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Asymptomatic and symptomatic embolic events in infective endocarditis: associated factors and clinical impact
Monteiro, Thaíssa S; Correia, Marcelo G; Golebiovski, Wilma F; Barbosa, Giovanna Ianini F; Weksler, Clara; Lamas, Cristiane C.
  • Monteiro, Thaíssa S; Instituto Nacional de Cardiologia. Departamento de Doenças da Válvula Cardíaca. Rio de Janeiro. BR
  • Correia, Marcelo G; Instituto Nacional de Cardiologia. Departamento de Doenças da Válvula Cardíaca. Rio de Janeiro. BR
  • Golebiovski, Wilma F; Instituto Nacional de Cardiologia. Departamento de Doenças da Válvula Cardíaca. Rio de Janeiro. BR
  • Barbosa, Giovanna Ianini F; Instituto Nacional de Cardiologia. Departamento de Doenças da Válvula Cardíaca. Rio de Janeiro. BR
  • Weksler, Clara; Instituto Nacional de Cardiologia. Departamento de Doenças da Válvula Cardíaca. Rio de Janeiro. BR
  • Lamas, Cristiane C; Instituto Nacional de Cardiologia. Departamento de Doenças da Válvula Cardíaca. Rio de Janeiro. BR
Braz. j. infect. dis ; 21(3): 240-247, May-June 2017. tab
Article in English | LILACS | ID: biblio-839230
ABSTRACT
ABSTRACT

Background:

Embolic complications of infective endocarditis are common. The impact of asymptomatic embolism is uncertain.

Objectives:

To determine the frequency of emboli due to IE and to identify events associated with embolism.

Methods:

Retrospective analysis of an endocarditis database, prospectively implemented, with a post hoc study driven by analysis of data on embolic events. Data was obtained from the International Collaboration Endocarditis case report forms and additional information on embolic events and imaging reports were obtained from the medical records. Variables associated with embolism were analyzed by the statistical software R version 3.1.0.

Results:

In the study period, 2006-2011, 136 episodes of definite infective endocarditis were included. The most common complication was heart failure (55.1%), followed by embolism (50%). Among the 100 medical records analyzed for emboli in left-sided infective endocarditis, 36 (36%) were found to have had asymptomatic events, 11 (11%) to the central nervous system and 28 (28%) to the spleen. Cardiac surgery was performed in 98/136 (72%). In the multivariate analysis, splenomegaly was the only associated factor for embolism to any site (p < 0.01, OR 4.7, 95% CI 2.04-11). Factors associated with embolism to the spleen were positive blood cultures (p = 0.05, OR 8.9, 95% CI 1.45-177) and splenomegaly (p < 0.01, OR 9.28, 95% CI 3.32-29); those associated to the central nervous system were infective endocarditis of the mitral valve (p < 0.05, OR 3.5, 95% CI 1.23-10) and male gender (p < 0.05, OR 3.2, 95% CI 1.04-10). Splenectomy and cardiac surgery did not impact on in-hospital mortality.

Conclusions:

Asymptomatic embolism to the central nervous system and to the spleen were frequent. Splenomegaly was consistently associated with embolic events.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Embolism / Endocarditis, Bacterial / Asymptomatic Diseases Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2017 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Nacional de Cardiologia/BR

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Full text: Available Index: LILACS (Americas) Main subject: Embolism / Endocarditis, Bacterial / Asymptomatic Diseases Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2017 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Nacional de Cardiologia/BR