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

Valenzuela, Ives A; Hunter, Madeleine D; Sundheim, Kathryn M; Klein, Babette V.; Dunn, Lauren E; Sorabella, Robert A.; Han, S.; Willey, Joshua Z.; George, Isaac; Gutierrez, José

doi:10.1111/imj.13958

“…Thirdly, IE patients of the later-period group developed less ischemic stroke (27.3% vs 10.3%, OR = 3.269, CI: 1.592-6.714). Previous studies reported that Staphylococcus aureus infection and vegetations on the mitral valve were risk factors for ischemic stroke [21,22] , but among the patients in this study, the later-period group showed a lower percentage of Staphylococcus aureus infection and a nonsignificant rise in patients with mitral vegetations (34.7% vs 30.9%). We speculate that an older age at onset and a higher proportion of diabetics (10.6% vs 5.2%) may play a more important role in triggering ischemic stroke.…”

Section: Clinical Featurescontrasting

confidence: 77%

A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

Ren

¹

,

Mo

²

,

Chen

³

et al. 2019

Preprint

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Background: Infective endocarditis (IE) is a lethal disease which has been changing significantly over the past decades; however, information about IE in China remains scarce. This study surveyed the changes in clinical characteristics of IE at a tertiary hospital in southern China over a period of nearly eighteen years. Methods: Medical records with IE patients consecutively hospitalized between June 2001 and June 2018 were selected from the electronic medical records system in Nanfang Hospital of Southern Medical University. Data were divided by admission time into two groups: early-period group, June 2001 to December 2009 and later-period group, January 2010 to July 2018. Results: A Total of 313 IE patients were included in our study. Compared with the early-period group, patients in the later-period group included fewer intravenous drug users (IVDU), older age at onset, reduced development of pulmonary embolism, less renal dysfunction, decreased proportion of Staphylococcus aureus infection and fewer vegetations observed in the right heart by echocardiography. The later-period group also showed a higher proportion of ischemic strokes and higher rate of whole-blood culture positive compared with the early-period group. The in-hospital mortality rate remained about the same between the two periods. Conclusions: Our study demonstrated a dramatic change in the profile and characteristics of IE over a period of eighteen years at a tertiary hospital in southern China, especially the decrease in intravenous drug users (IVDU), which might be responsible for many other changes.

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“…Ischemic stroke is one of the most common central nervous events in IE patients, and occurred in 22% of the patients in our study, and was more common in the later-period group (27.3% vs 10.3%, P = 0.001, OR = 3.269). It has been reported that Staphylococcus aureus infection and vegetations on the mitral valve were risk factors for ischemic stroke [18,19] , but among the patients in this study, the later-period group showed a lower percentage of Staphylococcus aureus infection (20.0% vs 41.3%, P = 0.004, OR = 0.355) and a nonsignificant rise in patients with mitral vegetations (34.7% vs 30.9%).…”

Section: Discussioncontrasting

confidence: 66%

A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

Ren

¹

,

Mo

²

,

Chen

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background: Infective endocarditis (IE) is a lethal disease which has been changing significantly over the past decades; however, information about IE in China remains scarce. This study surveyed the changes in clinical characteristics of IE in southern China over a period of nearly eighteen years. Methods: Medical records with IE patients consecutively hospitalized between June 2001 and June 2018 were selected from the electronic medical records system in Nanfang Hospital at Southern Medical University. Data were divided by admission time into two groups: early-period group, June 2001 to December 2009 and later-period group, January 2010 to July 2018. Results: A Total of 313 IE patients were included in our study. Compared with the early-period group, patients in the later-period group included fewer intravenous drug users (IVDU), older age at onset, reduced development of pulmonary embolism, less renal dysfunction, decreased proportion of Staphylococcus aureus infection and fewer vegetations observed in the right heart by echocardiography. The later-period group also showed a higher proportion of ischemic strokes and higher rate of whole-blood culture positive compared with the early-period group. The in-hospital mortality rate remained about the same between the two periods. Conclusions: Our study demonstrated a dramatic change in the profile and characteristics of IE over a period of eighteen years in southern China, especially the decrease in intravenous drug users (IVDU), which might be responsible for many other changes.

show abstract

“…Staphylococcus aureus infection and vegetations on the mitral valve were risk factors for ischemic stroke [30,31] , but among the patients in this study, the later-period group showed a lower percentage of Staphylococcus aureus infection and a nonsignificant rise in patients with mitral vegetations. We speculate that an older age at onset and a higher proportion of diabetics may play a more important role in triggering ischemic stroke.…”

Section: Ie Patients Of the Later-period Group Developed Less Ischemicontrasting

confidence: 57%

A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

Ren

¹

,

Mo

²

,

Chen

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background: Infective endocarditis (IE) is a lethal disease which has been changing significantly over the past decades; however, information about IE in China remains scarce. This study surveyed the changes in clinical characteristics of IE at a tertiary hospital in southern China over a period of nearly eighteen years. Methods: Medical records with IE patients consecutively hospitalized between June 2001 and June 2018 were selected from the electronic medical records system in Nanfang Hospital of Southern Medical University. Data were divided by admission time into two groups: early-period group, June 2001 to December 2009 and later-period group, January 2010 to July 2018. Results: A Total of 313 IE patients were included in our study. Compared with the early-period group, patients in the later-period group included fewer intravenous drug users (IVDU), older age at onset, reduced development of pulmonary embolism, less renal dysfunction, decreased proportion of Staphylococcus aureus infection and fewer vegetations observed in the right heart by echocardiography. The later-period group also showed a higher proportion of ischemic strokes and higher rate of whole-blood culture positive compared with the early-period group. The in-hospital mortality rate remained about the same between the two periods. Conclusions: Our study demonstrated a dramatic change in the profile and characteristics of IE over a period of eighteen years at a tertiary hospital in southern China, especially the decrease in intravenous drug users (IVDU), which might be responsible for many other changes.

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

Abstract: Among patients with IE, there exist characteristics that relate differentially to ischaemic and haemorrhagic stroke risk.

Cited by 27 publications

References 44 publications

A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

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