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Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study

BACKGROUND: In rheumatic mitral stenosis (MS), left atrial (LA) thrombus and LA spontaneous echo contrast (LA SEC) reflect hypercoagulability. The study focuses on whether D-dimer levels predict the existence of LA thrombus and SEC in patients with severe MS. METHODS: 95 consecutive patients with se...

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Autores principales: Sukulal, Kiron, Mohanan Nair, Krishna Kumar, Sasidharan, Bijulal, Valaparambil, Ajitkumar, Ganapathi, Sanjay, Sivasubramanian, Sivasankaran, Sivadasanpillai, Harikrishnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296235/
https://www.ncbi.nlm.nih.gov/pubmed/32534681
http://dx.doi.org/10.1016/j.ihj.2020.04.002
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author Sukulal, Kiron
Mohanan Nair, Krishna Kumar
Sasidharan, Bijulal
Valaparambil, Ajitkumar
Ganapathi, Sanjay
Sivasubramanian, Sivasankaran
Sivadasanpillai, Harikrishnan
author_facet Sukulal, Kiron
Mohanan Nair, Krishna Kumar
Sasidharan, Bijulal
Valaparambil, Ajitkumar
Ganapathi, Sanjay
Sivasubramanian, Sivasankaran
Sivadasanpillai, Harikrishnan
author_sort Sukulal, Kiron
collection PubMed
description BACKGROUND: In rheumatic mitral stenosis (MS), left atrial (LA) thrombus and LA spontaneous echo contrast (LA SEC) reflect hypercoagulability. The study focuses on whether D-dimer levels predict the existence of LA thrombus and SEC in patients with severe MS. METHODS: 95 consecutive patients with severe MS referred for transesophageal echocardiogram (TEE) between July 2011 and March 2012 to evaluate LA thrombus prior to balloon mitral valvotomy (BMV) were included in the study. D-Dimer levels in these patients were observed. RESULTS: Out of the 95 patients, 15 (15.8%) had LA thrombus and 52 patients had LA SEC (54.7%). Any correlation between D-Dimer levels and existence (or non-existence) of LA thrombus was not noticed from the receiver operating characteristics (ROC) curve with an area of .535. For patients with LA SEC, the D-Dimer levels were found to be considerably higher (776 ± 866 μg/L vs. 294 ± 331 μg/L, p = .001). An ideal cut-off level of 393 μg/L for diagnosing LA SEC was illustrated by the ROC curve with a sensitivity of 63.4%, specificity of 83.72%, positive predictive value of 82.5% and a negative predictive value of 65.45%. CONCLUSIONS: D-dimer levels were not representative of the presence or absence of LA thrombus in patients with severe MS. Nonetheless, this study demonstrated the substantial link between D-Dimer level and LA SEC. If a D-Dimer level of 400 μg/L or higher is taken as positive, it has high specificity and positive predictive value for diagnosing LA SEC.
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spelling pubmed-72962352020-09-15 Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study Sukulal, Kiron Mohanan Nair, Krishna Kumar Sasidharan, Bijulal Valaparambil, Ajitkumar Ganapathi, Sanjay Sivasubramanian, Sivasankaran Sivadasanpillai, Harikrishnan Indian Heart J Original Article BACKGROUND: In rheumatic mitral stenosis (MS), left atrial (LA) thrombus and LA spontaneous echo contrast (LA SEC) reflect hypercoagulability. The study focuses on whether D-dimer levels predict the existence of LA thrombus and SEC in patients with severe MS. METHODS: 95 consecutive patients with severe MS referred for transesophageal echocardiogram (TEE) between July 2011 and March 2012 to evaluate LA thrombus prior to balloon mitral valvotomy (BMV) were included in the study. D-Dimer levels in these patients were observed. RESULTS: Out of the 95 patients, 15 (15.8%) had LA thrombus and 52 patients had LA SEC (54.7%). Any correlation between D-Dimer levels and existence (or non-existence) of LA thrombus was not noticed from the receiver operating characteristics (ROC) curve with an area of .535. For patients with LA SEC, the D-Dimer levels were found to be considerably higher (776 ± 866 μg/L vs. 294 ± 331 μg/L, p = .001). An ideal cut-off level of 393 μg/L for diagnosing LA SEC was illustrated by the ROC curve with a sensitivity of 63.4%, specificity of 83.72%, positive predictive value of 82.5% and a negative predictive value of 65.45%. CONCLUSIONS: D-dimer levels were not representative of the presence or absence of LA thrombus in patients with severe MS. Nonetheless, this study demonstrated the substantial link between D-Dimer level and LA SEC. If a D-Dimer level of 400 μg/L or higher is taken as positive, it has high specificity and positive predictive value for diagnosing LA SEC. Elsevier 2020 2020-04-15 /pmc/articles/PMC7296235/ /pubmed/32534681 http://dx.doi.org/10.1016/j.ihj.2020.04.002 Text en © 2020 Cardiological Society of India. Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Sukulal, Kiron
Mohanan Nair, Krishna Kumar
Sasidharan, Bijulal
Valaparambil, Ajitkumar
Ganapathi, Sanjay
Sivasubramanian, Sivasankaran
Sivadasanpillai, Harikrishnan
Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study
title Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study
title_full Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study
title_fullStr Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study
title_full_unstemmed Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study
title_short Implication of d-dimer in rheumatic severe mitral stenosis – A tertiary centre study
title_sort implication of d-dimer in rheumatic severe mitral stenosis – a tertiary centre study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296235/
https://www.ncbi.nlm.nih.gov/pubmed/32534681
http://dx.doi.org/10.1016/j.ihj.2020.04.002
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