BACKGROUND: Infective endocarditis often is complicated by embolic events after
hospital admission. Identifying patients at higher risk may improve the disease
outcome. This study was aimed at identifying predictors of embolic risk among the
clinical and laboratory data obtained on hospital admission in patients diagnosed
as having definite infective endocarditis according to the Duke criteria.
METHODS: Ninety-four patients were enrolled in a prospective study. The results
of hematologic, echocardiographic, and microbiological investigations were
analyzed, using statistical methods as appropriate. Multivariate analysis was
applied to variables significantly associated with embolism in univariate
analysis.
RESULTS: Forty-six percent of patients had a major embolic complication after
admission. No association was found between embolism and sex, site of infection,
or microorganism involved. Patients with embolism were significantly younger, had
larger vegetation, and showed a significantly higher level of serum C-reactive
protein and lower albumin concentrations than those without embolism. Young age,
larger vegetation size, and high levels of C-reactive protein were the
independent variables associated with an increased incidence of embolic events in
the multivariate logistic regression analysis.
CONCLUSIONS: Our data indicate that patients with infective endocarditis with
young age and/or with large vegetation and/or with high serum levels of
C-reactive protein are at increased risk of major embolic complications during
the in-hospital course of the disease