Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1783546807097229312 |
---|---|
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. |
format | Online Article Text |
id | pubmed-7296235 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT sukulalkiron implicationofddimerinrheumaticseveremitralstenosisatertiarycentrestudy AT mohanannairkrishnakumar implicationofddimerinrheumaticseveremitralstenosisatertiarycentrestudy AT sasidharanbijulal implicationofddimerinrheumaticseveremitralstenosisatertiarycentrestudy AT valaparambilajitkumar implicationofddimerinrheumaticseveremitralstenosisatertiarycentrestudy AT ganapathisanjay implicationofddimerinrheumaticseveremitralstenosisatertiarycentrestudy AT sivasubramaniansivasankaran implicationofddimerinrheumaticseveremitralstenosisatertiarycentrestudy AT sivadasanpillaiharikrishnan implicationofddimerinrheumaticseveremitralstenosisatertiarycentrestudy |