Usefulness of Anticoagulant Therapy in the Prevention of Embolic Complications in Patients with Acute Infective Endocarditis
Background. The use of anticoagulant therapy (ACT) in patients with acute infective endocarditis (IE) remains a controversial issue. Our study attempts to estimate the impact of ACT on the occurrence of embolic complications and the usefulness of ACT in the prevention of embolism in IE patients. Met...
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| creator | Lim, Dal-Soo Lee, Seung-Jae Park, Jin-Sik Choi, Rak-Kyeong Hong, Suk-Keun Oh, Sam-Sae |
| description | Background. The use of anticoagulant therapy (ACT) in patients with acute infective endocarditis (IE) remains a controversial issue. Our study attempts to estimate the impact of ACT on the occurrence of embolic complications and the usefulness of ACT in the prevention of embolism in IE patients. Methods. The present authors analyzed 150 patients with left-sided IE. Embolisms including cerebrovascular events (CVE) and the use of ACT were checked at the time of admission and during hospitalization. Results. 57 patients (38.0%) experienced an embolic event. There was no significant difference in the incidence of CVE and in-hospital mortality between patients with and without warfarin use at admission, although warfarin-naïve patients were significantly more likely to have large (>1 cm) and mobile vegetation. In addition, there was no significant difference in the incidence of postadmission embolism and in-hospital death between patients with and without in-hospital ACT. On multivariate logistic regression analysis, ACT at admission was not significantly associated with a lower risk of embolism in patients with IE. Conclusions. The role of ACT in the prevention of embolism was limited in IE patients undergoing antibiotic therapy, although it seems to reduce the embolic potential of septic vegetation before treatment. |
| doi_str_mv | 10.1155/2014/254187 |
| format | Article |
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The use of anticoagulant therapy (ACT) in patients with acute infective endocarditis (IE) remains a controversial issue. Our study attempts to estimate the impact of ACT on the occurrence of embolic complications and the usefulness of ACT in the prevention of embolism in IE patients. Methods. The present authors analyzed 150 patients with left-sided IE. Embolisms including cerebrovascular events (CVE) and the use of ACT were checked at the time of admission and during hospitalization. Results. 57 patients (38.0%) experienced an embolic event. There was no significant difference in the incidence of CVE and in-hospital mortality between patients with and without warfarin use at admission, although warfarin-naïve patients were significantly more likely to have large (>1 cm) and mobile vegetation. In addition, there was no significant difference in the incidence of postadmission embolism and in-hospital death between patients with and without in-hospital ACT. On multivariate logistic regression analysis, ACT at admission was not significantly associated with a lower risk of embolism in patients with IE. Conclusions. The role of ACT in the prevention of embolism was limited in IE patients undergoing antibiotic therapy, although it seems to reduce the embolic potential of septic vegetation before treatment.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2014/254187</identifier><identifier>PMID: 25110667</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Puplishing Corporation</publisher><subject>Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aneurysms ; Antibiotics ; Anticoagulants ; Anticoagulants (Medicine) ; Anticoagulants - therapeutic use ; Cardiac arrhythmia ; Child ; Embolism - drug therapy ; Embolism - etiology ; Embolism - prevention & control ; Embolization ; Endocarditis ; Endocarditis, Bacterial - complications ; Female ; Health aspects ; Heart ; Hemorrhage ; Hospitalization ; Hospitals ; Humans ; Infective endocarditis ; Kaplan-Meier Estimate ; Magnetic resonance imaging ; Male ; Medical records ; Meningitis ; Microorganisms ; Middle Aged ; Prostheses ; Pulmonary embolisms ; Regression analysis ; Risk Factors ; Stroke ; Time Factors ; Vegetation ; Veins & arteries ; Young Adult</subject><ispartof>BioMed research international, 2014-01, Vol.2014 (2014), p.1-7</ispartof><rights>Copyright © 2014 Seung-Jae Lee et al.</rights><rights>COPYRIGHT 2014 John Wiley & Sons, Inc.</rights><rights>Copyright © 2014 Seung-Jae Lee et al. Seung-Jae Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2014 Seung-Jae Lee et al. