Valvular and Congenital DiseaseThe risk of stroke and death in patients with aortic and mitral valve endocarditis☆,☆☆
Section snippets
Patient selection
A total of 2114 consecutive patients who underwent a transthoracic (TTE) or a transesophageal echocardiogram (TEE) for suspicion of endocarditis during the period from Jan 1, 1991, through Dec 31, 1999, were evaluated. Patients were enrolled if they were suspected to have IE and were not rejected by the Duke criteria.24 Demographic, clinical, microbiologic, pathologic, and echocardiographic data were collected from each patient’s medical record and clinical course. Of the 450 patients with
Demographic features
There were 145 patients with definite IE and isolated MV or AV involvement. The mean age of the cohort was 54.5 years (Table I).Empty Cell Total (n = 145) No. % Age (y) (mean ± SD) 54.5 ± 15.3 MV endocarditis 83 57.2 AV endocarditis 62 42.8 Male sex 88 60.7 Race White 80 56.3 Black 55 38.7 Intravenous drug use 13 9.0 HIV positive 4 2.8 Presence of prosthetic valve 62 42.8 Dialysis 22 15.2 Diabetes mellitus 33 22.8 History of cancer 10 6.9 Immune suppression 13 9.0 Transfer
Discussion
There are important differences in the demographic characteristics and echocardiographic findings between cases of MV IE and cases of AV IE. These differences include the risk of stroke. Stroke is 1.5 times more common in all patients with MV IE and more than 5 times more common in cases of native MV IE. In addition, preventable strokes tend to occur much earlier in patients with MV IE. In a multivariable analysis, valve location and vegetation length were the only independent predictors of
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2022, Infective Endocarditis: A Multidisciplinary ApproachNeurologic complications of infective endocarditis
2022, Infective Endocarditis: A Multidisciplinary Approach
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Supported by the following grants: American Society of Echocardiography: Outcomes Research Award (C. H. C., G. E. P., G. R. C., T. R.), Four Schools Physician Scientist Program sponsored by the Lucille P. Markee Charitable Trust (C. H. C.), and Joseph C. Greenfield Jr Scholars (C. H. C.).
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Reprint requests: Christopher H. Cabell, MD, DUMC Box 31020, Durham, NC 27710. E-mail: [email protected]