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Risk of stroke subsequent to infective endocarditis: A nationwide study.

Østergaard, Lauge; Andersson, Niklas Worm; Kristensen, Søren Lund; Dahl, Anders; Bundgaard, Henning; Iversen, Kasper; Eske-Bruun, Niels; Gislason, Gunnar; Torp-Pedersen, Christian; Valeur, Nana; Køber, Lars; Fosbøl, Emil Loldrup.
Am Heart J; 212: 144-151, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31004917

BACKGROUND:

The aim of the study was to investigate the associated risk of stroke after discharge of infective endocarditis (IE) in patients with stroke during IE admission compared with patients without stroke during IE admission.

METHODS:

Using Danish nationwide registries, we identified nonsurgically treated patients with IE discharged alive in the period from 1996 to 2016. The study population was grouped into (1) patients with stroke during IE admission and (2) patients without stroke during IE admission. Multivariable adjusted Cox proportional-hazard analysis was used to compare the associated risk of stroke between groups.

RESULTS:

We identified 4,284 patients with IE, of whom 239 (5.6%) had a stroke during IE admission. We identified differentials in the associated risk of stroke during follow-up between groups (P = .006 for interaction with time). The associated risk of stroke was higher in patients with stroke during IE admission with a 1-year follow-up, HR = 3.21 (95% CI 1.66-6.20), compared with patients without stroke during IE admission. From 1 to 5 years of follow-up, we identified no difference in the associated risk of stroke between groups, HR = 0.91 (95% CI 0.33-2.50).

CONCLUSIONS:

Patients with nonsurgically treated IE with a stroke during IE admission were at significant higher associated risk of subsequent stroke within the first year of follow-up as compared with patients without a stroke during IE admission. This risk difference was not evident beyond 1 year of discharge. These findings underline the need for identification of causes and mechanisms of recurrent strokes after IE to develop preventive means.
Selo DaSilva