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D-dimer Vs. FSP

Can the HS (high sensitivity or quantitative) D-dimer test replace the fibrin split products (FSP) test? Why or why not? Also in pregnancy, since the D-dimer is always elevated, has any one tested and compared FSP levels in pregnancy as well? Thanks. Mohamed Emara, PhD, MT (ASCP)

Hello, Dr. Emara, and thank you for your question. The quantitative D-dimer is preferred over the time-honored semiquantitative fibrin degradation products (FDP), also called the FSP,  for its speed and accuracy. Quantitative D-dimer is available with all automated coagulometers and is thus available in most institutions that provide coagulation testing. In addition, at least one manual quantitative D-dimer is available, the SimpliRed assay. There is no real instance where the FDP assay provides information that improves on or amplifies the D-dimer.

The quantitative D-dimer assay may be used to rule out venous thromboembolism in patients who experience associated symptoms such as chest congestion, but because a number of inflammatory conditions raise the D-dimer level, it cannot be used as conclusive evidence of deep venous thrombosis or pulmonary embolism. According toKrivak TC, Zorn KK. Venous thromboembolism in obstetrics and gynecology. Obstet Gynecol 2007;109:761-77, neither the D-dimer nor FDP is effective in diagnosing abruptio placentae.

Of course, if you are using the D-dimer to diagnose and monitor disseminated intravascular coagulation (DIC), which is the primary application of the FDP assay, it is effective in all instances, as D-dimer elevations in DIC are profound and far exceed inflammation or venous thromboembolism levels.

Comments (2)
May 8, 2011 4:03pm

I am also looking for other laboratory advice to whether HS
I am also looking for other laboratory advice to whether HS D-dimer is used for the diagnosis of abruptio placentae and whether there are any recent articles examined this tool. Thanks.

From Geo: I found one 14-year-old study addressing this question. The authors did a case-control study and found no value in using the D-dimer for abruptio placentae. Here is the reference: Neiger R, Krohn HJ, Trofatter MO. Plasma fibrin D-dimer in pregnancies complicated by partial placental abruption. Tenn Med 1997;90:403-5.

May 6, 2011 5:55pm

Thank you for your response. This exactly what we feel, but
Thank you for your response. This exactly what we feel, but we wanted to see other views before we discontinue using FSP.

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