Research Article Open Access

Stroke Associated with Infective Endocarditis. Frequency and Prognostic Implications

Juan José Mengual Chirife1, Manuel Gómez-Choco1 and Ester Moral1
  • 1 Complex Hospitalari Moisès Broggi, Spain

Abstract

Stroke can be one of the most severe complications of Infective Endocarditis (IE) and it happens in 14% of patients with IE. Therefore, we aimed to review stroke frequency in patients diagnosed with IE in our hospital from 2010 to 2020. We defined it as IE-Associated Stroke (IEAS) when the stroke happened one month before or after IE's diagnosis. Sixty-six patients were diagnosed with IE during this period time and 15 (22%) suffered IEAS: 13 ischemic strokes, one Subarachnoid Hemorrhage (SAH) and one parenchymal hemorrhage with SAH. Patients with IEAS were more frequently men (80% vs 51% p = 0.042) and had less atrial fibrillation (13.3% vs 37.3%, p = 0.071). Although not statistically significant, Streptococcus sp (53% vs. 44.9%) and Staphylococcus aureus (33.3% vs. 16.3%) were more frequent in patients with IEAS. Mortality was increased in patients with IEAS (60% vs 13.7%, p = 0.001) especially in patients where stroke diagnosis was posterior to IE (88.9% vs 16.7%, p = 0.011). Hypertension (93.8% vs 63%, p = 0.013) and diabetes (53.2% vs 30%, p0 = 0.052) were also more frequent in those patients who died. In multivariate analysis, hypertension (OR 13.7 95% CI 1.4-138.4) and IEAS (OR 12.8 95% CI 2.8-58) were independently associated with death. The frequency of IEAS in our patients is comparable to what has been described in the literature. IEAS was associated with increased mortality.

American Journal of Infectious Diseases
Volume 17 No. 4, 2021, 127-132

DOI: https://doi.org/10.3844/ajidsp.2021.127.132

Submitted On: 13 April 2021 Published On: 7 September 2021

How to Cite: Chirife, J. J. M., Gómez-Choco, M. & Moral, E. (2021). Stroke Associated with Infective Endocarditis. Frequency and Prognostic Implications. American Journal of Infectious Diseases, 17(4), 127-132. https://doi.org/10.3844/ajidsp.2021.127.132

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Keywords

  • Infectious Endocarditis
  • Ischemic Stroke
  • Hemorrhagic Stroke