Residual vegetation after treatment for left-sided infective endocarditis and subsequent risk of stroke and recurrence of endocarditis
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Residual vegetation after treatment for left-sided infective endocarditis and subsequent risk of stroke and recurrence of endocarditis. / Østergaard, Lauge; Dahl, Anders; Fosbøl, Emil; Bruun, Niels Eske; Oestergaard, Louise Bruun; Lauridsen, Trine Kiilerich; Valeur, Nana; Køber, Lars; Hassager, Christian; Ihlemann, Nikolaj.
I: International Journal of Cardiology, Bind 293, 2019, s. 67-72.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Residual vegetation after treatment for left-sided infective endocarditis and subsequent risk of stroke and recurrence of endocarditis
AU - Østergaard, Lauge
AU - Dahl, Anders
AU - Fosbøl, Emil
AU - Bruun, Niels Eske
AU - Oestergaard, Louise Bruun
AU - Lauridsen, Trine Kiilerich
AU - Valeur, Nana
AU - Køber, Lars
AU - Hassager, Christian
AU - Ihlemann, Nikolaj
PY - 2019
Y1 - 2019
N2 - Background: Little is known about the subsequent risk of stroke and recurrence of IE for patients surviving infective endocarditis (IE) with a residual vegetation at discharge. Methods: Patients were consecutively included in the East Danish Endocarditis Registry from 2002 to 2012. We included patients undergoing medical treatment only during IE admission who were discharged alive. Size of residual vegetation was assessed by echocardiography at discharge and patients were categorized according to median length of residual vegetation. Using multivariable adjusted Cox Proportional hazard analysis, we assessed the associated risk of stroke and recurrence of IE between study groups. Results: Among 915 IE patients, 305 were included after selection criteria were applied, 151 patients without residual vegetation, 73 patients with 1–5 mm residual vegetation, and 81 patients with >5 mm residual vegetation. We identified an increased associated risk of stroke for patients with 1–5 mm and > 5 mm residual vegetation, HR = 0.88 (95% CI: 0.26–2.94) and HR = 2.95 (95% CI:1.18–7.34) compared with patients without residual vegetation. No difference was seen between groups for the associated risk of recurrence of IE, HR = 1.39 (95% CI: 0.91–2.13) and HR = 1.38 (95% CI: 0.91–2.10) for patients with a residual vegetation 1–5 mm and > 5 mm compared with patients without residual vegetation. Conclusions: Patients surviving IE with a residual vegetation > 5 mm had an increased associated risk of stroke compared with patients without residual vegetation. These findings provide new perspectives on a patient group sparsely describe, suggesting a potential benefit of therapy among patients surviving IE with a residual vegetation > 5 mm.
AB - Background: Little is known about the subsequent risk of stroke and recurrence of IE for patients surviving infective endocarditis (IE) with a residual vegetation at discharge. Methods: Patients were consecutively included in the East Danish Endocarditis Registry from 2002 to 2012. We included patients undergoing medical treatment only during IE admission who were discharged alive. Size of residual vegetation was assessed by echocardiography at discharge and patients were categorized according to median length of residual vegetation. Using multivariable adjusted Cox Proportional hazard analysis, we assessed the associated risk of stroke and recurrence of IE between study groups. Results: Among 915 IE patients, 305 were included after selection criteria were applied, 151 patients without residual vegetation, 73 patients with 1–5 mm residual vegetation, and 81 patients with >5 mm residual vegetation. We identified an increased associated risk of stroke for patients with 1–5 mm and > 5 mm residual vegetation, HR = 0.88 (95% CI: 0.26–2.94) and HR = 2.95 (95% CI:1.18–7.34) compared with patients without residual vegetation. No difference was seen between groups for the associated risk of recurrence of IE, HR = 1.39 (95% CI: 0.91–2.13) and HR = 1.38 (95% CI: 0.91–2.10) for patients with a residual vegetation 1–5 mm and > 5 mm compared with patients without residual vegetation. Conclusions: Patients surviving IE with a residual vegetation > 5 mm had an increased associated risk of stroke compared with patients without residual vegetation. These findings provide new perspectives on a patient group sparsely describe, suggesting a potential benefit of therapy among patients surviving IE with a residual vegetation > 5 mm.
KW - Infective endocarditis
KW - Recurrent endocarditis
KW - Residual vegetation
KW - Stroke
U2 - 10.1016/j.ijcard.2019.06.059
DO - 10.1016/j.ijcard.2019.06.059
M3 - Journal article
C2 - 31307845
AN - SCOPUS:85068799450
VL - 293
SP - 67
EP - 72
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 238431120