Possible relationship between antiphospholipid antibodies and embolic events in infective endocarditis
| Autor: | Christine, Selton-Suty, Charles-Henry, Maigrat, Jean, Devignes, François, Goehringer, Marie-Line, Erpelding, François, Alla, Carine, Thivilier, Olivier, Huttin, Clément, Venner, Yves, Juilliere, Thanh, Doco-Lecompte, Thomas, Lecompte, Catherine, Campagnac |
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| Přispěvatelé: | Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Réanimation Médicale [CHRU Nancy], Service de Cardiologie [Institut Lorrain du Cœur et des Vaisseaux], Service de Cardiologie [CHRU Nancy], Division of Haematology (Div Haemato - GENEVE), Hôpitaux Universitaires de Genève (HUG) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Embolism 030204 cardiovascular system & hematology Asymptomatic Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Endocarditis Humans 030212 general & internal medicine Platelet activation Correlation of Data Stroke ComputingMilieux_MISCELLANEOUS Aged Creatinine business.industry Middle Aged medicine.disease Platelet Activation stroke 3. Good health chemistry Predictive value of tests Infective endocarditis Antibodies Antiphospholipid endocarditis Female [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie medicine.symptom Cardiology and Cardiovascular Medicine business neurologic events |
| Zdroj: | Heart Heart, BMJ Publishing Group, 2018, 104 (6), pp.509-516. ⟨10.1136/heartjnl-2017-312359⟩ |
| ISSN: | 1355-6037 1468-201X |
| DOI: | 10.1136/heartjnl-2017-312359⟩ |
| Popis: | ObjectiveAntiphospholipid (aPL) antibodies may activate platelets and contribute to vegetation growth and embolisation in infective endocarditis (IE). We aimed to determine the value of aPL as predictors of embolic events (EE) in IE.MethodsWe studied 186 patients with definite IE (Duke-Li criteria, all types of IE) from the Nanc-IE prospective registry (2007–2012) who all had a frozen blood sample and at least one imaging procedure to detect asymptomatic or confirm symptomatic EE. Anticardiolipin (aCL) and anti-β2-glycoprotein I (β2GPI) antibodies (IgG and IgM) were assessed after the end of patients’ inclusion. The relationship between antibodies and the detection of EE after IE diagnosis were studied with Kaplan-Meier and Cox multivariate analyses.ResultsAt least one EE was detected in 118 (63%) patients (52 cerebral, 95 other locations) after IE diagnosis in 80 (time interval between IE and EE diagnosis: 5.9±11.3 days). At least one aPL antibody was found in 31 patients (17%).Detection of EE over time after IE diagnosis was more frequent among patients with anti-β2GPI IgM (log-rank P=0.0036) and that of cerebral embolisms, among patients with aCL IgM and anti-β2GPI IgM (log-rank P=0.002 and PFactors predictive of EE were anti-β2GPI IgM (HR=3.45 (1.47–8.08), P=0.0045), creatinine (2.74 (1.55–4.84), P=0.0005) and vegetation size (2.41 (1.41–4.12), P=0.0014). Those of cerebral embolism were aCL IgM (2.84 (1.22–6.62), P=0.016) and anti-β2GPI IgM (4.77 (1.79–12.74), P=0.0018).ConclusionThe presence of aCL and anti-β2GPI IgM was associated with EE, particularly cerebral ones, and could contribute to assess the embolic risk of IE. |
| Databáze: | OpenAIRE |
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