Prediction of Acute-phase Complications in Patients with Infectious Endocarditis
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- Saito Fumiya
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Toyoda Shigeru
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Arikawa Takuo
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Inami Shu
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Watanabe Ryo
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Obi Syotaro
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Sakuma Masashi
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Kanaya Tomoaki
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Abe Shichiro
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Nakajima Toshiaki
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
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- Inoue Teruo
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Japan
Abstract
<p>Objective Embolic events are frequent and life-threatening complications of infective endocarditis (IE). Recently, an embolic risk assessment at admission, based on the Embolic Risk (ER) French Calculator, was designed to predict the development of symptomatic emboli associated with IE. This study aimed to validate the ER French Calculator for the prediction of in-hospital events, including embolic events. </p><p>Methods We retrospectively analyzed the clinical features of 52 consecutive patients with left-sided IE to identify possible predictors of in-hospital events within 30 days of admission. </p><p>Results New embolic events were seen in 15 patients (29%), cardiac surgery was performed in 22 patients (42%), and 1 patient (2%) died within 30 days of admission. A composite endpoint of embolic complications, cardiac surgery, or death was observed in 28 patients (54%). The cumulative incidence of new embolic events was significantly higher in the high-risk group identified by the ER French Calculator than in the low-risk group (log-rank test; p=0.0004). The incidence of the composite endpoint was higher in the high-risk group than in the low-risk group (log-rank test; p<0.0001). A multivariate Cox proportional hazards model indicated that the high-risk designation on the ER French Calculator predicted embolic events (p=0.0410) and composite events (p=0.0371) independently of other candidate predictors. </p><p>Conclusion The ER French Calculator may be a useful tool for predicting new in-hospital embolic events and other unfavorable in-hospital events in patients with IE. </p>
Journal
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- Internal Medicine
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Internal Medicine 58 (16), 2323-2331, 2019-08-15
The Japanese Society of Internal Medicine