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Colegio de Medicina Interna de México.

2024, Number 8

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Med Int Mex 2024; 40 (8)

Prevalence of acute ischemic stroke in patients with infective endocarditis in a Colombian population

Rozo OEJ, Márquez RBA, Perilla RLP, Colorado LL, Lizarazo DN, Vargas RLJ

Language: Spanish
References: 22
Page: 465-471
PDF size: 190.85 Kb.


ABSTRACT

Objective: To characterize patients with infective endocarditis and ischemic stroke.
Patients and Methods: An observational, descriptive study was carried out, including patients over 18 years of age treated at the San Rafael Hospital, Tunja, Colombia, from January 2010 to January 2019 with a confirmed diagnosis of infective endocarditis. The dependent variable was the presence of ischemic stroke, while the independent variables were sociodemographic data (age, sex and comorbidities), test data (blood count, acute phase reactants, electrolytes, liver and kidney function) and imaging data.
Results: There were included 87 patients with confirmed diagnosis of infective endocarditis. The prevalence of stroke was 33.7%. The variables urban residence, diabetes mellitus, cardiac arrhythmias and epilepsy increased the probability that a patient with bacterial endocarditis would suffer an ischemic stroke.
Conclusions: The history of diabetes, epilepsy, cardiac arrhythmias, and urban residence are correlated to the presence of ischemic stroke in this population. Most of these events occurr in people under 35 years of age, unlike other populations worldwide, which makes it pertinent to suspect infective endocarditis in young patients who present with cerebrovascular accidents.


REFERENCES

  1. Pigretti S, Zurrú MC, Arias A, Parcerisa F, et al. Endocarditisinfecciosa: ¿Afectan su pronóstico las complicaciones neurológicas?Medicina (B Aires) 2017; 77 (2): 89-94.

  2. Lee Y, Siddiqui WJ. Secuelas neurológicas de la endocarditis.En: StatPearls. Treasure Island (FL): StatPearls 2020.

  3. Roldan CA, Sibbitt W, Qualls C, Jung R, et al. Libman-Sacksendocarditis and embolic cerebrovascular disease. JACCCardiovasc Imaging 2013; 6 (9): 973-983. https://doi.org/10.1016/j.jcmg.2013.04.012

  4. Llenas-García J, Guerra-Vales JM, Montes-Moreno S,López-Ríos F. Nonbacterial thrombotic endocarditis: Clinicopathologicstudy of a necropsy series. Rev Esp Cardiol2007; 60 (5): 493-500. https://doi.org/10.1016/S1885-5857(07)60190-X

  5. Champey J, Pavese P, Bouvaist H, Kastler A, et al. Value ofbrain MRI in infective endocarditis: a narrative literaturereview. Eur J Clin Microbiol Infect Dise 2016; 35 (2): 159-168. https://doi.org/10.1007/s10096-015-2523-6

  6. Swanton RH. Osteomyelitis and infective endocarditis. PostgrMed J 1994; 70 (830): 885-90. https://doi.org/10.1136/pgmj.70.830.885

  7. Cooper HA, Thompson EC, Laureno R, Fuisz A, et al.Subclinical brain embolization in left-sided results fromthe evaluation by MRI of the brains of patients with leftsidedintracardiac solid masses (EMBOLISM) pilot study.Circulation 2009; 120: 585-91. https://doi.org/10.1161/CIRCULATIONAHA.108.834432

  8. Snygg MU, Gustafsson L, Rosengren L, Alsiö A, et al.Cerebrovascular complications in patients with left-sidedinfective endocarditis are common: A prospective study usingmagnetic resonance imaging and neurochemical braindamage markers. Clin Infect Dis 2008; 47: 23-30. https://doi.org/10.1086/588663

  9. Ruttmann E, Willeit J, Ulmer H, Chevtchik O, et al. Neurologicaloutcome of septic cardioembolic stroke after infectiveendocarditis. Stroke 2006; 37:.2094-2099. https://doi.org/10.1161/01.STR.0000229894.28591.3f

  10. Hill EE, Herijgers P, Claus P, Vanderschueren S, et al. Infectiveendocarditis : changing epidemiology and predictors of6-month mortality : a prospective cohort study. Eur Heart J2006; 196-203. https://doi.org/10.1093/eurheartj/ehl427

  11. Meneses-Silvera K, Castro-Monsalve J, Flórez-Rodríguez C,Donis I, et al. Enfermedad reumática cardiaca: ¿Estamosrealmente haciendo lo necesario? Rev Colomb Cardiol2020; 27 (3): 189-92. DOI: https://doi.org/10.1016/j.rccar.2019.10.003

  12. García Cabrera E, Fernández Hidalgo N, Almirante B,Ivanova Georgieva R, et al. Neurological complications ofinfective endocarditis risk factors, outcome, and impactof cardiac surgery: A multicenter observational study. Circulation 2013; 127: 2272-2284. https://doi.org/10.1161/CIRCULATIONAHA.112.000813

  13. Grabowski M, Hryniewiecki T, Janas J. Stepinska J. Clinicallyovert and silent cerebral embolism in the course of infectiveendocarditis. J Neurol 2011; 258: 1133-1139. https://doi.org/10.1007/s00415-010-5897-5

  14. Anderson DJ, Goldstein LB, Wilkinso WE, Corey GR, et al.Stroke location, characterization, severity, and outcome inmitral vs aortic valve endocarditis, Neurology 2003; 61: 1341-1346. https://doi.org/10.1212/01.wnl.0000094359.47929.e4

  15. Merkler AE, Chu SY, Lerario MP, Navi BB, Kamel H. Temporalrelationship between infective endocarditis and stroke. AmAcad Neurol 2015; 85: 512-516. https://doi.org/10.1212/WNL.0000000000001835

  16. Cooper HA, Thompson EC, Laureno R, Fuisz A, et al. Subclinicalbrain embolization in left-sided infective endocarditisresults from the evaluation by MRI of the Brains of PatientsWith Left-Sided Intracardiac Solid Masses (EMBOLISM)pilot study. Circulation 2009; 120: 585-59. https://doi.org/10.1161/CIRCULATIONAHA.108.834432

  17. Duval X, Lung B, Klein I, Brochet E, et al. Effect ofearly cerebral magnetic resonance imaging on clinicaldecisions in infective endocarditis. Ann Int Med 2010;152 (8). https://doi.org/10.7326/0003-4819-152-8-201004200-00006

  18. Cunha BA, Jimada I, Chawla K. Case study Intracranialcomplications of acute bacterial endocarditis. Surg NeurolInt 2018; 9: 107. https://doi.org/10.4103/sni.sni_67_18

  19. Klein I, Lung B, Labreuche J, Hess A, et al. Cerebral microbleedsare frequent in infective endocarditis a case–control study. Stroke 2009; 40: 3461-3465. https://doi.org/10.1161/STROKEAHA.109.562546

  20. Yanes DM, Diabetol C, Yanes JMDM, García RJ, et al.Infective endocarditis according to type 2 diabetes mellitusstatus: an observational study in Spain, 2001-2015.Cardiovasc Diabetol 2019; 1-13. https://doi.org/10.1186/s12933-019-0968-0

  21. Braun S. Current challenges of infective endocarditis.Rev Esp Cardiol 2003; 56 (6): 543-5. https://doi.org/10.1157/13048150

  22. Hogevik H, Olaison L, Anderson R, Lindberg J. Epidemiologicaspects of infective endocarditis in an urbanpopulation. Medicine 1995; 74 (6): 324-39. https://doi.org/10.1097/00005792-199511000-00003




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