M Rajappa1, T N Sunil Roy2, A Raj3, V Trehan3, V Mallika4. 1. Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. 2. Department of Cardiology, Belhoul Speciality Hospital, Dubai, United Arab Emirates. 3. Department of Cardiology, G.B. Pant Hospital, New Delhi, India. 4. Department of Biochemistry, G.B. Pant Hospital, New Delhi, India.
Abstract
BACKGROUND: Systemic embolism is a serious and sometime fatal complication of rheumatic MS. OBJECTIVE: We assessed the predictive power of D-Dimer level to predict occurrence of left atrial (LA) thrombi in patients with rheumatic mitral stenosis (MS). METHODS: D-dimer levels were analyzed for 24 patients with rheumatic MS with LA clot and 22 patients with rheumatic MS with no LA clot undergoing transeosophageal echocardiography. A level more than 4 µg/ml was taken as elevated to predict the presence of LA clot in the study groups. RESULTS: For a cut-off value of 4 µg/ml, sensitivity was 66.67 % and specificity 100 % for prediction of LA clot and AUC 0.710. A cut-off value of less than 1 µg/ml, sensitivity was 91.67 % and 87. 5 % negative predictive value for ruling out presence of LA clot and AUC 0.721. CONCLUSION: A higher value of D-dimer can predict the possible presence of a LA clot and very low value can predict absence of clot in patients with rheumatic MS.
BACKGROUND: Systemic embolism is a serious and sometime fatal complication of rheumatic MS. OBJECTIVE: We assessed the predictive power of D-Dimer level to predict occurrence of left atrial (LA) thrombi in patients with rheumatic mitral stenosis (MS). METHODS: D-dimer levels were analyzed for 24 patients with rheumatic MS with LA clot and 22 patients with rheumatic MS with no LA clot undergoing transeosophageal echocardiography. A level more than 4 µg/ml was taken as elevated to predict the presence of LA clot in the study groups. RESULTS: For a cut-off value of 4 µg/ml, sensitivity was 66.67 % and specificity 100 % for prediction of LA clot and AUC 0.710. A cut-off value of less than 1 µg/ml, sensitivity was 91.67 % and 87. 5 % negative predictive value for ruling out presence of LA clot and AUC 0.721. CONCLUSION: A higher value of D-dimer can predict the possible presence of a LA clot and very low value can predict absence of clot in patients with rheumatic MS.
Entities:
Keywords:
D-Dimer levels; Left atrial thrombus; Rheumatic MS; Transoesophageal echocardiography
Authors: K Yamamoto; U Ikeda; K K Minezaki; H Fukazawa; O Mizuno; S Kim; H Fujikawa; H Sekiguchi; K Shimada Journal: Am J Cardiol Date: 1997-04-15 Impact factor: 2.778