The impact of thrombocytopenia on mortality in infective endocarditis − a meta-analysis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-08-05 DOI:10.1016/j.ijcha.2025.101760

Nadji Hannachi , Antoine Mariotti , Nabila El Gueddari , Laurence Camoin-Jau

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Abstract

Thrombocytopenia, a condition characterized by low platelet counts, is recognized as a risk factor in various infectious diseases, but it is not commonly included in prognostic scoring systems for infective endocarditis (IE). This meta-analysis aimed to assess the relationship between thrombocytopenia and mortality in patients with IE.

The study included 25 observational studies (21 retrospective and 4 prospective), covering a total of 110,411 patients diagnosed with IE. The primary outcome was in-hospital mortality associated with thrombocytopenia. Secondary outcomes included the mean difference in platelet counts between survivors and deceased patients, as well as long-term mortality.

The results demonstrated that patients with thrombocytopenia had significantly higher in-hospital mortality (Odds Ratio [OR]: 1.99; 95 % Confidence Interval [CI]: 1.72–2.31; P < 0.00001). Additionally, patients who died during hospitalization had significantly lower platelet counts compared to survivors (Mean Difference [MD]: −36,750/µL; 95 % CI: −52,570 to −20,920; P < 0.00001). Long-term mortality was also elevated in thrombocytopenic patients (Hazard Ratio [HR]: 2.08; 95 % CI: 1.29–3.34; P = 0.002).

These findings suggest that thrombocytopenia is significantly associated with both in-hospital and long-term mortality in patients with IE. The notable reduction in platelet counts among deceased patients further emphasizes its prognostic significance. The study highlights the need to consider thrombocytopenia in future prognostic models for IE. However, caution is advised when interpreting these results, and additional research is necessary to confirm these associations.

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血小板减少症对感染性心内膜炎患者死亡率的影响——荟萃分析

血小板减少症是一种以血小板计数低为特征的疾病，被认为是各种感染性疾病的危险因素，但它通常不包括在感染性心内膜炎（IE）的预后评分系统中。本荟萃分析旨在评估IE患者血小板减少症与死亡率之间的关系。该研究包括25项观察性研究（21项回顾性研究和4项前瞻性研究），共涵盖110,411例诊断为IE的患者。主要结局是与血小板减少症相关的住院死亡率。次要结果包括幸存者和死亡患者血小板计数的平均差异，以及长期死亡率。结果表明，血小板减少患者的住院死亡率显著高于其他患者(优势比[OR]: 1.99；95%置信区间[CI]: 1.72-2.31；P & lt;0.00001)。此外，与幸存者相比，住院期间死亡的患者血小板计数显著降低(Mean Difference [MD]:−36750 /µL；95% CI:−52,570 ~−20,920；P & lt;0.00001)。血小板减少患者的长期死亡率也升高(危险比[HR]: 2.08；95% ci: 1.29-3.34；P = 0.002)。这些发现表明，血小板减少症与IE患者的住院死亡率和长期死亡率均显著相关。死亡患者血小板计数的显著降低进一步强调了其预后意义。该研究强调了在IE的未来预后模型中考虑血小板减少的必要性。然而，在解释这些结果时，建议谨慎，需要进一步的研究来证实这些关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.