Adjunctive dabigatran therapy improves outcome of experimental left-sided Staphylococcus aureus endocarditis

BackgroundStaphylococcus aureus is the most frequent and fatal cause of left-sided infective endocarditis (IE). New treatment strategies are needed to improve the outcome. S. aureus coagulase promotes clot and fibrin formation. We hypothesized that dabigatran, could reduce valve vegetations and inflammation in S. aureus IE.MethodsWe used a rat model of severe aortic valve S. aureus IE. All infected animals were randomized to receive adjunctive dabigatran (10 mg/kg b.i.d., n = 12) or saline (controls, n = 11) in combination with gentamicin. Valve vegetation size, bacterial load, cytokine, cell integrins expression and peripheral platelets and neutrophils were assessed 3 days post-infection.ResultsAdjunctive dabigatran treatment significantly reduced valve vegetation size compared to controls (p+) unbound to neutrophils.ConclusionAdjunctive dabigatran reduced the vegetation size, bacterial load, and inflammation in experimental S. aureus IE.