[Determination of D-Dimer value in diagnosis of atrial thrombus in patients with atrial fibrillation]

ABSTRACT

Considering the and importance of formation of atrial Thrombus [AT] in patients who had developed atrial fibrilation [AF] and its early diagnosis, and with some regards to several reports on benefits of applying the D-Dimer test in such conditions, this study was carried out to detemine the accuracy and value of this test compared to the gold standard method of Trans-Esophageal Echocardiography [TEE] in patients referring to Modarres hospital. This clinical trial was performed on 73 patients whom were diagnosed as having AF. A more accurate method of TEE was applied to confirm if they had atrial thrombi. For determination of value of D-Dimer test in diagnosis of AT, 5 [cc] of blood was taken from any subjects. The results were regarded normal if the D-Dimer level was less than 500 ng/ml. Then positive and negative predictive values [PPV and NPV] were calculated as diagnostic measurments. Of the 73 subjects of this study [67% women versus 33% men] with mean age of 44.7 +/- 12 years old, there was 53.4% who had the history of Warfarin usage. According to the results of D-Dimer test, 33% had reached to positive levels, whereas 67% revealed to have no thrombus. The PPV of this test was calculated 48.6% and the NPV was 81.6%. Regarding the present condition of our patients and the excessive use of Warfarin among them and also probable failures of D-Dimer test, this test does not have the acceptible capability [particularly duringin these situations] in diagnosing AT