What is the alternative to D-dimer testing?

Updated: Jun 06, 2019
  • Author: Daniel R Ouellette, MD, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

A potential alternative to D-dimer testing is assessment of the ischemia-modified albumin (IMA) level, which data suggest is 93% sensitive and 75% specific for pulmonary embolism. [52] Notably, in a study comparing the prognostic value of IMA to D-dimer testing, IMA assessment in combination with Wells and Geneva probability scores appeared to positively impact overall sensitivity and negative predictive value. [52] The positive predictive value of IMA, in particular, is better than D-dimer. However, it should not be used alone. [53]


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