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c527t-eb6bac5017b3652334f710ddf2dff3435b774099a6e4575d2b4f904efe7299b23</citedby><cites>FETCH-LOGICAL-c527t-eb6bac5017b3652334f710ddf2dff3435b774099a6e4575d2b4f904efe7299b23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119712/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119712/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25110667$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Conti, Alfredo</contributor><creatorcontrib>Lim, Dal-Soo</creatorcontrib><creatorcontrib>Lee, Seung-Jae</creatorcontrib><creatorcontrib>Park, Jin-Sik</creatorcontrib><creatorcontrib>Choi, Rak-Kyeong</creatorcontrib><creatorcontrib>Hong, Suk-Keun</creatorcontrib><creatorcontrib>Oh, Sam-Sae</creatorcontrib><title>Usefulness of Anticoagulant Therapy in the Prevention of Embolic Complications in Patients with Acute Infective Endocarditis</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Background. The use of anticoagulant therapy (ACT) in patients with acute infective endocarditis (IE) remains a controversial issue. Our study attempts to estimate the impact of ACT on the occurrence of embolic complications and the usefulness of ACT in the prevention of embolism in IE patients. Methods. The present authors analyzed 150 patients with left-sided IE. Embolisms including cerebrovascular events (CVE) and the use of ACT were checked at the time of admission and during hospitalization. Results. 57 patients (38.0%) experienced an embolic event. There was no significant difference in the incidence of CVE and in-hospital mortality between patients with and without warfarin use at admission, although warfarin-naïve patients were significantly more likely to have large (>1 cm) and mobile vegetation. In addition, there was no significant difference in the incidence of postadmission embolism and in-hospital death between patients with and without in-hospital ACT. On multivariate logistic regression analysis, ACT at admission was not significantly associated with a lower risk of embolism in patients with IE. Conclusions. The role of ACT in the prevention of embolism was limited in IE patients undergoing antibiotic therapy, although it seems to reduce the embolic potential of septic vegetation before treatment.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aneurysms</subject><subject>Antibiotics</subject><subject>Anticoagulants</subject><subject>Anticoagulants (Medicine)</subject><subject>Anticoagulants - therapeutic use</subject><subject>Cardiac arrhythmia</subject><subject>Child</subject><subject>Embolism - drug therapy</subject><subject>Embolism - etiology</subject><subject>Embolism - prevention & control</subject><subject>Embolization</subject><subject>Endocarditis</subject><subject>Endocarditis, Bacterial - complications</subject><subject>Female</subject><subject>Health aspects</subject><subject>Heart</subject><subject>Hemorrhage</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infective endocarditis</subject><subject>Kaplan-Meier Estimate</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical records</subject><subject>Meningitis</subject><subject>Microorganisms</subject><subject>Middle Aged</subject><subject>Prostheses</subject><subject>Pulmonary embolisms</subject><subject>Regression analysis</subject><subject>Risk Factors</subject><subject>Stroke</subject><subject>Time Factors</subject><subject>Vegetation</subject><subject>Veins & arteries</subject><subject>Young Adult</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqF0s1rFDEYB-BBFFvWnjwrAS-irM13Zi6FZVm1ULCH9hwymTc7KbPJOpnZUvCPN-PU9ePSXBKShx_Jm7coXhP8iRAhzikm_JwKTkr1rDiljPClJJw8P64ZOynOUrrDeZRE4kq-LE6oIARLqU6LH7cJ3NgFSAlFh1Zh8Daa7diZMKCbFnqzf0A-oKEFdN3DATKIYaKbXR07b9E67vZ5NtN-muh1XmaW0L0fWrSy4wDoMjiwgz8A2oQmWtM3fvDpVfHCmS7B2eO8KG4_b27WX5dX375crldXSyuoGpZQy9pYgYmqmRSUMe4UwU3jaOMc40zUSnFcVUYCF0o0tOauwhwcKFpVNWWL4mLO3Y_1Dhqbb9ebTu97vzP9g47G639Pgm_1Nh40J6RSZAp4_xjQx-8jpEHvfLLQ5SpBHJMmkhDJhMTiaSoELbGieEp99x-9i2MfciV-KVmWUqk_ams60D64mK9op1C94lRhSlkuyaL4OCvbx5R6cMfXEaynTtFTp-i5U7J--3dBjvZ3X2TwYQatD42590-kvZkxZALOHHH-DcUU-wmTq87C</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Lim, Dal-Soo</creator><creator>Lee, Seung-Jae</creator><creator>Park, Jin-Sik</creator><creator>Choi, Rak-Kyeong</creator><creator>Hong, Suk-Keun</creator><creator>Oh, Sam-Sae</creator><general>Hindawi Puplishing Corporation</general><general>Hindawi Publishing Corporation</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CWDGH</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140101</creationdate><title>Usefulness of Anticoagulant Therapy in the