title: Usefulness of anticoagulant therapy in the prevention of embolic complications in patients with acute infective endocarditis.
abstract: BACKGROUND
  The use of anticoagulant therapy (ACT) in patients with acute infective endocarditis (IE) remains a controversial issue. Our study attempts to estimate the impact of ACT on the occurrence of embolic complications and the usefulness of ACT in the prevention of embolism in IE patients.
  
  
  METHODS
  The present authors analyzed 150 patients with left-sided IE. Embolisms including cerebrovascular events (CVE) and the use of ACT were checked at the time of admission and during hospitalization.
  
  
  RESULTS
  57 patients (38.0%) experienced an embolic event. There was no significant difference in the incidence of CVE and in-hospital mortality between patients with and without warfarin use at admission, although warfarin-naïve patients were significantly more likely to have large (>1 cm) and mobile vegetation. In addition, there was no significant difference in the incidence of postadmission embolism and in-hospital death between patients with and without in-hospital ACT. On multivariate logistic regression analysis, ACT at admission was not significantly associated with a lower risk of embolism in patients with IE.
  
  
  CONCLUSIONS
  The role of ACT in the prevention of embolism was limited in IE patients undergoing antibiotic therapy, although it seems to reduce the embolic potential of septic vegetation before treatment.
authors.affiliation: Department of Neurology, Sejong General Hospital, 91-121 Sosabon 2-dong, Sosa-gu, Bucheon-si, Gyeonggi-do 422-711, Republic of Korea.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon 422-711, Republic of Korea.
authors.forename: Sam-Sae
authors.initials: SS
authors.lastname: Oh
authors.affiliation: Department of Cardiology, Sejong General Hospital, Bucheon 422-711, Republic of Korea.
authors.forename: Dal-Soo
authors.initials: DS
authors.lastname: Lim
authors.affiliation: Department of Cardiology, Sejong General Hospital, Bucheon 422-711, Republic of Korea.
authors.forename: Suk-Keun
authors.initials: SK
authors.lastname: Hong
authors.affiliation: Department of Cardiology, Sejong General Hospital, Bucheon 422-711, Republic of Korea.
authors.forename: Rak-Kyeong
authors.initials: RK
authors.lastname: Choi
authors.affiliation: Department of Cardiology, Sejong General Hospital, Bucheon 422-711, Republic of Korea.
authors.forename: Jin-Sik
authors.initials: JS
authors.lastname: Park
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D002648:Child; D004617:Embolism / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control*; D004697:Endocarditis, Bacterial / Q000150:complications*; D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000925:Anticoagulants
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