stepCoagulation & thrombus formation
Confidencehigh
RationaleAnchor molecule; fibrin turnover and thrombus formation marker in AMI.
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresType-II-associated
R — rupture / Type-I—
C — confounder / Type-II67
A — assay feasibility96
E — evidence strength63
T1DI (composite)15
Specificity differential (R−C)-52
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 3
2anemia / acute blood lossmag 2
3hypovolemia / dehydrationmag 1
4tachyarrhythmiamag 2
5hypoxemia / respiratory failuremag 2
6hypertensive emergencymag 1
7high-demand / peri-operative stressmag 3
Coverage: 7/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 21 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Platelet-poor plasma
Collection tube
Sodium citrate 3.2% (light blue-top)
Method / principle
Immunoturbidimetric (latex) or ELISA; POC immunofiltration
Reagent / substrate
Monoclonal anti-D-dimer (neoepitope) antibody-latex
Platform
Coagulation analyzer; POC
Turnaround · availability
STAT · FDA-cleared
Literature evidence(60)
- Plasma fibrin clot properties in atopic dermatitis: links between thrombosis and atopy.Journal of thrombosis and thrombolysis · 2010 · PMID 20419337 · doi
- A timely diagnosis of myocardial infarction.Biomarkers in medicine · 2010 · PMID 20550472 · doi
- Evaluation of D-dimer in the diagnosis of suspected aortic dissection.Clinical chemistry and laboratory medicine · 2010 · PMID 20704542 · doi
- Effect of apixaban, an oral and direct factor Xa inhibitor, on coagulation activity biomarkers following acute coronary syndrome.Thrombosis and haemostasis · 2010 · PMID 20806117 · doi
- Circulating inflammatory and hemostatic biomarkers are associated with risk of myocardial infarction and coronary death, but not angina pectoris, in older men.Journal of thrombosis and haemostasis : JTH · 2009 · PMID 19682232 · doi
- Plasma soluble fibrin monomer complex as a marker of coronary thrombotic events in patients with acute myocardial infarction.The Tohoku journal of experimental medicine · 2009 · PMID 19713681 · doi
- Contribution of novel biomarkers to incident stable angina and acute coronary syndrome: the PRIME Study.European heart journal · 2008 · PMID 18621771 · doi
- Characterization of the pro-thrombotic state in CAPD patients.Renal failure · 2008 · PMID 18661409 · doi
- The prognostic utility of D-dimer and fibrin monomer at long-term follow-up after hospitalization with coronary chest pain.Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis · 2008 · PMID 18832914 · doi
- Early decrease in coagulation activity after myocardial infarction is associated with lower risk of new ischaemic events: observations from the ESTEEM Trial.European heart journal · 2007 · PMID 17314111 · doi
- Fibrinolysis in patients with an abdominal aortic aneurysm with special emphasis on rupture and shock.Journal of thrombosis and haemostasis : JTH · 2007 · PMID 17922806 · doi
- A multimarker risk stratification approach to non-ST elevation acute coronary syndrome: implications of troponin T, CRP, NT pro-BNP and fibrin D-dimer levels.Journal of internal medicine · 2007 · PMID 17986200 · doi
- Do plasma biomarkers of coagulation and fibrinolysis differ between patients who have experienced an acute myocardial infarction versus stable exertional angina?American heart journal · 2007 · PMID 18035075 · doi
- Assessment of markers of thrombin generation in patients with acute myocardial infarction complicated by ventricular fibrillation.Clinical cardiology · 2006 · PMID 16649726 · doi
- Plasma markers of activated hemostasis in the early diagnosis of acute coronary syndromes.Clinica chimica acta; international journal of clinical chemistry · 2006 · PMID 16696962 · doi
- Activated coagulation during open and endovascular abdominal aortic aneurysm repair.Journal of vascular surgery · 2006 · PMID 16765226 · doi
- Tissue plasminogen activator antigen is strongly associated with myocardial infarction in young women.Journal of thrombosis and haemostasis : JTH · 2005 · PMID 15670033 · doi
- Evaluation and management of the acutely dyspneic patient: the role of biomarkers.The American journal of emergency medicine · 2005 · PMID 15915417 · doi
- Tissue factor pathway inhibitor, natural coagulation inhibitors and hemostatic activation markers in patients with acute coronary syndromes.Saudi medical journal · 2005 · PMID 15983678
