The prognostic value of D-dimer in patients with infective endocarditis

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ABSTRACT Objectives: Infective endocarditis (IE) is a severe disease with a high morbidity and mortality rate. Identification of high-risk patients is needed to guide the management plan. D-dimer is a fibrin degradation product and is used as a global indicator of coagulation activation and fibrinolysis in the clinical practice. In our study, we investigated the D-dimer prognostic role in patients with IE and tried to find its correlation with bad outcomes, aiming for early stratification of patients with high risk for developing complications to get prompt management and improve the outcome. Methodology: Fifty patients with IE were included in the study; d-dimer level was analyzed and correlated with IE complications. Results: D-dimer level was insignificantly higher in patients who died during hospitalization and in patients with embolic complications. The increasing d-dimer trend was significantly higher in the dead group and insignificantly higher in the group of embolic complications. Regarding the in-hospital mortality, the receiver operator characteristic (ROC) curve analysis showed that levels >4 mg/L had a sensitivity of 60% and a specificity of 60 and levels >6 mg/L had a sensitivity of 52% and a specificity of 67% for predicting the in-hospital mortality ( P = 0.3). Regarding the embolization, the ROC analysis curve showed that levels >2.8 mg/L had a sensitivity of 67% and specificity of 58%, and levels >4 mg/L had a sensitivity of 58% and a specificity of 69% for predicting the embolic complication in the study population ( P = 0.2). D-dimer level >6 mg/L had a significantly higher incidence of heart failure and sepsis. Conclusion: D-dimer level in IE patients is a simple, available biomarker that could be used as an indicator for IE bad outcome.

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