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Evaluation of D-dimer levels in patients with prosthetic valve thrombosis: relationship with thrombus burden and cerebrovascular events.
- Source :
-
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis [Blood Coagul Fibrinolysis] 2018 Apr; Vol. 29 (3), pp. 294-299. - Publication Year :
- 2018
-
Abstract
- : Plasma D-dimer level is an indicator of thrombosis and endogenous fibrinolytic activity. We investigated the association between the D-dimer levels and thrombus burden and cerebrovascular events in patients with obstructive prosthetic valve thrombosis (PVT). This retrospective study included 47 patients with obstructive left-sided PVT and 32 controls in whom PVT was excluded with comprehensive transthoracic and transesophageal echocardiography (TEE). The patient group included 11 aortic, 27 mitral, and 9 aortic and mitral valve PVT patients and the control group included 2 aortic, 25 mitral, and 5 aortic and mitral valve patients. Laboratory analysis including plasma D-dimer levels was performed at the time of admission in all patients. The baseline characteristics were similar between the two groups. The plasma D-dimer levels were significantly higher in patients with obstructive PVT compared with controls [680 (110-3590) vs. 310 (80-380) μg/l; P < 0.001]. By multivariate logistic regression analysis high D-dimer level, low-INR value on admission, high NYHA functional class and recent history of cerebrovascular accident (CVA), and transient ischemic attack (TIA) were the independent predictors of obstructive PVT. A plasma D-dimer level of greater than 365 μg/l predicted the presence of PVT with a sensitivity of 81% and a specificity of 69% (AUC= 0.781, P < 0.001). Plasma D-dimer levels were significantly higher in patients with a recent history of CVA/TIA [2140 (470-2980) vs. 590 (380-830) μg/l; P = 0.021]. In addition to the so-called indicators of PVT including subtherapeutic anticoagulation, increased D-Dimer levels may strengthen the suspicion of PVT. Moreover, higher plasma D-dimer levels were associated with higher thrombus burden and higher prevalence of recent CVA/TIA.
- Subjects :
- Aged
Aged, 80 and over
Case-Control Studies
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Thrombosis etiology
Cerebrovascular Disorders diagnosis
Fibrin Fibrinogen Degradation Products analysis
Heart Valve Prosthesis adverse effects
Thrombosis diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5733
- Volume :
- 29
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
- Publication Type :
- Academic Journal
- Accession number :
- 29570480
- Full Text :
- https://doi.org/10.1097/MBC.0000000000000722