- Long-term treatment with ximelagatran, an oral direct thrombin inhibitor, persistently reduces the coagulation activity after a myocardial infarction.Journal of thrombosis and haemostasis : JTH · 2005 · PMID 16194202 · doi
- Association between early postoperative coagulation activation and peri-operative myocardial ischaemia in patients undergoing vascular surgery.Anaesthesia · 2005 · PMID 16288612 · doi
- Increased levels of soluble tissue factor during long-term treatment with warfarin in patients after an acute myocardial infarction.Journal of thrombosis and haemostasis : JTH · 2004 · PMID 15099277 · doi
- [Role of fibrin D-dimer in acute coronary syndrome. Prospective study of 22 cases].La Tunisie medicale · 2004 · PMID 15127704
- Interleukin-6, fibrin D-dimer, and coagulation factors VII and XIIa in prediction of coronary heart disease.Arteriosclerosis, thrombosis, and vascular biology · 2004 · PMID 15205218 · doi
- A randomized comparison of the effects of aspirin and clopidogrel on thrombotic risk factors and C-reactive protein following myocardial infarction: the CADET trial.Journal of thrombosis and haemostasis : JTH · 2004 · PMID 15550024 · doi
- Coagulation indicators in chronic stable effort angina and unstable angina: relationship with acute phase reactants and clinical outcome.Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis · 2002 · PMID 11943939 · doi
- Evaluation of coagulation markers for early diagnosis of acute coronary syndromes in the emergency room.Clinical chemistry · 2002 · PMID 12406977
- Procoagulant effects of thrombolytic therapy in acute myocardial infarction.Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih · 2002 · PMID 12894883
- Factor V Leiden and its relation to left ventricular thrombus in acute myocardial infarction.Acta cardiologica · 2001 · PMID 11315119 · doi
- Thrombogenesis in sickle cell disease.The Journal of laboratory and clinical medicine · 2001 · PMID 11385360 · doi
- Coagulation activity and clinical outcome in unstable coronary artery disease.Arteriosclerosis, thrombosis, and vascular biology · 2001 · PMID 11397720 · doi
- Prognostic role of hemostatic markers in acute coronary syndromes patients.Clinica chimica acta; international journal of clinical chemistry · 2001 · PMID 11557250 · doi
- How to search for the role and prevalence of defective fibrinolytic states as triggers of myocardial infarction? The haemostasis epidemiologist's view.Italian heart journal : official journal of the Italian Federation of Cardiology · 2001 · PMID 11666092
- Fibrin specificity and procoagulant effect related to the kallikrein-contact phase system and to plasmin generation with double-bolus reteplase and front-loaded alteplase thrombolysis in acute myocardial infarction.The American journal of cardiology · 2000 · PMID 10922430 · doi
- Plasma levels of activated protein C-protein C inhibitor complex in patients with hypercoagulable states.American journal of hematology · 2000 · PMID 10936861 · doi
- Reactivation of coagulation after stopping infusions of recombinant hirudin and unfractionated heparin in unstable angina and myocardial infarction without ST elevation: results of a randomized trial. OASIS Pilot Study Investigators. Organization to Assess Strategies for Ischemic++ Syndromes.European heart journal · 2000 · PMID 10952840 · doi
- D-Dimer is an early diagnostic marker of coronary ischemia in patients with chest pain.American heart journal · 2000 · PMID 10966534 · doi
- Early risk stratification of unstable angina/non-Q myocardial infarction: biochemical markers of coronary thrombosis.International journal of cardiology · 1999 · PMID 10328612 · doi
- [Blood coagulation and fibrinolysis in arteriosclerosis].Zeitschrift fur Kardiologie · 1999 · PMID 10413853 · doi
- Study on the hypercoagulable state in patients with angina and myocardial infarction.Journal of Tongji Medical University = Tong ji yi ke da xue xue bao · 1998 · PMID 10806795 · doi
Showing 40 of 60 linked references.
Clinical trials(1)
- A Randomized Controlled Clinical Trial of PARIS Coronary Thrombosis Risk Score Combined With D-dimer to Guide New Oral Anticoagulant Antithrombotic Therapy in Patients With Acute Coronary Syndrome After Percutaneous Coronary InterventionNCT05638867 · PHASE4 · RECRUITING · Aspirin + Clopidogrel + Rivaroxaban, Aspirin + Clopidogrel