Uso y limitaciones del dímero D en la exclusión del tromboembolismo venoso

D-dimer is a marker of thrombin and plasmin generation. The usefulness of D-dimer measurement as a negative predictive value in the exclusion of thromboembolic disease in patients with low or moderate clinical pretest has been demonstrated for some time. However, the appearance of new methodologies, which express the results in different units and have a different degree of approval for use in thromboembolic disease, exclusion algorithm has generated a degree of confusion. The objective of this review is to compile and disseminate the recommendations of the different international guidelines on the use of D-dimer in the diagnosis of thromboembolic disease. The different degrees of approval of the Food and Drug Administration are discussed for the laboratory methods (help in the diagnosis vs. exclusion), the units in which the results should be expressed, what information should be included when a D-dimer result is reported, how to establish the cut-off points of the different methods and in which patients the D-dimer assay can be used to exclude thromboembolic disease.