Indunil Karunarathna Explores Clinical and Diagnostic Significance of D-Dimer
Indunil Karunarathna, Founder of Uva Clinical Research Lab (UCRL), shared on LinkedIn:
”Clinical and Diagnostic Significance of D-Dimer From Coagulation Physiology to Multisystem Applications
Uva Clinical Research Lab 2025 Uva Clinical Anaesthesia and Intensive Care ISSN 2827-7198, 2025
D-dimer, a fibrin degradation product, has emerged as a critical biomarker in evaluating thrombotic and fibrinolytic activity within the human body.
Biochemically, D-dimer forms when cross-linked fibrin undergoes plasmin-mediated proteolysis, reflecting the dynamic balance between clot formation and breakdown.
Its high sensitivity and low specificity confer significant clinical utility in ruling out venous thromboembolism (VTE), disseminated intravascular coagulation (DIC), and other hypercoagulable states, though interpretation must be context-specific.
This review provides a comprehensive analysis of the physiological mechanisms of D-dimer formation, the principles of coagulation and fibrinolysis, and the kinetics of its clearance.
We discuss specimen collection, assay methodologies, age-adjusted cutoffs, and factors influencing test accuracy.
Clinical applications are explored in depth, including its role in diagnosing pulmonary embolism, deep vein thrombosis, DIC, stroke, COVID-19–related coagulopathy, and venom-induced consumption coagulopathy.
Integration with risk stratification tools such as the Wells and Geneva scores, as well as the Pulmonary Embolism Rule-out Criteria (PERC), is highlighted to optimize diagnostic pathways.
The review emphasizes both the diagnostic and prognostic implications of D-dimer in diverse patient populations, advocating for judicious use alongside clinical judgment.”
Read the full article here.
Article: Clinical and Diagnostic Significance of D-Dimer From Coagulation Physiology to Multisystem Applications
Authors: Indunil Karunarathna
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