D-Dimer assay as a non invasive test for the diagnosis of left atrial Thrombi in Indian patients with Rheumatic MS

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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.

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Rajappa, M., Sunil Roy, T. N., Raj, A., Trehan, V., & Mallika, V. (2013). D-Dimer assay as a non invasive test for the diagnosis of left atrial Thrombi in Indian patients with Rheumatic MS. African Health Sciences, 13(3), 584–589. https://doi.org/10.4314/ahs.v13i3.9

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