Bahy Abofrekha, Jessica Schwartz, Chloe Lahoud, Ahmad Mustafa, Chapman Wei, Salman Khan, Mitchell Weinberg, Martin Miguel Amor
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Hospitalized patients aged 18-75 with APS were compared to those without APS. Patients with major pre-existing risks for IE or significant confounders (e.g., prosthetic valves, specific congenital/rheumatic heart diseases, ESRD) were excluded. Multivariable logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).Results297,459 patients fitted our inclusion criteria. On multivariate analysis, APS was significantly associated with over double the odds of IE (aOR 2.03; 95% CI 1.22-3.37). Importantly, APS also conferred considerably increased risks of MRSA sepsis (aOR 1.75; 95% CI 1.18-2.58) and MSSA sepsis (aOR 1.86; 95% CI 1.28-2.70).ConclusionAPS emerged as a significant independent risk factor for IE, Methicillin-resistant (MRSA), and Methicillin-sensitive <i>Staphylococcus aureus (MSSA)</i> sepsis. This suggests a broader vulnerability to infection, possibly linked to underlying endothelial dysfunction or immune dysregulation inherent in APS. These findings highlight the critical need for increased clinical suspicion, vigilant monitoring, and potentially tailored prophylactic or treatment approaches for severe infections in patients with APS.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1158-1165"},"PeriodicalIF":1.9000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of antiphospholipid syndrome with infective endocarditis and sepsis induced by Staphylococcus aureus: A U.S. nationwide inpatient sample analysis.\",\"authors\":\"Bahy Abofrekha, Jessica Schwartz, Chloe Lahoud, Ahmad Mustafa, Chapman Wei, Salman Khan, Mitchell Weinberg, Martin Miguel Amor\",\"doi\":\"10.1177/09612033251366391\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>BackgroundAntiphospholipid syndrome (APS) predisposes patients to thrombosis and cardiac valve lesions such as Libman-Sacks endocarditis. These vegetations are sterile yet can provide a nidus for infection; the risk of infective endocarditis (IE) and other serious infections in APS patients remains poorly quantified in large populations, representing a knowledge gap.ObjectiveTo quantify the risk of the primary outcome, IE, and secondary outcomes of MRSA sepsis and MSSA sepsis, associated with APS using a large, nationally representative inpatient database.MethodsWe conducted a cross-sectional study using the National Inpatient Sample (NIS) database from 2016 to 2020. Hospitalized patients aged 18-75 with APS were compared to those without APS. Patients with major pre-existing risks for IE or significant confounders (e.g., prosthetic valves, specific congenital/rheumatic heart diseases, ESRD) were excluded. Multivariable logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).Results297,459 patients fitted our inclusion criteria. On multivariate analysis, APS was significantly associated with over double the odds of IE (aOR 2.03; 95% CI 1.22-3.37). Importantly, APS also conferred considerably increased risks of MRSA sepsis (aOR 1.75; 95% CI 1.18-2.58) and MSSA sepsis (aOR 1.86; 95% CI 1.28-2.70).ConclusionAPS emerged as a significant independent risk factor for IE, Methicillin-resistant (MRSA), and Methicillin-sensitive <i>Staphylococcus aureus (MSSA)</i> sepsis. This suggests a broader vulnerability to infection, possibly linked to underlying endothelial dysfunction or immune dysregulation inherent in APS. These findings highlight the critical need for increased clinical suspicion, vigilant monitoring, and potentially tailored prophylactic or treatment approaches for severe infections in patients with APS.</p>\",\"PeriodicalId\":18044,\"journal\":{\"name\":\"Lupus\",\"volume\":\" \",\"pages\":\"1158-1165\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lupus\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/09612033251366391\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lupus","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/09612033251366391","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/8 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:抗磷脂综合征(APS)使患者易患血栓和心脏瓣膜病变,如Libman-Sacks心内膜炎。这些植物是无菌的,但可以为感染提供一个中心;在大量人群中,APS患者感染性心内膜炎(IE)和其他严重感染的风险仍然缺乏量化,这代表了知识差距。目的利用具有全国代表性的大型住院患者数据库,量化与APS相关的MRSA败血症和MSSA败血症的主要结局、IE和次要结局的风险。方法采用2016 - 2020年全国住院患者样本(NIS)数据库进行横断面研究。将18-75岁的APS住院患者与非APS住院患者进行比较。排除存在IE或重大混杂因素(如人工瓣膜、特定先天性/风湿性心脏病、ESRD)的主要预先存在风险的患者。采用多变量logistic回归计算校正优势比(aORs), 95%置信区间(CIs)。结果297,459例患者符合我们的纳入标准。多变量分析显示,APS与IE的发生率显著相关(aOR 2.03;95% ci 1.22-3.37)。重要的是,APS也会显著增加MRSA败血症的风险(aOR 1.75;95% CI 1.18-2.58)和MSSA脓毒症(aOR 1.86;95% ci 1.28-2.70)。结论aps是IE、耐甲氧西林(MRSA)和甲氧西林敏感金黄色葡萄球菌(MSSA)败血症的重要独立危险因素。这表明APS更容易受到感染,可能与潜在的内皮功能障碍或固有的免疫失调有关。这些发现强调了增加临床怀疑、警惕监测以及针对APS患者严重感染量身定制预防或治疗方法的迫切需要。
Association of antiphospholipid syndrome with infective endocarditis and sepsis induced by Staphylococcus aureus: A U.S. nationwide inpatient sample analysis.
BackgroundAntiphospholipid syndrome (APS) predisposes patients to thrombosis and cardiac valve lesions such as Libman-Sacks endocarditis. These vegetations are sterile yet can provide a nidus for infection; the risk of infective endocarditis (IE) and other serious infections in APS patients remains poorly quantified in large populations, representing a knowledge gap.ObjectiveTo quantify the risk of the primary outcome, IE, and secondary outcomes of MRSA sepsis and MSSA sepsis, associated with APS using a large, nationally representative inpatient database.MethodsWe conducted a cross-sectional study using the National Inpatient Sample (NIS) database from 2016 to 2020. Hospitalized patients aged 18-75 with APS were compared to those without APS. Patients with major pre-existing risks for IE or significant confounders (e.g., prosthetic valves, specific congenital/rheumatic heart diseases, ESRD) were excluded. Multivariable logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).Results297,459 patients fitted our inclusion criteria. On multivariate analysis, APS was significantly associated with over double the odds of IE (aOR 2.03; 95% CI 1.22-3.37). Importantly, APS also conferred considerably increased risks of MRSA sepsis (aOR 1.75; 95% CI 1.18-2.58) and MSSA sepsis (aOR 1.86; 95% CI 1.28-2.70).ConclusionAPS emerged as a significant independent risk factor for IE, Methicillin-resistant (MRSA), and Methicillin-sensitive Staphylococcus aureus (MSSA) sepsis. This suggests a broader vulnerability to infection, possibly linked to underlying endothelial dysfunction or immune dysregulation inherent in APS. These findings highlight the critical need for increased clinical suspicion, vigilant monitoring, and potentially tailored prophylactic or treatment approaches for severe infections in patients with APS.
期刊介绍:
The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…