Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 4/2013

01-08-2013 | Cardiovascular Infections (D Levine, Section Editor)

Impact of Antiplatelet Therapy on Clinical Manifestations and Outcomes of Cardiovascular Infections

Authors: Ammar Habib, Larry M. Baddour, M. Rizwan Sohail

Published in: Current Infectious Disease Reports | Issue 4/2013

Login to get access

Abstract

Despite advances in medical and surgical management, infective endocarditis remains associated with significant morbidity and mortality. Septic embolization to the brain and other organs is one of the most dreaded complications of infective endocarditis. Given the critical role of platelets in bacterial vegetation formation on cardiac valves or cardiac device leads, antiplatelet agents, including aspirin, have recently generated much interest as adjunctive therapies in cardiovascular infections. In this article, we review the published evidence evaluating the role of platelets in the pathogenesis of cardiovascular infections and the rationale for using antiplatelet agents in these infections.
Literature
1.
Le KY, Sohail MR, Friedman PA, et al. Impact of timing of device removal on mortality in patients with cardiovascular implantable electronic device infections. Hear Rhythm. 2011;8:1678–85.CrossRef
2.
Sohail MR, Henrikson CA, Braid-Forbes MJ, Forbes KF, Lerner DJ. Mortality and cost associated with cardiovascular implantable electronic device infections. Arch Intern Med. 2011;171:1821–8.PubMedCrossRef
3.
Sohail MR, Uslan DZ, Khan AH, et al. Management and outcome of permanent pacemaker and implantable cardioverter-defibrillator infections. J Am Coll Cardiol. 2007;49:1851–9.PubMedCrossRef
4.
Tleyjeh IM, Steckelberg JM, Murad HS, et al. Temporal trends in infective endocarditis: a population-based study in Olmsted County, Minnesota. JAMA. 2005;293:3022–8.PubMedCrossRef
5.
Vilacosta I, Graupner C, San Roman JA, et al. Risk of embolization after institution of antibiotic therapy for infective endocarditis. J Am Coll Cardiol. 2002;39:1489–95.PubMedCrossRef
6.
Bonow RO, Carabello BA, Chatterjee K, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:e1–142.PubMedCrossRef
7.
Kim DH, Kang DH, Lee MZ, et al. Impact of early surgery on embolic events in patients with infective endocarditis. Circulation. 2010;122:S17–22.PubMedCrossRef
8.
Clawson CC, Rao GH, White JG. Platelet interaction with bacteria. IV. Stimulation of the release reaction. Am J Pathol. 1975;81:411–20.PubMed
9.
Fowler VG Jr, Scheld W, Bayer AS. Endocarditis and Intravascular Infections. In: Mandell GLBJ, Dolin R, editors. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009.
10.
Kupferwasser LI, Yeaman MR, Shapiro SM, et al. Acetylsalicylic acid reduces vegetation bacterial density, hematogenous bacterial dissemination, and frequency of embolic events in experimental Staphylococcus aureus endocarditis through antiplatelet and antibacterial effects. Circulation. 1999;99:2791–7.PubMedCrossRef
11.
Scheld WM, Valone JA, Sande MA. Bacterial adherence in the pathogenesis of endocarditis. Interaction of bacterial dextran, platelets, and fibrin. J Clin Invest. 1978;61:1394–404.PubMedCrossRef
12.
Kupferwasser LI, Yeaman MR, Nast CC, et al. Salicylic acid attenuates virulence in endovascular infections by targeting global regulatory pathways in Staphylococcus aureus. J Clin Invest. 2003;112:222–33.PubMed
13.
Nicolau DP, Freeman CD, Nightingale CH, et al. Reduction of bacterial titers by low-dose aspirin in experimental aortic valve endocarditis. Infect Immun. 1993;61:1593–5.PubMed
14.
Nicolau DP, Marangos MN, Nightingale CH, Quintiliani R. Influence of aspirin on development and treatment of experimental Staphylococcus aureus endocarditis. Antimicrob Agents Chemother. 1995;39:1748–51.PubMedCrossRef
15.
Nicolau DP, Tessier PR, Nightingale CH. Beneficial effect of combination antiplatelet therapy on the development of experimental Staphylococcus aureus endocarditis. Int J Antimicrob Agents. 1999;11:159–61.PubMedCrossRef
16.
Nicolau DP, Tessier PR, Nightingale CH, Quintiliani R. Influence of adjunctive ticlopidine on the treatment of experimental Staphylococcus aureus endocarditis. Int J Antimicrob Agents. 1998;9:227–9.PubMedCrossRef
17.
Domenico P, Schwartz S, Cunha BA. Reduction of capsular polysaccharide production in Klebsiella pneumoniae by sodium salicylate. Infect Immun. 1989;57:3778–82.PubMed
18.
Polonio RE, Mermel LA, Paquette GE, Sperry JF. Eradication of biofilm-forming Staphylococcus epidermidis (RP62A) by a combination of sodium salicylate and vancomycin. Antimicrob Agents Chemother. 2001;45:3262–6.PubMedCrossRef
19.
Taha TH, Durrant SS, Mazeika PK, Nihoyannopoulos P, Oakley CM. Aspirin to prevent growth of vegetations and cerebral emboli in infective endocarditis. J Intern Med. 1992;231:543–6.PubMedCrossRef