Prevention of Embolic Complications in Patients with Acute Infective Endocarditis</title><author>Lim, Dal-Soo ; Lee, Seung-Jae ; Park, Jin-Sik ; Choi, Rak-Kyeong ; Hong, Suk-Keun ; Oh, Sam-Sae</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c527t-eb6bac5017b3652334f710ddf2dff3435b774099a6e4575d2b4f904efe7299b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aneurysms</topic><topic>Antibiotics</topic><topic>Anticoagulants</topic><topic>Anticoagulants (Medicine)</topic><topic>Anticoagulants - therapeutic use</topic><topic>Cardiac arrhythmia</topic><topic>Child</topic><topic>Embolism - drug therapy</topic><topic>Embolism - etiology</topic><topic>Embolism - prevention & control</topic><topic>Embolization</topic><topic>Endocarditis</topic><topic>Endocarditis, Bacterial - complications</topic><topic>Female</topic><topic>Health aspects</topic><topic>Heart</topic><topic>Hemorrhage</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infective endocarditis</topic><topic>Kaplan-Meier Estimate</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medical records</topic><topic>Meningitis</topic><topic>Microorganisms</topic><topic>Middle Aged</topic><topic>Prostheses</topic><topic>Pulmonary embolisms</topic><topic>Regression analysis</topic><topic>Risk Factors</topic><topic>Stroke</topic><topic>Time Factors</topic><topic>Vegetation</topic><topic>Veins & arteries</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lim, Dal-Soo</creatorcontrib><creatorcontrib>Lee, Seung-Jae</creatorcontrib><creatorcontrib>Park, Jin-Sik</creatorcontrib><creatorcontrib>Choi, Rak-Kyeong</creatorcontrib><creatorcontrib>Hong, Suk-Keun</creatorcontrib><creatorcontrib>Oh, Sam-Sae</creatorcontrib><collection>الدوريات العلمية والإحصائية - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lim, Dal-Soo</au><au>Lee, Seung-Jae</au><au>Park, Jin-Sik</au><au>Choi, Rak-Kyeong</au><au>Hong, Suk-Keun</au><au>Oh, Sam-Sae</au><au>Conti, Alfredo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of Anticoagulant Therapy in the Prevention of Embolic Complications in Patients with Acute Infective Endocarditis</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>2014</volume><issue>2014</issue><spage>1</spage><epage>7</epage><pages>1-7</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>Background. The use of anticoagulant therapy (ACT) in patients with acute infective endocarditis (IE) remains a controversial issue. Our study attempts to estimate the impact of ACT on the occurrence of embolic complications and the usefulness of ACT in the prevention of embolism in IE patients. Methods. The present authors analyzed 150 patients with left-sided IE. Embolisms including cerebrovascular events (CVE) and the use of ACT were checked at the time of admission and during hospitalization. Results. 57 patients (38.0%) experienced an embolic event. There was no significant difference in the incidence of CVE and in-hospital mortality between patients with and without warfarin use at admission, although warfarin-naïve patients were significantly more likely to have large (>1 cm) and mobile vegetation. In addition, there was no significant difference in the incidence of postadmission embolism and in-hospital death between patients with and without in-hospital ACT. On multivariate logistic regression analysis, ACT at admission was not significantly associated with a lower risk of embolism in patients with IE. Conclusions. The role of ACT in the prevention of embolism was limited in IE patients undergoing antibiotic therapy, although it seems to reduce the embolic potential of septic vegetation before treatment.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Puplishing Corporation</pub><pmid>25110667</pmid><doi>10.1155/2014/254187</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Adolescent Adult Aged Aged, 80 and over Aneurysms Antibiotics Anticoagulants Anticoagulants (Medicine) Anticoagulants - therapeutic use Cardiac arrhythmia Child Embolism - drug therapy Embolism - etiology Embolism - prevention & control Embolization Endocarditis Endocarditis, Bacterial - complications Female Health aspects Heart Hemorrhage Hospitalization Hospitals Humans Infective endocarditis Kaplan-Meier Estimate Magnetic resonance imaging Male Medical records Meningitis Microorganisms Middle Aged Prostheses Pulmonary embolisms Regression analysis Risk Factors Stroke Time Factors Vegetation Veins & arteries Young Adult |
| title | Usefulness of Anticoagulant Therapy in the Prevention of Embolic Complications in Patients with Acute Infective Endocarditis |
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