Infectious Endocardity and cerebral vascular accident in hospital university Ibn Rochd Casablanca (about 101 patients)

Abstract

The association of stroke and infectious endocarditis is very common, mainly infections of the valves on the left side. The introduction of anticoagulation in the case of left-sided infective endocarditis is controversial, as it is unclear whether anticoagulation has an impact on the risk of stroke and hemorrhage in this population. The objective of this study was to assess the effect of anticoagulation on the onset of stroke and bleeding complications in patients with left-sided infective endocarditis. We included infectious endocarditis patients on the left side diagnosed in the cardiology department of CHU Ibn Rochd Casablanca over a period spread from January 2014 to January 2019. The inclusion criterion was the administration of therapeutic anticoagulation before admission. The assessment of these patients was based on the occurrence of a 10-week imaging-confirmed stroke. 101 patients with left-sided infectious endocarditis were identified. The subjects on anticoagulants (n-32) were older (median age 61 vs. 43), more likely to have a history of atrial fibrillation (18% vs. 3%), more often wearing valvular prostheses (23% vs. 7%) and had a lower incidence of mitral valve involvement (29% vs. 41%). There was no significant difference in the occurrence of stroke, cerebrovascular hemorrhage, or 10-week mortality between the 2 cohorts. Pre-existing anticoagulation has no effect on the occurrence of stroke, cerebrovascular hemorrhage or mortality in patients with left-sided infective endocarditis within 10 weeks.