E-ISSN 0976-2833 | ISSN 0975-3583
 

Original Research (Original Article) 


The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation

Samir Rafla, Tarek Beshay.

Abstract
Objectives: The aim of this study was to evaluate the ability of D-Dimer for the diagnosis of left atrial appendage (LAA) thrombus in patients with chronic atrial fibrillation (AF).

Methods: 80 patients with chronic AF who fulfilled the inclusion and exclusion criteria were studied prospectively. 45 patients had LAA thrombus diagnosed by transesophageal echocardiography (TEE) constituted group I (LAA thrombus group). The other 35 patients without LAA thrombus constituted group II. All the 45 patients (100%) in group I with LAA thrombus had elevated D-Dimer levels while only 10 patients (28.5%) in group II without LAA thrombus had elevated D-Dimer levels (P < 0.001). All the patients received oral anticoagulation with warfarin keeping the INR between 2 and 3 for 3 months. TEE was done to all the patients at 3-month follow up.

Results: 12 patients (26.7%) in group I had elevated D-Dimer levels. The number of patients with positive D-Dimer decreased significantly at 3-month follow up (P < 0.001) while on warfarin. LAA thrombus resolved completely in 35 patients (77.8%) at 3-month follow up. In group II, all the 35 patients (100%) had negative D-Dimer levels at 3-month follow up. At 6-month follow up all the patients in group I and II had negative D-Dimer levels (100%).

Conclusion: The sensitivity of D-Dimer for the diagnosis of LAA thrombus is 100%. The specificity of D-Dimer for the diagnosis of LAA thrombus is 71.4%. So, patients with positive and elevated D-Dimer levels should undergo TEE for the diagnosis of LAA thrombus. While a negative D-Dimer test result makes the diagnosis of LAA thrombus is extremely unlikely. Appropriate oral anticoagulation results in complete resolution of LAA thrombus within 6 months.

Key words: Chronic atrial fibrillation; D Dimer; Left atrial thrombi; marevan; warfarin; transesophageal echocardiography.


 
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Pubmed Style

Samir Rafla, Tarek Beshay. The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation. . 2020; 11(3): 117-123. doi:10.31838/jcdr.2020.11.03.27


Web Style

Samir Rafla, Tarek Beshay. The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation. http://www.jcdronline.org//?mno=120001 [Access: August 04, 2020]. doi:10.31838/jcdr.2020.11.03.27


AMA (American Medical Association) Style

Samir Rafla, Tarek Beshay. The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation. . 2020; 11(3): 117-123. doi:10.31838/jcdr.2020.11.03.27



Vancouver/ICMJE Style

Samir Rafla, Tarek Beshay. The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation. . (2020), [cited August 04, 2020]; 11(3): 117-123. doi:10.31838/jcdr.2020.11.03.27



Harvard Style

Samir Rafla, Tarek Beshay (2020) The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation. , 11 (3), 117-123. doi:10.31838/jcdr.2020.11.03.27



Turabian Style

Samir Rafla, Tarek Beshay. 2020. The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation. Journal of Cardiovascular Disease Research, 11 (3), 117-123. doi:10.31838/jcdr.2020.11.03.27



Chicago Style

Samir Rafla, Tarek Beshay. "The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation." Journal of Cardiovascular Disease Research 11 (2020), 117-123. doi:10.31838/jcdr.2020.11.03.27



MLA (The Modern Language Association) Style

Samir Rafla, Tarek Beshay. "The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation." Journal of Cardiovascular Disease Research 11.3 (2020), 117-123. Print. doi:10.31838/jcdr.2020.11.03.27



APA (American Psychological Association) Style

Samir Rafla, Tarek Beshay (2020) The Role of D-Dimer in the Diagnosis of Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation. Journal of Cardiovascular Disease Research, 11 (3), 117-123. doi:10.31838/jcdr.2020.11.03.27





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