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Description

Thuny et al reported risk factors for embolic episodes and mortality associated with infective endocarditis, incuding changes seen on echocardiography. These can help to identify a patient who may benefit from more aggressive management. The authors are from La Timone Hospital (Marseille), Saint-Antoine Hospital (Paris), Chalres Nicolle Hospital (Rouen) and Second University (Naples).


Risk factors for total embolic events on multivariate analysis:

(1) Streptococcus bovis (adjusted odds ratio 3.9)

(2) Staphylococcus aureus (adjusted odds ratio 2.4)

 

Risk factors for new embolic events on multivariate analysis:

(1) vegetation length > 10 mm (adjusted odds ratio 9.0)

(2) severe vegetation mobility (adjusted odds ratio 2.4; prolapsing vegetation that crosses the coaptation plane of the leaflets during the cardiac cycle)

 

Risk factors for 1-year mortality on multivariate analysis:

(1) older age (adjusted relative risk 1.02 per year; age 35 years has an aRR 2.0))

(2) female sex (adjusted relative risk 1.6)

(3) serum creatinine > 2 mg/dL (adjusted relative risk 1.9)

(4) prosthetic heart valve (adjusted relative risk 1.6)

(5) Staphylococcus aureus endocarditis (adjusted relative risk 2.0)

(6) moderate or severe heart failure (adjusted relative risk 1.6)

(7) vegetation length > 15 mm (adjusted relative risk 1.8)


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