Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014:2014:254187.
doi: 10.1155/2014/254187. Epub 2014 Jul 10.

Usefulness of anticoagulant therapy in the prevention of embolic complications in patients with acute infective endocarditis

Seung-Jae Lee  1 , Sam-Sae Oh  2 , Dal-Soo Lim  3 , Suk-Keun Hong  3 , Rak-Kyeong Choi  3 , Jin-Sik Park  3
Affiliations

Usefulness of anticoagulant therapy in the prevention of embolic complications in patients with acute infective endocarditis

Seung-Jae Lee et al. Biomed Res Int. 2014.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The flowchart of anticoagulant therapy (ACT) at the time of admission and during hospitalization. UFH: unfractionated heparin; LMWH: low-molecular-weight heparin.
Figure 2
Figure 2
Time distribution of embolic events based on the diagnosis and treatment of infective endocarditis (IE). Negative value indicates the time interval before IE diagnosis.
Figure 3
Figure 3
Kaplan-Meier survival curves for patients with and without anticoagulant therapy (ACT). There is no significant difference in survival between patients with and without ACT (P > 0.05 by log-rank test).
See this image and copyright information in PMC

References

    1. Tornos P, Almirante B, Mirabet S, Permanyer G, Pahissa A, Soler-Soler J. Infective endocarditis due to Staphylococcus aureus: Deleterious effect of anticoagulant therapy. Archives of Internal Medicine. 1999;159(5):473–475. - PubMed
    1. Delahaye JP, Poncet P, Malquarti V, Beaune J, Garé JP, Mann JM. Cerebrovascular accidents in infective endocarditis: role of anticoagulation. European Heart Journal. 1990;11(12):1074–1078. - PubMed
    1. Wilson WR, Geraci JE, Danielson GK, et al. Anticoagulant therapy and central nervous system complications in patients with prosthetic valve endocarditis. Circulation. 1978;57(5):1004–1007. - PubMed
    1. Rasmussen RV, Snygg-Martin U, Olaison L, et al. Major cerebral events in staphylococcus aureus infective endocarditis: is anticoagulant therapy safe? Cardiology. 2009;114(4):284–291. - PubMed
    1. Snygg-Martin U, Rasmussen RV, Hassager C, Bruun NE, Andersson R, Olaison L. Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis. European Journal of Clinical Microbiology and Infectious Diseases. 2011;30(2):151–157. - PubMed

LinkOut - more resources