20.
Chan KL, Dumesnil JG, Cujec B, et al. A randomized trial of aspirin on the risk of embolic events in patients with infective endocarditis. J Am Coll Cardiol. 2003;42:775–80.PubMedCrossRef
21.
Chan KL, Tam J, Dumesnil JG, et al. Effect of long-term aspirin use on embolic events in infective endocarditis. Clin Infect Dis. 2008;46:37–41.PubMedCrossRef
22.
Anavekar NS, Tleyjeh IM, Mirzoyev Z, et al. Impact of prior antiplatelet therapy on risk of embolism in infective endocarditis. Clin Infect Dis. 2007;44:1180–6.PubMedCrossRef
23.
•• Anavekar NS, Schultz JC, De Sa DD, et al. Modifiers of symptomatic embolic risk in infective endocarditis. Mayo Clin Proc. 2011;86:1068–74. This study showed that embolization risk in patients with endocarditis was significantly less in patients receiving statin therapy, but not with chronic antiplatelet therapy. Neither chronic statin therapy nor aspirin therapy had a significant effect on 6-month mortality.
24.
Serebruany VL, Miller M, Pokov AN, et al. Effect of statins on platelet PAR-1 thrombin receptor in patients with the metabolic syndrome (from the PAR-1 inhibition by statins [PARIS] study). Am J Cardiol. 2006;97:1332–6.PubMedCrossRef
25.
Tleyjeh IM, Kashour T, Hakim FA, et al. Statins for the prevention and treatment of infections: a systematic review and meta-analysis. Arch Intern Med. 2009;169:1658–67.PubMedCrossRef
26.
• Snygg-Martin U, Rasmussen RV, Hassager C, Bruun NE, Andersson R, Olaison L. The relationship between cerebrovascular complications and previously established use of antiplatelet therapy in left-sided infective endocarditis. Scand J Infect Dis. 2011;43:899–904. This study showed no significant reduction in cerebrovascular complication rate in endocarditis patients receiving chronic antiplatelet therapy.
27.
• Eisen DP, Corey GR, McBryde ES, et al. Reduced valve replacement surgery and complication rate in Staphylococcus aureus endocarditis patients receiving acetyl-salicylic acid. J Infect. 2009;58:332–8. This was a randomized trial that showed that recent aspirin therapy was associated with reduced rate of acute valve replacement surgery without a significant effect on rate of embolization or hemorrhagic stroke.
28.
Pepin J, Tremblay V, Bechard D, et al. Chronic antiplatelet therapy and mortality among patients with infective endocarditis. Clin Microbiol Infect. 2009;15:193–9.PubMedCrossRef
29.
•• Habib A, Le KY, Baddour LM, et al. Predictors of Mortality in Patients With Cardiovascular Implantable Electronic Device Infections. Am J Cardiol 2012. This study showed that patients with CIED infection that were on chronic aspirin therapy were less likely to have vegetations on cardiac device leads or heart valves, and less likely to have systemic manifestations of infection. There was no significant difference in mortality or pathogen distribution, however.
30.
Greenspon AJ, Prutkin JM, Sohail MR, et al. Timing of the most recent device procedure influences the clinical outcome of lead-associated endocarditis results of the MEDIC (Multicenter Electrophysiologic Device Infection Cohort). J Am Coll Cardiol. 2012;59:681–7.PubMedCrossRef
31.
Le KY, Sohail MR, Friedman PA, et al. Clinical predictors of cardiovascular implantable electronic device-related infective endocarditis. Pacing Clin Electrophysiol. 2011;34:450–9.PubMedCrossRef
32.
Habib A, Irfan M, Baddour LM, et al. Impact of prior aspirin therapy on clinical manifestations of cardiovascular implantable electronic device infections. Europace 2012.
33.
34.
Hart RG, Kagan-Hallet K, Joerns SE. Mechanisms of intracranial hemorrhage in infective endocarditis. Stroke. 1987;18:1048–56.PubMedCrossRef
Metadata
Title
Impact of Antiplatelet Therapy on Clinical Manifestations and Outcomes of Cardiovascular Infections
Authors
Ammar Habib
Larry M. Baddour
M. Rizwan Sohail
Publication date
01-08-2013
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 4/2013
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-013-0347-z

Other articles of this Issue 4/2013

Current Infectious Disease Reports 4/2013 Go to the issue

CARDIOVASCULAR INFECTIONS (D LEVINE, SECTION EDITOR)

Pathophysiology of Infective Endocarditis

Cardiovascular Infections (D Levine, Section Editor)

Endocarditis Caused by Resistant Enterococcus: An Overview

Cardiovascular Infections (D Levine, Section Editor)

Management of MRSA/GISA, VISA Endocarditis

Hot Topic

Why We Need Crowdsourced Data in Infectious Disease Surveillance

CARDIOVASCULAR INFECTIONS (D LEVINE, SECTION EDITOR)

Role of Echocardiography in Guiding the Optimal Timing of Surgery in Infective Endocarditis

Invited Commentary

Expatriates: Special Considerations in Pretravel Preparation
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits