Zampino Rosa, Iossa Domenico, Ursi Maria Paola, Bertolino Lorenzo, Karruli Arta, Molaro Rosa, Esposito Gennaro, Vitrone Martina, D'Amico Fabiana, Albisinni Rosina, Durante-Mangoni Emanuele
Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Unit of Infectious & Transplant Medicine, A.O.R.N. Ospedali dei Colli-Ospedale Monaldi, 80131 Naples, Italy.
J Clin Med. 2021 Nov 18;10(22):5386. doi: 10.3390/jcm10225386.
(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 ( = 0.012) and a prolonged PT-INR ( = 0.013) were associated with higher in-hospital mortality, while prolonged aPTT ( = 0.021) was associated with increased 1-year mortality. () infection ( = 0.003), prosthetic valve endocarditis (PVE) ( = 0.001), surgical indication ( = 0.002) and higher D-dimer levels ( = 0.005) were independent predictors of in-hospital mortality. PVE ( = 0.001), a higher Charlson Comorbidity Index ( = 0.049), surgical indication ( = 0.001) and prolonged aPTT ( = 0.012) were independent predictors of 1-year mortality. Higher levels of D-dimers ( < 0.001) and a shorter aPTT ( < 0.001) were associated with embolic complications of IE. etiology was bound to higher D-dimers levels ( < 0.001) and a shorter aPTT ( = 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.
(1) 背景：本研究旨在评估感染性心内膜炎（IE）主要止血参数的临床意义及预后作用：凝血酶原时间国际标准化比值（PT-INR）、活化部分凝血活酶时间（aPTT）、纤维蛋白原、D-二聚体、血小板计数、同型半胱氨酸。(2) 方法：我们研究了337例IE患者。分析了临床、血液化学和超声心动图参数。入院时测量凝血参数。(3) 结果：D-二聚体水平（P = 0.012）和PT-INR延长（P = 0.013）与较高的院内死亡率相关，而aPTT延长（P = 0.021）与1年死亡率增加相关。金黄色葡萄球菌感染（P = 0.003）、人工瓣膜心内膜炎（PVE）（P = 0.001）、手术指征（P = 0.002）及较高的D-二聚体水平（P = 0.005）是院内死亡率的独立预测因素。PVE（P = 0.001）、较高的Charlson合并症指数（P = 0.049）、手术指征（P = 0.001）及aPTT延长（P = 0.012）是1年死亡率的独立预测因素。较高的D-二聚体水平（P < 0.001）和较短的aPTT（P < 0.001）与IE的栓塞并发症相关。金黄色葡萄球菌病因与较高的D-二聚体水平（P < 0.001）和较短的aPTT（P = 0.006）相关。(4) 结论：D-二聚体升高与IE患者较高的院内死亡风险相关。高D-二聚体和短aPTT与IE较高的栓塞事件风险相关。较长的aPTT与1年死亡率相关。
