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

Rosa Zampino1,2, Domenico Iossa2,3, Maria Paola Ursi1

  • 1Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.

Journal of Clinical Medicine
|November 27, 2021
PubMed

Insights

Elevated D-dimers and prolonged PT-INR indicate higher in-hospital mortality in infective endocarditis (IE). Shorter activated partial thromboplastin time (aPTT) predicts embolic events, while longer aPTT is linked to increased 1-year mortality in IE patients.

Area of Science:

  • Cardiology
  • Hematology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) is a serious infection affecting heart valves.
  • Hemostasis parameters play a crucial role in IE pathogenesis and outcomes.
  • Assessing prognostic markers in IE is vital for patient management.

Purpose of the Study:

  • To evaluate the clinical significance of key hemostasis markers in IE.
  • To determine the prognostic role of PT-INR, aPTT, fibrinogen, D-dimers, platelet count, and homocysteine in IE.
  • To identify predictors of mortality and embolic complications in IE patients.

Main Methods:

  • A cohort of 337 patients diagnosed with IE was analyzed.
  • Clinical, hemato-chemical, and echocardiography data were collected.
  • Coagulation parameters, including D-dimers and aPTT, were measured upon admission.

Main Results:

  • Elevated D-dimers and prolonged PT-INR were associated with increased in-hospital mortality (p=0.012, p=0.013).
  • Prolonged aPTT correlated with higher 1-year mortality (p=0.021).
  • Higher D-dimer levels and shorter aPTT were linked to embolic complications (p<0.001).

Conclusions:

  • Elevated D-dimers are a significant predictor of in-hospital mortality in IE.
  • Both high D-dimers and short aPTT are associated with a greater risk of embolic events in IE.
  • aPTT duration serves as a prognostic indicator for both short-term and long-term outcomes in IE.

Keywords:
D-dimersaPTTbiomarkersembolismprognosis

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