From the Guidelines
Elevated D-dimer levels can be caused by various conditions, including venous thromboembolism, sepsis, disseminated intravascular coagulation, malignancies, recent trauma or surgery, and acute myocardial infarction, as well as following fibrinolytic therapy, as noted in the 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines 1. These conditions lead to intravascular activation of the coagulation cascade and secondary fibrinolysis, resulting in elevated D-dimer levels. Some key points to consider include:
- Venous thromboembolism, such as deep vein thrombosis or pulmonary embolism, can cause elevated D-dimer levels 1.
- Sepsis and disseminated intravascular coagulation are other critical conditions that can lead to elevated D-dimer levels 1.
- Malignancies, recent trauma or surgery, and acute myocardial infarction can also cause elevated D-dimer levels 1.
- Fibrinolytic therapy can also result in elevated D-dimer levels 1. It is essential to note that while elevated D-dimer levels can indicate these conditions, they are not specific to any single condition, making D-dimer more valuable as a rule-out test than for confirming specific diagnoses. Some other conditions that may cause elevated D-dimer levels include:
- Recent trauma or surgery
- Malignancies
- Acute myocardial infarction
- Fibrinolytic therapy
- Sepsis
- Disseminated intravascular coagulation
- Venous thromboembolism, such as deep vein thrombosis or pulmonary embolism.
From the Research
Causes of Elevated D-dimer
Elevated D-dimer levels can be caused by various conditions, including:
- Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) 2, 3, 4, 5, 6
- Sepsis, a life-threatening condition that occurs when the body's response to an infection becomes uncontrolled 2, 3
- Cancer, with higher levels observed in breast, prostate, and bowel cancers 3
- Trauma or surgery, which can increase the risk of VTE and subsequently elevate D-dimer levels 2
- Infection and arrhythmias, which can also cause elevated D-dimer levels 3
- Other conditions, such as cardiopulmonary resuscitation, which can lead to elevated D-dimer levels 2
Conditions Associated with Elevated D-dimer
Some conditions are more commonly associated with elevated D-dimer levels, including:
- Pulmonary embolism, which is the third most common cause of death from cardiovascular disease after heart attack and stroke 5
- Deep vein thrombosis, which can lead to chronic thromboembolic pulmonary hypertension and post-thrombotic syndrome 5
- Cancer, which can cause elevated D-dimer levels due to the biology of the underlying tumor 3
- Sepsis, which can cause elevated D-dimer levels due to the body's response to infection 2
Clinical Significance of Elevated D-dimer
Elevated D-dimer levels can have significant clinical implications, including: