Prophylaxis of experimental endocarditis with antiplatelet and antithrombin agents : a role for long-term prevention of infective endocarditis in humans?

Détails

ID Serval
serval:BIB_5374C570E777
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prophylaxis of experimental endocarditis with antiplatelet and antithrombin agents : a role for long-term prevention of infective endocarditis in humans?
Périodique
Journal of Infectious Diseases
Auteur(s)
Veloso T.R., Que Y.A., Chaouch A., Giddey M., Vouillamoz J., Rousson V., Moreillon P., Entenza J.M.
ISSN
1537-6613 (Electronic)
ISSN-L
0022-1899
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
211
Numéro
1
Pages
72-79
Langue
anglais
Résumé
BACKGROUND: Infective endocarditis (IE) mostly occurs after spontaneous low-grade bacteremia. Thus, IE cannot be prevented by circumstantial antibiotic prophylaxis. Platelet activation following bacterial-fibrinogen interaction or thrombin-mediated fibrinogen-fibrin polymerization is a critical step in vegetation formation. We tested the efficacy of antiplatelet and antithrombin to prevent experimental IE.
METHODS: A rat model of experimental IE following prolonged low-grade bacteremia mimicking smoldering bacteremia in humans was used. Prophylaxis with antiplatelets (aspirin, ticlopidine [alone or in combination], eptifibatide, or abciximab) or anticoagulants (antithrombin dabigatran etexilate or anti-vitamin K acenocoumarol) was started 2 days before inoculation with Streptococcus gordonii or Staphylococcus aureus. Valve infection was assessed 24 hours later.
RESULTS: Aspirin plus ticlopidine, as well as abciximab, protected 45%-88% of animals against S. gordonii and S. aureus IE (P < .05). Dabigatran etexilate protected 75% of rats against IE due to S. aureus (P < .005) but failed to protect against S. gordonii (<30% protection). Acenocoumarol was ineffective.
CONCLUSIONS: Antiplatelet and direct antithrombin agents may be useful in the prophylaxis of IE in humans. In particular, the potential dual benefit of dabigatran etexilate might be reconsidered for patients with prosthetic valves, who require life-long anticoagulation and in whom S. aureus IE is associated with high mortality.
Mots-clé
Endocarditis, Bacterial/drug therapy, Fibrinolytic Agents/pharmacology, Platelet Aggregation Inhibitors/pharmacology
Pubmed
Web of science
Open Access
Oui
Création de la notice
05/02/2015 15:26
Dernière modification de la notice
08/05/2019 18:41
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