Changes in hemostasis parameters in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia complicated by endocarditis or thromboembolic events : a prospective gender-age adjusted cohort study

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Forsblom , E , Lepäntalo , A , Wartiovaara-Kautto , U , Ruotsalainen , E & Järvinen , A 2019 , ' Changes in hemostasis parameters in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia complicated by endocarditis or thromboembolic events : a prospective gender-age adjusted cohort study ' , APMIS : Acta pathologica, microbiologica et immunologica Scandinavica , vol. 127 , no. 7 , pp. 515-528 . https://doi.org/10.1111/apm.12955

Title: Changes in hemostasis parameters in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia complicated by endocarditis or thromboembolic events : a prospective gender-age adjusted cohort study
Author: Forsblom, Erik; Lepäntalo, Aino; Wartiovaara-Kautto, Ulla; Ruotsalainen, Eeva; Järvinen, Asko
Other contributor: University of Helsinki, HUS Inflammation Center
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, Infektiosairauksien yksikkö
University of Helsinki, HUS Inflammation Center







Date: 2019-07
Language: eng
Number of pages: 14
Belongs to series: APMIS : Acta pathologica, microbiologica et immunologica Scandinavica
ISSN: 0903-4641
DOI: https://doi.org/10.1111/apm.12955
URI: http://hdl.handle.net/10138/318821
Abstract: The aim of this study was to examine the changes in hemostasis parameters in endocarditis and thromboembolic events in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia (MS-SAB) - a topic not evaluated previously. In total, 155 patients were recruited and were categorized according to the presence of endocarditis or thromboembolic events with gender-age adjusted controls. Patients who deceased within 90 days or patients not chosen as controls were excluded. SAB management was supervised by an infectious disease specialist. Patients with endocarditis (N = 21), compared to controls (N = 21), presented lower antithrombin III at day 4 (p <0.05), elevated antithrombin III at day 90 (p <0.01), prolonged activated partial thromboplastin time at days 4 and 10 (p <0.05), and enhanced thrombin-antithrombin complex at day 4 (p <0.01). Thromboembolic events (N = 8), compared to controls (N = 34), significantly increased thrombin-antithrombin complex at day 4 (p <0.05). In receiver operating characteristic analysis, the changes in these hemostasis parameters at day 4 predicted endocarditis and thromboembolic events (p <0.05). No differences in hemoglobin, thrombocyte, prothrombin fragment, thrombin time, factor VIII, D-dimer or fibrinogen levels were observed between cases and controls. The results suggest that nonfatal MS-SAB patients present marginal hemostasis parameter changes that, however, may have predictability for endocarditis or thromboembolic events. Larger studies are needed to further assess the connection of hemostasis to complications in SAB.
Subject: Endocarditis
hemostasis
infectious specialist consultation
staphylococcus aureus bacteremia
thromboembolic events
INFECTIOUS-DISEASE CONSULTATION
VENOUS THROMBOEMBOLISM
PLATELET ACTIVATION
BLOOD-COAGULATION
INCREASED RISK
D-DIMER
MORTALITY
PROTEIN
ASSOCIATION
MANAGEMENT
3121 General medicine, internal medicine and other clinical medicine
3111 Biomedicine
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