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Clinical risk factors for acute ischaemic and haemorrhagic stroke in patients with infective endocarditis

Ives Valenzuela1, Madeleine D Hunter1, Kathryn Sundheim1

  • 1College of Physicians and Surgeons, Columbia University, New York, New York, USA.

Internal Medicine Journal
|May 10, 2018
PubMed

Insights

Infective endocarditis (IE) patients have distinct risk factors for ischemic and hemorrhagic strokes. Identifying these factors can improve stroke risk assessment and management in IE.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Stroke is a serious complication of infective endocarditis (IE), often leading to poor outcomes.
  • Risk factors for specific stroke subtypes (ischemic vs. hemorrhagic) in IE patients are not well-established.

Purpose of the Study:

  • To identify risk factors associated with ischemic and hemorrhagic strokes in patients with infective endocarditis.

Main Methods:

  • Retrospective chart review of 1157 adult patients with IE and stroke diagnoses at a US academic center.
  • Univariate and multivariable logistic regression analyses were used to determine risk factors for stroke subtypes.
  • Correlation matrices assessed collinearity, and odds ratios (OR) with 95% confidence intervals were calculated.

Main Results:

  • Ischemic stroke risk factors in IE patients included prior stroke, Staphylococcus infection, mitral vegetations, and valvular abscess.
  • Hemorrhagic stroke risk factors included fungal infection, male gender, and rheumatic heart disease.
  • The overall prevalence of non-surgical stroke in IE patients was 15.4%.

Conclusions:

  • Distinct patient characteristics are associated with increased risk for ischemic versus hemorrhagic stroke in the context of infective endocarditis.
  • Understanding these differential risk factors is crucial for targeted prevention and treatment strategies in IE patients.
Abstract

Keywords:
endocarditisintracranial haemorrhagerheumatic heart diseasestrokesubarachnoid haemorrhage

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