Risk of stroke subsequent to infective endocarditis: A nationwide study
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Risk of stroke subsequent to infective endocarditis : A nationwide study. / Østergaard, Lauge; Andersson, Niklas Worm; Kristensen, Søren Lund; Dahl, Anders; Bundgaard, Henning; Iversen, Kasper; Eske-Bruun, Niels; Gislason, Gunnar; Torp-Pedersen, Christian; Valeur, Nana; Køber, Lars; Fosbøl, Emil Loldrup.
In: American Heart Journal, Vol. 212, 06.2019, p. 144-151.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Risk of stroke subsequent to infective endocarditis
T2 - A nationwide study
AU - Østergaard, Lauge
AU - Andersson, Niklas Worm
AU - Kristensen, Søren Lund
AU - Dahl, Anders
AU - Bundgaard, Henning
AU - Iversen, Kasper
AU - Eske-Bruun, Niels
AU - Gislason, Gunnar
AU - Torp-Pedersen, Christian
AU - Valeur, Nana
AU - Køber, Lars
AU - Fosbøl, Emil Loldrup
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2019/6
Y1 - 2019/6
N2 - BACKGROUND: The aim of the study was to investigate the associated risk of stroke after discharge of infective endocarditis (IE) in patients with stroke during IE admission compared with patients without stroke during IE admission.METHODS: Using Danish nationwide registries, we identified nonsurgically treated patients with IE discharged alive in the period from 1996 to 2016. The study population was grouped into (1) patients with stroke during IE admission and (2) patients without stroke during IE admission. Multivariable adjusted Cox proportional-hazard analysis was used to compare the associated risk of stroke between groups.RESULTS: We identified 4,284 patients with IE, of whom 239 (5.6%) had a stroke during IE admission. We identified differentials in the associated risk of stroke during follow-up between groups (P = .006 for interaction with time). The associated risk of stroke was higher in patients with stroke during IE admission with a 1-year follow-up, HR = 3.21 (95% CI 1.66-6.20), compared with patients without stroke during IE admission. From 1 to 5 years of follow-up, we identified no difference in the associated risk of stroke between groups, HR = 0.91 (95% CI 0.33-2.50).CONCLUSIONS: Patients with nonsurgically treated IE with a stroke during IE admission were at significant higher associated risk of subsequent stroke within the first year of follow-up as compared with patients without a stroke during IE admission. This risk difference was not evident beyond 1 year of discharge. These findings underline the need for identification of causes and mechanisms of recurrent strokes after IE to develop preventive means.
AB - BACKGROUND: The aim of the study was to investigate the associated risk of stroke after discharge of infective endocarditis (IE) in patients with stroke during IE admission compared with patients without stroke during IE admission.METHODS: Using Danish nationwide registries, we identified nonsurgically treated patients with IE discharged alive in the period from 1996 to 2016. The study population was grouped into (1) patients with stroke during IE admission and (2) patients without stroke during IE admission. Multivariable adjusted Cox proportional-hazard analysis was used to compare the associated risk of stroke between groups.RESULTS: We identified 4,284 patients with IE, of whom 239 (5.6%) had a stroke during IE admission. We identified differentials in the associated risk of stroke during follow-up between groups (P = .006 for interaction with time). The associated risk of stroke was higher in patients with stroke during IE admission with a 1-year follow-up, HR = 3.21 (95% CI 1.66-6.20), compared with patients without stroke during IE admission. From 1 to 5 years of follow-up, we identified no difference in the associated risk of stroke between groups, HR = 0.91 (95% CI 0.33-2.50).CONCLUSIONS: Patients with nonsurgically treated IE with a stroke during IE admission were at significant higher associated risk of subsequent stroke within the first year of follow-up as compared with patients without a stroke during IE admission. This risk difference was not evident beyond 1 year of discharge. These findings underline the need for identification of causes and mechanisms of recurrent strokes after IE to develop preventive means.
KW - Aged
KW - Aged, 80 and over
KW - Denmark/epidemiology
KW - Endocarditis/complications
KW - Female
KW - Follow-Up Studies
KW - Hospitalization/trends
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Registries
KW - Retrospective Studies
KW - Risk Assessment/methods
KW - Risk Factors
KW - Stroke/epidemiology
KW - Survival Rate/trends
KW - Time Factors
U2 - 10.1016/j.ahj.2019.03.010
DO - 10.1016/j.ahj.2019.03.010
M3 - Journal article
C2 - 31004917
VL - 212
SP - 144
EP - 151
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
ER -
ID: 237418685