Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis

(1) Background: The aim of this study was to assess the clinical significance and prognostic role of the main hemostasis parameters in infective endocarditis (IE): prothrombin time as international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT), fibrinogen, D-dimers, platele...

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Autores principales:	Rosa Zampino, Domenico Iossa, Maria Paola Ursi, Lorenzo Bertolino, Arta Karruli, Rosa Molaro, Gennaro Esposito, Martina Vitrone, Fabiana D’Amico, Rosina Albisinni, Emanuele Durante-Mangoni, on behalf of the Monaldi Hospital CardiovascularInfection Group
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	prognosis embolism D-dimers aPTT biomarkers Medicine R
Acceso en línea:	https://doaj.org/article/3eb4d942ea7440a685682290729495be
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spelling	oai:doaj.org-article:3eb4d942ea7440a685682290729495be2021-11-25T18:02:21ZClinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis10.3390/jcm102253862077-0383https://doaj.org/article/3eb4d942ea7440a685682290729495be2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5386https://doaj.org/toc/2077-0383(1) Background: The aim of this study was to assess the clinical significance and prognostic role of the main hemostasis parameters in infective endocarditis (IE): prothrombin time as international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT), fibrinogen, D-dimers, platelet count, homocysteine. (2) Methods: We studied 337 patients with IE. Clinical, hemato-chemical and echocardiography parameters were analyzed. Coagulation parameters were measured on admission. (3) Results: D-dimers levels (<i>p</i> = 0.012) and a prolonged PT-INR (<i>p</i> = 0.013) were associated with higher in-hospital mortality, while prolonged aPTT (<i>p</i> = 0.021) was associated with increased 1-year mortality. <i>Staphylococcus aureus</i> (<i>S. aureus</i>) infection (<i>p</i> = 0.003), prosthetic valve endocarditis (PVE) (<i>p</i> = 0.001), surgical indication (<i>p</i> = 0.002) and higher D-dimer levels (<i>p</i> = 0.005) were independent predictors of in-hospital mortality. PVE (<i>p</i> = 0.001), a higher Charlson Comorbidity Index (<i>p</i> = 0.049), surgical indication (<i>p</i> = 0.001) and prolonged aPTT (<i>p</i> = 0.012) were independent predictors of 1-year mortality. Higher levels of D-dimers (<i>p</i> < 0.001) and a shorter aPTT (<i>p</i> < 0.001) were associated with embolic complications of IE. <i>S. aureus</i> etiology was bound to higher D-dimers levels (<i>p</i> < 0.001) and a shorter aPTT (<i>p</i> = 0.006). (4) Conclusions: Elevated D-dimers are associated with a higher risk for in-hospital mortality in IE patients. High D-dimers and a short aPTT are associated with a higher risk for embolic events in IE. A longer aPTT is associated with 1-year mortality.Rosa ZampinoDomenico IossaMaria Paola UrsiLorenzo BertolinoArta KarruliRosa MolaroGennaro EspositoMartina VitroneFabiana D’AmicoRosina AlbisinniEmanuele Durante-Mangonion behalf of the Monaldi Hospital CardiovascularInfection Group MDPI AGarticleprognosisembolismD-dimersaPTTbiomarkersMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5386, p 5386 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	prognosis embolism D-dimers aPTT biomarkers Medicine R
spellingShingle	prognosis embolism D-dimers aPTT biomarkers Medicine R Rosa Zampino Domenico Iossa Maria Paola Ursi Lorenzo Bertolino Arta Karruli Rosa Molaro Gennaro Esposito Martina Vitrone Fabiana D’Amico Rosina Albisinni Emanuele Durante-Mangoni on behalf of the Monaldi Hospital CardiovascularInfection Group Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis
description	(1) Background: The aim of this study was to assess the clinical significance and prognostic role of the main hemostasis parameters in infective endocarditis (IE): prothrombin time as international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT), fibrinogen, D-dimers, platelet count, homocysteine. (2) Methods: We studied 337 patients with IE. Clinical, hemato-chemical and echocardiography parameters were analyzed. Coagulation parameters were measured on admission. (3) Results: D-dimers levels (<i>p</i> = 0.012) and a prolonged PT-INR (<i>p</i> = 0.013) were associated with higher in-hospital mortality, while prolonged aPTT (<i>p</i> = 0.021) was associated with increased 1-year mortality. <i>Staphylococcus aureus</i> (<i>S. aureus</i>) infection (<i>p</i> = 0.003), prosthetic valve endocarditis (PVE) (<i>p</i> = 0.001), surgical indication (<i>p</i> = 0.002) and higher D-dimer levels (<i>p</i> = 0.005) were independent predictors of in-hospital mortality. PVE (<i>p</i> = 0.001), a higher Charlson Comorbidity Index (<i>p</i> = 0.049), surgical indication (<i>p</i> = 0.001) and prolonged aPTT (<i>p</i> = 0.012) were independent predictors of 1-year mortality. Higher levels of D-dimers (<i>p</i> < 0.001) and a shorter aPTT (<i>p</i> < 0.001) were associated with embolic complications of IE. <i>S. aureus</i> etiology was bound to higher D-dimers levels (<i>p</i> < 0.001) and a shorter aPTT (<i>p</i> = 0.006). (4) Conclusions: Elevated D-dimers are associated with a higher risk for in-hospital mortality in IE patients. High D-dimers and a short aPTT are associated with a higher risk for embolic events in IE. A longer aPTT is associated with 1-year mortality.
format	article
author	Rosa Zampino Domenico Iossa Maria Paola Ursi Lorenzo Bertolino Arta Karruli Rosa Molaro Gennaro Esposito Martina Vitrone Fabiana D’Amico Rosina Albisinni Emanuele Durante-Mangoni on behalf of the Monaldi Hospital CardiovascularInfection Group
author_facet	Rosa Zampino Domenico Iossa Maria Paola Ursi Lorenzo Bertolino Arta Karruli Rosa Molaro Gennaro Esposito Martina Vitrone Fabiana D’Amico Rosina Albisinni Emanuele Durante-Mangoni on behalf of the Monaldi Hospital CardiovascularInfection Group
author_sort	Rosa Zampino
title	Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis
title_short	Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis
title_full	Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis
title_fullStr	Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis
title_full_unstemmed	Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis
title_sort	clinical significance and prognostic value of hemostasis parameters in 337 patients with acute infective endocarditis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3eb4d942ea7440a685682290729495be
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Clinical Significance and Prognostic Value of Hemostasis Parameters in 337 Patients with Acute Infective Endocarditis

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