title: Prediction of hemorrhagic transformation following embolic stroke in patients with prosthetic valve endocarditis.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.
authors.forename: In-Jeong
authors.initials: IJ
authors.lastname: Cho
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Shin
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Geu-Ru
authors.initials: GR
authors.lastname: Hong
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
keywords: Embolization; Hemorrhagic stroke; Infective endocarditis