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Plasma D-Dimer Test Accuracy Can Be Affected by Heparin Administration
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In their excellent review, Kelly et al1 clearly pointed out the clinical utility of using plasma D-dimer (D-d) levels in the diagnosis of acute venous thromboembolism (VTE).1 In particular, they showed that concomitant administration of calcium heparin does not affect significantly D-d levels and, therefore, the utility of the test is not compromised in clinical practice in which many patients may be already receiving heparin at the performance of the D-d test. However, more recent evidence shows that anticoagulant administration, also in small dosages and for a short time, can affect the accuracy of plasma D-ds.2-3
Recently, we investigated the diagnostic accuracy of a rapid semiquantitative D-d test (Dimertest; Dade Behring Inc, Deerfield, Ill) in 298 patients referred to us with the suspicion of deep vein thrombosis.4 When we excluded patients already receiving heparin at the performance of the D-d test, our analysis demonstrates a trend in ameliorating D-d sensitivity . . . [Full Text of this Article]
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