Abstract
Embolic complications (EC) occur in about 30% to 40% of left-sided infective endocarditis (LSIE) and are associated with a poor prognosis. We analysed risk factors for embolic events in the systematic analysis of a large cohort of consecutive patients treated for infective endocarditis (IE). 533 consecutive patients admitted for definite or probable LSIE were included in this study. Mean age was 64 and 26% had a prosthetic valve. The location of IE was aortic in 68%. Causative microorganisms were Streptococcaceae in 40% and Staphylococcaceae in 27%. Rate of valve surgery and mortality during the initial hospital stay were 26% and 11%, respectively. The mean follow up was 5±6 years. Embolic events occur in 164 patients (30%). In multivariate analysis, presence of vegetation was an independent risk factor for embolic event (hazard ratio HR=1.96, p<0.001), whilst older age and Streptococcus infection were independently associated with a lower risk of embolic events (HR=0.99, p=0.02 and HR=0.64, p=0.02 respectively). Patients with LSIE and streptococcal infection have a lower risk of embolic events than others. The presence of vegetations was independently associated with an increased risk of embolic events.
Published Version
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