title: Prediction of Symptomatic Embolism in Filipinos With Infective Endocarditis Using the Embolic Risk French Calculator.
abstract: BACKGROUND
  Cardioembolic events are life-threatening complications of infective endocarditis (IE). The embolic risk French calculator estimates the embolic risk in IE computed on admission. Variables in this tool include age, diabetes, atrial fibrillation, prior embolism, vegetation length, andStaphylococcus aureuson culture. A computed risk of > 7% was considered high in the development of this tool. Knowledge of this risk applied in our local setting is important to guide clinicians in preventing such catastrophic complications. Among patients with IE, we aim to determine the efficacy of the embolic risk French calculator, using a computed score of > 7%, in predicting major embolic events.
  
  
  METHODS
  All adults admitted from 2013 to 2016 with definite IE were included. The risk for embolic events was computed on admission. All were monitored for the duration of admission for the occurrence of the primary outcome (any major embolic event: arterial emboli, intracranial hemorrhage, pulmonary infarcts, or aneurysms). Secondary outcomes were: 1) composite of death and embolic events; and 2) death from any cause.
  
  
  RESULTS
  Eighty-seven adults with definite IE were included. Majority had a valvular heart disease and preserved ejection fraction (EF). The mitral valve was most commonly involved. Embolic events occurred in 25 (29%). Multivariate analysis identified a high embolic score > 7% (relative risk (RR): 15.12, P < 0.001), vegetation area ≥ 18 mm2(RR: 6.39, P < 0.01), and a prior embolism (RR: 5.18, P = 0.018) to be independent predictors of embolic events. For the composite of embolic events and death, independent predictors include a high score of > 7% (RR: 13.56, P < 0.001) and a prior embolus (RR: 13.75, P = 0.002). Independent predictors of death were a high score > 7% (RR: 6.20, P = 0.003) and EF ≤ 45% (RR: 9.91, P = 0.004).
  
  
  CONCLUSIONS
  Cardioembolic events are more prevalent in our study compared to previous data. The embolic risk French calculator is a useful tool to estimate and predict risk for embolic events and in-hospital mortality. The risk of developing embolic events should be weighed against the risks of early preventive cardiac surgery, as to institute timely and appropriate management.
authors.affiliation: Section of Cardiology, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines.
authors.forename: Jaime Alfonso M
authors.initials: JA
authors.lastname: Aherrera
authors.affiliation: Section of Cardiology, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines.
authors.forename: Maria Teresa B
authors.initials: MT
authors.lastname: Abola
authors.affiliation: Section of Cardiology, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines.
authors.forename: Maria Margarita O
authors.initials: MM
authors.lastname: Balabagno
authors.affiliation: Section of Cardiology, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines.
authors.forename: Lauro L
authors.initials: LL
authors.lastname: Abrahan
authors.affiliation: Section of Cardiology, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines.
authors.forename: Jose Donato A
authors.initials: JD
authors.lastname: Magno
authors.affiliation: Section of Cardiology, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines.
authors.forename: Paul Ferdinand M
authors.initials: PF
authors.lastname: Reganit
authors.affiliation: Section of Cardiology, Department of Medicine, University of the Philippines-Philippine General Hospital, Philippines.
authors.forename: Felix Eduardo R
authors.initials: FE
authors.lastname: Punzalan
keywords: Echocardiography; Embolism; Endocarditis; Risk calculator