当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > The presence of infection-related antiphospholipid antibodies in infective endocarditis determines a major risk factor for embolic events.

The presence of infection-related antiphospholipid antibodies in infective endocarditis determines a major risk factor for embolic events.

Abstract：

OBJECTIVES:The impact of infection-associated antiphospholipid antibodies (APA) on endothelial cell activation, blood coagulation and fibrinolysis was evaluated in patients with infective endocarditis with and without major embolic events. BACKGROUND:An embolic event is a common and severe complication of infective endocarditis. Despite the fact that APAs are known to be associated with infectious diseases, their pathogenic role in infective endocarditis has not been clearly defined. METHODS:The relationship among the occurrence of major embolic events, echocardiographic vegetation size, endothelial cell activation, thrombin generation, fibrinolysis and APA was examined in 91 patients with definite infective endocarditis, including 26 patients with embolic events and 65 control subjects without embolic events. RESULTS:Overall, 14.3% of patients exhibited elevated APA levels. Embolic events occurred more frequently in patients with elevated levels of APA than in patients without (61.5% vs. 23.1%; p = 0.008). Patients with elevated levels of APA showed higher levels of prothrombin-fragment F1 +2 (p = 0.005), plasminogen-activator inhibitor 1 (p = 0.0002), von Willebrand factor (p = 0.002) and lower levels of activated protein C (p = 0.001) than patients with normal levels of APA. Thrombin generation and endothelial cell activation were both positively correlated with levels of APA. The occurrence of elevated APA levels was frequently associated with structural valve abnormalities (p = 0.01) and vegetations >1.3 cm (p = 0.002). CONCLUSIONS:Infection-associated elevated APA levels in patients with infective endocarditis are related to endothelial cell activation, thrombin generation and impairment of fibrinolysis. This may contribute to the increased risk for major embolic events in these patients.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Kupferwasser LI,Hafner G,Mohr-Kahaly S,Erbel R,Meyer J,Darius H

doi

10.1016/s0735-1097(99)00024-8

subject

Has Abstract

pub_date

1999-04-01 00:00:00

pages

1365-71

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(99)00024-8

journal_volume

pub_type

杂志文章

在线工具

The presence of infection-related antiphospholipid antibodies in infective endocarditis determines a major risk factor for embolic events.