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PREDICTION OF HEMORRHAGIC TRANSFORMATION FOLLOWING EMBOLIC STROKE IN PATIENTS WITH PROSTHETIC VALVE ENDOCARDITIS

  • Cho, In-Jeong (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Kim, Jin-Sun (Division of Cardiology, Bundang CHA Medical Center, CHA University) ;
  • Chang, Hyuk-Jae (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Kim, Yong-Jin (Division of Cardiology, Seoul National University College of Medicine) ;
  • Lee, Sang-Chol (Division of Cardiology, Sungkyunkwan University School of Medicine) ;
  • Choi, Jung-Hyun (Division of Cardiology, Pusan National University Hospital) ;
  • Shin, Sanghoon (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Shim, Chi Young (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Hong, Geu-Ru (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Ha, Jong-Won (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System) ;
  • Chung, Namsik (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System)
  • Received : 2013.03.14
  • Accepted : 2013.08.12
  • Published : 2013.09.27

Abstract

Background: Hemorrhagic transformation (HT) of stroke is a disastrous complication in patients with infective endocarditis (IE). In patients with mechanical heart valves complicated by IE, physicians struggle with the appropriateness of anticoagulation administration given the risk of thromboembolism and HT of stroke. In this study, we aimed to define predictive parameters of HT of stroke in patients with prosthetic valve endocarditis (PVE). Methods: This study was a multicenter, retrospective design. We recruited from 7 institutions a total of 111 patients diagnosed with PVE during May, 2011 to April, 2012. Results: Complication of stroke was seen in 26/111 patients (23%), and HT of stroke was seen in 11/111 patients (10%). Most patients with HT (9/11, 82%) had supratherapeutic prothrombin times. However, there were no significant differences in clinical and laboratory values between PVE patients without stroke and those patients who had a stroke and with or without concurrent HT. Furthermore, echocardiographic parameters also did not show significant between-group differences. Conclusion: Even though this was a multicenter study, a limited number of patients was identified and may explain the negative results seen here. However, a large number of PVE patients with stroke also developed HT. Therefore, further studies to define predictive parameters of HT should be implemented in a larger population.

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Cited by

  1. Cerebrovascular Complications and Infective Endocarditis: Impact of Available Evidence on Clinical Outcome vol.2018, pp.None, 2018, https://doi.org/10.1155/2018/4109358
  2. Stroke Risk Following Infection in Patients with Continuous-Flow Left Ventricular Assist Device vol.31, pp.1, 2019, https://doi.org/10.1007/s12028-018-0662-1
  3. Cerebrovascular Complication and Valve Surgery in Infective Endocarditis vol.41, pp.4, 2013, https://doi.org/10.1055/s-0041-1726327