J Cardiovasc Ultrasound.  2013 Sep;21(3):123-129. 10.4250/jcu.2013.21.3.123.

Prediction of Hemorrhagic Transformation Following Embolic Stroke in Patients with Prosthetic Valve Endocarditis

• Cho IJ
• Kim JS
• Chang HJ
• Kim YJ
• Lee SC
• Choi JH
• Shin S
• Shim CY
• Hong GR
• Ha JW
• Chung N

• KMID: 1500191
• DOI: http://doi.org/10.4250/jcu.2013.21.3.123

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.

Keyword

Infective endocarditis; Embolization; Hemorrhagic stroke

MeSH Terms

Endocarditis*
Heart Valves
Humans
Prothrombin Time
Retrospective Studies
Stroke*
Thromboembolism

Figure

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  Fig. 1 Study population.

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