Author/Authors :
Rajappa, M Jawaharlal Institute of Postgraduate Medical Education and Research - Department of Biochemistry, India , Sunil Roy, TN Belhoul Speciality Hospital - Department of Cardiology, United Arab Emirates , Raj, A Govind Ballabh (G.B.) Pant Hospital - Department of Cardiology, India , Trehan, V Govind Ballabh (G.B.) Pant Hospital - Department of Cardiology, India , Mallika, V Govind Ballabh (G.B.) Pant Hospital - Department of Biochemistry, India , rajappa, m. department of biochemistry,jawaharlal institute of postgraduate medical education and research, India , sunil roy, t.n. department of cardiology,belhoul speciality hospital, United Arab Emirates , raj, a. department of cardiology,g.b. pant hospital, India , trehan, v. department of cardiology,g.b. pant hospital, India , mallika, v. department of biochemistry,g.b. pant hospital, 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. Conclusions: 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.
Keywords :
Rheumatic MS , Left atrial thrombus , D , Dimer levels , Transoesophageal echocardiography
