Prediction of Hemorrhagic Transformation Following Embolic Stroke in Patients with Prosthetic Valve Endocarditis.
10.4250/jcu.2013.21.3.123
- Author:
In Jeong CHO
1
;
Jin Sun KIM
;
Hyuk Jae CHANG
;
Yong Jin KIM
;
Sang Chol LEE
;
Jung Hyun CHOI
;
Sanghoon SHIN
;
Chi Young SHIM
;
Geu Ru HONG
;
Jong Won HA
;
Namsik CHUNG
Author Information
1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. hjchang@yuhs.ac
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Infective endocarditis;
Embolization;
Hemorrhagic stroke
- MeSH:
Endocarditis*;
Heart Valves;
Humans;
Prothrombin Time;
Retrospective Studies;
Stroke*;
Thromboembolism
- From:Journal of Cardiovascular Ultrasound
2013;21(3):123-129
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Hemorrhagic transformation (HT) of stroke is a disastrous complication in patients with infective endocarditis (IE). In patients with mechanical heart valves complicated by IE, physicians struggle with the appropriateness of anticoagulation administration given the risk of thromboembolism and HT of stroke. In this study, we aimed to define predictive parameters of HT of stroke in patients with prosthetic valve endocarditis (PVE). METHODS: This study was a multicenter, retrospective design. We recruited from 7 institutions a total of 111 patients diagnosed with PVE during May, 2011 to April, 2012. RESULTS: Complication of stroke was seen in 26/111 patients (23%), and HT of stroke was seen in 11/111 patients (10%). Most patients with HT (9/11, 82%) had supratherapeutic prothrombin times. However, there were no significant differences in clinical and laboratory values between PVE patients without stroke and those patients who had a stroke and with or without concurrent HT. Furthermore, echocardiographic parameters also did not show significant between-group differences. CONCLUSION: Even though this was a multicenter study, a limited number of patients was identified and may explain the negative results seen here. However, a large number of PVE patients with stroke also developed HT. Therefore, further studies to define predictive parameters of HT should be implemented in a larger population.
