Differences in D-dimer blood concentration in atrial fibrillation patients with left atrial thrombus or severe left atrial spontaneous echo contrast

2021 ◽  
Author(s):  
Changjian Lin ◽  
Yangyang Bao ◽  
Wei Hua ◽  
Ning Zhang ◽  
Qi Jin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Concentration ◽  
Left Atrial ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Spontaneous Echo Contrast ◽  
D Dimer

scholarly journals Evidence-Based Case Report: The Use of D-Dimer Assay to Exclude Left Atrial Thrombus in Patient with Atrial Fibrillation >48 Hours

2019 ◽  
Vol 11 (6) ◽  
Author(s):  
Raymond Pranata ◽  
Emir Yonas ◽  
Veresa Chintya ◽  
Alexander Edo Tondas ◽  
Sunu Budhi Raharjo
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
Left Atrial ◽  
Evidence Based ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
D Dimer

scholarly journals Diagnostic accuracy of D-dimer to detect left atrial thrombus in patients with atrial fibrillation: a systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Diaz-Arocutipa ◽  
A.C Gonzales-Luna ◽  
A Branez-Condorena ◽  
A.V Hernandez
Keyword(s):  
Atrial Fibrillation ◽  
Diagnostic Accuracy ◽  
Left Atrial ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Left Atrial Thrombus ◽  
Summary Receiver Operating Characteristic ◽  
Atrial Thrombus ◽  
Cross Sectional ◽  
D Dimer

Abstract Background There is limited evidence on the use of biomarkers to diagnose left atrial thrombus in atrial fibrillation. Purpose We evaluated the diagnostic accuracy of D-dimer to detect left atrial thrombus in patients with atrial fibrillation. Methods We searched four electronic databases from inception to December 16, 2020 for observational studies evaluating diagnostic accuracy of D-dimer. Reference standard was left atrial thrombus detected by transesophageal echocardiography. Study quality was assessed with the QUADAS-2 tool. We performed a bivariate random-effects meta-analysis to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI). In addition, a summary receiver operating characteristic curve and optimal cut-off were estimated. Results Eleven cross-sectional studies involving 4380 patients were included. The mean age ranged from 49.8 to 74.1 years and 70% of patients were men. Left atrial thrombus was present in 7% of cases. In seven studies, the pooled sensitivity of D-dimer at 500 ng/mL was 53% (95% CI, 26–79%) and the pooled specificity was 92% (95% CI, 80–97%). The pooled sensitivity of age-adjusted D-dimer was 35% (95% CI, 18–57%) and the pooled specificity was 100% (95% CI, 100–100%) in two studies. The optimal cut-off was 390 ng/mL in 10 studies with a pooled sensitivity of 68% (95% CI, 44–85%) and a pooled specificity of 73% (95% CI, 54–86%). The risk of bias was low or unclear for all domains. Concerns regarding applicability were generally low for almost all studies Conclusion Our meta-analysis suggests that D-dimer has the potential to be useful to the detection of left atrial thrombus in patients with atrial fibrillation. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals CHA2DS2-VASc Score as a Predictor for Left Atrial Thrombus or Spontaneous Echo Contrast in Patients with Nonvalvular Atrial Fibrillation: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ping Sun ◽  
Zhi Hao Guo ◽  
Hong Bin Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Sensitivity Analysis ◽  
Publication Bias ◽  
Left Atrial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Left Atrial Thrombus ◽  
Nonvalvular Atrial Fibrillation ◽  
Atrial Thrombus ◽  
Spontaneous Echo Contrast

Objective. This meta-analysis aimed at exploring the predictive value of CHA2DS2-VASc score for the left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with nonvalvular atrial fibrillation (NVAF). Methods. PubMed, Embase, Web of Science, ScienceDirect, Cochrane Library, and Chinese core journals of the CNKI and Wanfang databases were searched to identify all the relevant papers that were published up to January 2020. The data were extracted for pooled odds ratios (ORs) with 95% confidence intervals (CIs), heterogeneity, subgroup, publication bias, and sensitivity analysis. Results. Overall, 15 studies containing 6223 patients with NVAF were enrolled. All studies were evaluated for LAT, and 12 studies were evaluated for LASEC. The pooled analysis using a random-effects model showed that a high CHA2DS2-VASc score was related with LAT/LASEC (pooled OR=1.59, 95% CI: 1.35–1.88, P<0.001) with high heterogeneity (I2=76.9%, P<0.001) and LAT (pooled OR=1.83, 95% CI: 1.44–2.33, P<0.001) with high heterogeneity (I2=79.4%, P<0.001). The subgroup analysis demonstrated that the sample size may be the main source of heterogeneity. Although the Begg’s funnel plot based on 15 studies for LAT/LASEC (P=0.029) and 12 studies for LAT (P=0.046) indicated the presence of publication bias among the included studies, the trim-and-fill method verified the stability of the pooled outcomes. In addition, sensitivity analysis indicated that all effects were stable. Conclusion. The results of this meta-analysis showed that the CHA2DS2-VASc score is related with LAT and LASEC in patients with NVAF. However, more studies are warranted to address this issue.

scholarly journals Nomogram to Predict Left Atrial Thrombus or Spontaneous Echo Contrast in Patients With Non-valvular Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhitong Li ◽  
Quanbo Liu ◽  
Fei Liu ◽  
Tesfaldet H. Hidru ◽  
Yuqi Tang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Individual Risk ◽  
Good Prediction ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Ventricular Ejection Fraction ◽  
Spontaneous Echo Contrast

Background: The predictive power of the CHADS2 and CHA2DS2-VASc scores for the presence of Left atrial thrombus (LAT)/ spontaneous echo contrast (SEC) in non-valvular atrial fibrillation (NVAF) is modest. The aim of this analysis is to define clinical and ultrasonic variables associated with LAT/SEC and to propose nomograms for individual risk prediction.Methods: Data on 1,813 consecutive NVAF patients who underwent transesophageal echocardiography (TEE) from January 2016 to January 2021 were collected. The univariate and multivariate logistic regression analyses were used to construct a nomogram. We examined the predictive ability of the risk scores by calculating the area under the curve (AUC). Moreover, the performance of the nomogram was assessed with respect to calibration, discrimination, and clinical usefulness.Results: LAT/SEC was found in 260 (21.0%) and 124 (21.6%) patients in the training and validation cohorts, respectively. On multivariate analysis, independent factors for LAT/SEC were Age, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), hypertension (HTN), previous stroke or transient ischemic attack, Non-paroxysmal AF and a nomogram was built based on these variables. The calibration curve for the probability of LAT/SEC showed good prediction agreement with actual observation. The nomogram achieved good concordance indexes of 0.836 and 0.794 in predicting LAT/SEC in the training and validation cohorts, respectively. Decision curve analysis demonstrated that the nomogram would be clinically useful.Conclusions: In this study, a nomogram was constructed that incorporated six characteristics of NVAF patients. The nomogram may be of great value for the prediction of LAT/SEC in NVAF patients.

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