title: [Measurement of d-dimers in non-valvular atrial fibrillation. First prospective Tunisian study].
abstract: Atrial fibrillation can expose to thrombo-embolic complications. Many biomarkers have been tested to refine the stratification of thrombo-embolic risk. The study aim was to assess the interest of the d-dimer testing in this pathology. We conducted a prospective observational study including 50 cases and 19 controls, enrolled at the cardiology department of the Mongi Slim Hospital, from July to November 2012. The d-dimer assay was performed on mini-VIDAS(®) and analyzed according to clinical, echocardiographic and biological data. The mean age of patients was 61.8±10.6years. The mean CHA2DS2-VASc score was 2.58±1.31. The average of D-dimer levels was 590±506ng/ml in patients and 225.26±112.95ng/ml in controls (P=0.02). No significant difference has been found between the d-dimer level and age, sex, type and etiology of atrial fibrillation, the CHA2DS2-VASc score, the left atrial surface. Among patients on acenocoumarol, d-dimer levels was significantly higher in patients with an INR<2 compared to those with an INR≥2 (P=0.004). We identified a positive d-dimer threshold (300ng/ml) in patients distinguishing them significantly with controls (P<0.001). In conclusion, the measurement of d-dimers could help clinicians to identify patients with atrial fibrillation having an increased coagulability and, therefore, an increased thrombo-embolic risk. It could be complementary to the determination of INR in monitoring anticoagulation therapy: d-dimers level refines the thrombo-embolic risk and INR measurement assesses the level of anticoagulation and the bleeding risk.
authors.affiliation: Laboratoire d'hématologie biologique, hôpital Aziza Othmana, Tunis, Tunisie. Electronic address: lahouwij@yahoo.fr.
authors.forename: W
authors.initials: W
authors.lastname: El Borgi
authors.affiliation: Laboratoire d'hématologie biologique, hôpital Aziza Othmana, Tunis, Tunisie. Electronic address: sanabenromdhane@yahoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Romdhane
authors.affiliation: Service de cardiologie, hôpital Mongi Slim La Marsa, Tunis, Tunisie. Electronic address: sdiri_wissem@yahoo.fr.
authors.forename: W
authors.initials: W
authors.lastname: Sdiri
authors.affiliation: Service de cardiologie, hôpital Mongi Slim La Marsa, Tunis, Tunisie. Electronic address: salma.longo@yahoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Longo
authors.affiliation: Laboratoire d'hématologie biologique, hôpital Aziza Othmana, Tunis, Tunisie. Electronic address: raouf.hafsia@rns.tn.
authors.forename: R
authors.initials: R
authors.lastname: Hafsia
authors.affiliation: Service de cardiologie, hôpital Mongi Slim La Marsa, Tunis, Tunisie. Electronic address: rachidboujnah@yahoo.fr.
authors.forename: M R
authors.initials: MR
authors.lastname: Boujnah
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013923:Thromboembolism / Q000097:blood; D014416:Tunisia
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; C036309:fibrin fragment D
keywords: Anticoagulants; Antithrombotic therapy; Atrial fibrillation; D-dimer; D-dimères; Fibrillation atriale; Thrombose; Thrombosis