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Hypercoagulation detected by routine and global laboratory hemostasis assays in patients with infective endocarditis

Ekaterina M Koltsova1,2, Maria A Sorokina1, Alexandra S Pisaryuk3,4

  • 1Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation.

Plos One
|December 15, 2021
PubMed

Insights

Infective endocarditis (IE) involves hypercoagulability and platelet activation. Some patients show hypocoagulation, possibly indicating consumption coagulopathy, but genetic factors did not link to embolism or mortality in this IE study.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Infectious Diseases

Background:

  • The coagulation system plays a critical role in infective endocarditis (IE) vegetation development and embolization.
  • Understanding coagulation and platelet status in IE is crucial for managing complications.

Purpose of the Study:

  • To assess coagulation and platelet status in IE patients using diverse laboratory assays.
  • To investigate the role of prothrombotic genetic polymorphisms in IE-related embolization and mortality.

Main Methods:

  • 37 IE patients were studied, assessing coagulation via standard assays (APTT, prothrombin, fibrinogen, D-dimer) and integral assays (TEG, TD).
  • Platelet functional activity was evaluated using flow cytometry.
  • Genetic polymorphisms in coagulation system genes were analyzed.

Main Results:

  • Elevated fibrinogen and fibrinogen-dependent TEG/TD parameters indicated systemic inflammation in IE patients.
  • Most patients exhibited hypercoagulation, evidenced by clot growth rate and D-dimer levels.
  • Some patients presented with hypocoagulation (prothrombin, TEG, TD), and resting platelets showed activation; decreased fibrinogen/TD correlated with fatal outcomes, while decreased TEG R parameter indicated embolism. No genetic associations were found.

Conclusions:

  • IE is generally characterized by hypercoagulability and platelet pre-activation.
  • A subset of IE patients may develop a hypocoagulant profile, potentially signifying consumption coagulopathy.
  • Genetic polymorphisms were not associated with embolism or mortality in this IE cohort.
Abstract

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