From the Guidelines
A D-dimer result of 0.8 is considered mildly elevated and should be interpreted in the context of clinical symptoms and risk factors, with further testing such as ultrasound or CT scan recommended if risk factors or concerning symptoms are present, as suggested by the 2020 European Society of Cardiology guidelines 1. The normal range for D-dimer is typically below 0.5 μg/mL (or 500 ng/mL), and this elevation suggests increased blood clot formation and breakdown in the body, but it's not severely high.
- The 2020 guidelines state that D-dimer levels are elevated in plasma in the presence of acute thrombosis because of simultaneous activation of coagulation and fibrinolysis, and the negative predictive value of D-dimer testing is high, making it useful for ruling out acute PE or DVT 1.
- However, many conditions can cause mild D-dimer elevations, including recent surgery, pregnancy, inflammation, infection, or advanced age, as noted in the 2008 European Society of Cardiology guidelines 1.
- The 2017 American College of Radiology guidelines also suggest that a negative D-dimer test effectively excludes PE or DVT in patients with a low or moderate clinical probability, but a positive result does not necessarily confirm them 1.
- Additionally, the 2020 Journal of Thrombosis and Haemostasis study found that markedly elevated D-dimers were a predictor of mortality in COVID-19 patients, highlighting the importance of considering D-dimer results in the context of clinical symptoms and risk factors 1.
- Given the mildly elevated D-dimer result, it is essential to discuss this result with a healthcare provider for proper interpretation and management, as they can assess the individual's clinical symptoms and risk factors to determine the best course of action, as recommended by the 2020 European Society of Cardiology guidelines 1.
From the Research
D-Dimer Result Interpretation
- A D-dimer result of 0.8 μg/ml is below the threshold value of 1.3 μg/ml suggested by 2 for diagnosing pulmonary embolism, indicating a low likelihood of pulmonary embolism.
- However, the study by 3 suggests that a D-dimer value of more than 3.6 μg/ml is highly possible for the existence of deep vein thrombosis, but a value of 0.8 μg/ml is below this threshold.
- The study by 4 used a threshold value of 0.5 μg/ml for D-dimer testing to exclude deep vein thrombosis, and a result of 0.8 μg/ml would be considered positive, requiring further testing such as compression ultrasonography (CUS).
- The age-adjusted D-dimer cut-off values, as reported by 5, may also be relevant, but the specific age-adjusted cut-off value for a D-dimer result of 0.8 μg/ml is not provided in the available evidence.
Diagnostic Implications
- Based on the available evidence, a D-dimer result of 0.8 μg/ml may require further testing, such as CUS or computed tomography pulmonary angiography (CTPA), to confirm or rule out the presence of deep vein thrombosis or pulmonary embolism.
- The study by 6 highlights the importance of integrating D-dimer levels with CTPA findings to improve diagnostic accuracy and efficiency for pulmonary embolism.
- However, the optimal threshold value for D-dimer testing and the specific diagnostic implications of a result of 0.8 μg/ml require careful consideration of the individual patient's clinical presentation and medical history, as well as consultation with relevant clinical guidelines and expert opinions 4, 2, 5, 3, 6.