title: Stroke location, characterization, severity, and outcome in mitral vs aortic valve endocarditis.
abstract: OBJECTIVE
  To characterize the incidence and clinical features of patients with infective endocarditis (IE) and stroke.
  
  
  METHODS
  The authors reviewed the records of 707 patients diagnosed with definite or possible IE between January 1984 and November 1999. Stroke was confirmed by application of strict definitions and classified by type, pathophysiology, vascular territory, and severity. The authors determined mortality rates for the initial hospitalization and 12 months after admission.
  
  
  RESULTS
  Strokes occurred in 68 (9.6%) of 707 patients with IE, 38 (17%) of 218 patients with mitral valve endocarditis (MVE), 14 (9%) of 149 patients with aortic valve endocarditis (AVE), and 16 (5%) of 340 patients with other forms of IE (OR for MVE vs AVE = 2.0, 95% CI 1.1 to 3.9). Among the patients with MVE or AVE and stroke, there were no significant relationships between site of vegetation and length of hospitalization, stroke severity, mortality during the initial hospitalization, or 12-month mortality. Fifty-two percent of patients with stroke and IE died within 1 year of admission.
  
  
  CONCLUSIONS
  The overall incidence of stroke in patients with IE (9.6%) is lower than previous reports (21 to 39%). Patients with MVE had a greater risk of stroke than patients with AVE. Fifty-two percent of patients died within 1 year of admission for IE.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Anderson
authors.forename: L B
authors.initials: LB
authors.lastname: Goldstein
authors.forename: W E
authors.initials: WE
authors.lastname: Wilkinson
authors.forename: G R
authors.initials: GR
authors.lastname: Corey
authors.forename: C H
authors.initials: CH
authors.lastname: Cabell
authors.forename: L L
authors.initials: LL
authors.lastname: Sanders
authors.forename: D J
authors.initials: DJ
authors.lastname: Sexton
mesh_terms: D001021:Aortic Valve; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011379:Prognosis; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D015996:Survival Rate