Key result
Severe MR in RHD is linked to normalized D-dimer levels, suggesting protection against thrombus formation.
Why the study?
Atrial fibrillation and mitral stenosis increase the risk of left atrial thrombus formation, but whether severe mitral regurgitation improves the systemic hypercoagulable state in these patients remains unclear.
Does severe mitral regurgitation reduce systemic coagulation activity as assessed by D-dimer levels in patients with rheumatic heart disease?
Cross-Sectional (n=400)
No
Does severe mitral regurgitation reduce systemic coagulation activity as assessed by D-dimer levels in patients with rheumatic heart disease?
Absolute Event Rate: 0.31% vs 0.31%
p-value: p=0.53
Severe mitral regurgitation in rheumatic heart disease is associated with normalized D-dimer levels, suggesting a protective effect against the hypercoagulable state and left atrial thrombus formation.
Introduction Atrial fibrillation and mitral stenosis, especially in combination, increase the risk of left atrial thrombus formation and systemic embolization. However, whether severe mitral regurgitation (MR) improves systemic hypercoagulable state in these patients is unclear. remains unclear. The study aims to study the impact of severe MR on systemic coagulation by the use of D-dimer levels. Methods It was a prospective, cross-sectional study done on 400 subjects consisting of 350 cases and 50 controls. The cases were divided into seven groups on basis of valvular pathology, rhythm, and presence of a clot. The D-dimer level was compared in all the subgroups. Result The mean age of the study population was 32.32±7.30 years with a 48% male population. The highest level of D-dimer was found in patients with thrombus (1.71 ± 1.74 µg/ml). Patients with mitral stenosis had significantly higher plasma D-dimer levels than the control group (p <0.001) while regardless of rhythm, patients with MR had a D-dimer level similar to the control group in sinus rhythm. Conclusion Severe MR reduces plasma D-dimer levels to control levels reflecting the protective effect against thrombus formation and systemic embolization.
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Goyal et al. (2021) conducted a cross-sectional in Rheumatic heart disease (n=400). Severe mitral regurgitation vs. Healthy controls was evaluated on Plasma D-dimer levels (median, µg/ml) (p=0.53). Severe mitral regurgitation reduced plasma D-dimer levels to normal control levels in patients with rheumatic heart disease, reflecting a protective effect against thrombus formation.
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