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Fibrinogen/fibrin degradation products and D‐dimer in clinical practice: Interpretation of discrepant results
Author(s) -
Sato Naoaki,
Takahashi Hoyu,
Shibata Akria
Publication year - 1995
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830480306
Subject(s) - d dimer , fibrinolysis , fibrinogen , fibrin , coagulation , dimer , medicine , chemistry , immunology , organic chemistry
In clinical practice, occasionally some patients show dissociated values of fibrinogen / fibrin degradation products (FDP) and D‐dimer (cross‐linked fibrin degradation products). In an attempt to assess the frequency, clinical backgrounds, and hemostatic states of these cases, FDP and D‐dimer were simultaneously measured together with other hemostatic parameters in 371 samples from patients with various diseases. As a whole, FDP values were positively correlated with D‐dimer values (r = 0.871, P < 0.0001), and both were elevated in parallel with the progress of activation of blood coagulation and fibrinolysis. However, in patients with elevated FDP and/or D‐dimer, 11.5% of samples showed relatively lower D‐dimer values than those expected from FDP levels, and these were regarded as an apparently dissociated group. In the dissociated group, activation of coagulation and fibrinolysis occurred to a lesser extent than others. Analysis of these samples suggested that the possible reasons for the dissociation bet ween FDP and D‐dimer values were accelerated fibrinogenolysis with or without secondary fibrinolysis, accelerated fibrinogenolysis by non‐plasmic proteinases, elevated soluble fibrin, and possibly false‐positive FDP levels due to unclottable fibrinogen remaining in the serum samples. In practice, simultaneous measurements of FDP and D‐dimer are useful for more accurate estimation of hyperfibrinolytic states. ©1995 Wiley‐Liss, Inc.