Risk factors for "major" embolic events in hospitalized patients with infective endocarditis.
BACKGROUND
Infective endocarditis often is complicated by embolic events after hospital admission. Identifying patients at higher risk may improve the disease outcome. This study was aimed at identifying predictors of embolic risk among the clinical and laboratory data obtained on hospital admission in patients diagnosed as having definite infective endocarditis according to the Duke criteria.


METHODS
Ninety-four patients were enrolled in a prospective study. The results of hematologic, echocardiographic, and microbiological investigations were analyzed, using statistical methods as appropriate. Multivariate analysis was applied to variables significantly associated with embolism in univariate analysis.


RESULTS
Forty-six percent of patients had a major embolic complication after admission. No association was found between embolism and sex, site of infection, or microorganism involved. Patients with embolism were significantly younger, had larger vegetation, and showed a significantly higher level of serum C-reactive protein and lower albumin concentrations than those without embolism. Young age, larger vegetation size, and high levels of C-reactive protein were the independent variables associated with an increased incidence of embolic events in the multivariate logistic regression analysis.


CONCLUSIONS
Our data indicate that patients with infective endocarditis with young age and/or with large vegetation and/or with high serum levels of C-reactive protein are at increased risk of major embolic complications during the in-hospital course of the disease.
Durante Mangoni
Emanuele
E
Institute of Medical Therapy, Second University of Naples, Italy.
Adinolfi
Luigi E
LE
Tripodi
Marie-Francoise
MF
Andreana
Augusto
A
Gambardella
Michele
M
Ragone
Enrico
E
Precone
Davide F
DF
Utili
Riccardo
R
Ruggiero
Giuseppe
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D004617:Embolism / Q000453:epidemiology / Q000209:etiology*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000473:pathology; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis
D012709:Serum Albumin; D002097:C-Reactive Protein