Patients with venous thromboembolism (VTE) and no obvious underlying cause or major clotting protein abnormalities whose D-dimer levels are <250 ng/mL have a significantly reduced long-term risk of recurrent VTE. Physicians should consider obtaining this test and providing this information to patients.
Given the burgeoning numbers of tests being developed to assess thrombophilia risk, the attraction of the D-dimer is that it may represent a global measure of risk of recurrent disease. Physicians should understand, however, that clinical research is still preliminary and look for further evidence of the prognostic performance of D-dimer across populations with different ethnicity and the outcomes of long-term treatment on patients at higher risk of VTE as measured by D-dimer.