title: Value of serum fibrinogen levels in the assessment of mechanical prosthetic valve thrombosis.
abstract: OBJECTIVE
  The evaluation of prosthetic valve thrombosis (PVT) is crucial due to higher mortality and morbidity rates. The study aim was to assess the value of fibrinogen in the diagnosis of PVT, an important and a common cause of prosthetic valve failure.
  
  
  METHODS
  Between December 2007 and April 2012, 154 patients with PVT and 116 control subjects with a normally functioning prosthesis were enrolled in the study. PVT was diagnosed using transesophageal echocardiography, and fibrinogen levels were measured at presentation. The patients and controls had similar demographic features.
  
  
  RESULTS
  NYHA functional class, ineffective anticoagulation, presence of symptoms and moderate to severe left atrial spontaneous echo contrast (LASEC) were significantly different between the groups. The fibrinogen level was significantly higher in patients with PVT compared to controls (393.46 +/- 127.87 versus 276.93 +/- 69.22 mg/dl, p < 0.001). Ineffective anticoagulation, the presence of symptoms, a poor NYHA functional class, the presence of moderate to severe LASEC and elevated fibrinogen levels were independent predictors of PVT on multivariate regression analysis (p < 0.001, odds ratio (OR) 38.811, 95% confidence interval (CI): 13.319-113.091; p < 0.001, OR 6.745, CI: 2.777-16.386; p = 0.031, OR 3.557, CI: 1.126-11.239; p = 0.026, OR 3.203, CI: 1.146-8.955, and p < 0.001, OR 1.011, CI: 1.007-1.016 respectively).
  
  
  CONCLUSIONS
  Besides known indicators of PVT, including ineffective anticoagulation, the presence of LASEC and decreased NYHA functional capacity, elevated fibrinogen levels may be a valuable marker for the assessment of PVT.
authors: Ahmet C
authors: AC
authors: Aykan
authors: Tayyar
authors: T
authors: Gökdeniz
authors: Sabahattin
authors: S
authors: Gündüz
authors: Mehmet A
authors: MA
authors: Astarcioğlu
authors: Ozan M
authors: OM
authors: Gürsoy
authors: Emre
authors: E
authors: Ertürk
authors: Ali E
authors: AE
authors: Oğuz
authors: Zübeyde
authors: Z
authors: Bayram
authors: Süleyman
authors: S
authors: Karakoyun
authors: Macit
authors: M
authors: Kalçik
authors: Mehmet
authors: M
authors: Ozkan
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D017548:Echocardiography, Transesophageal; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006325:Heart Atria / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D005340:Fibrinogen