The Effect of Preexisting Anticoagulation on Cerebrovascular Events in Left-Sided Infective Endocarditis

Infective endocarditis is associated with worse outcomes in stroke: A Thailand National Database Study

“…Second, we did not have data on the medical therapies used, which may affect stroke outcome. However, there is evidence to suggest that pre‐existing anticoagulation does not have effect on stroke, cerebrovascular haemorrhage or mortality in patients with left‐sided IE at 10 weeks 39 . Thirdly, we were unable to study mild strokes that were not admitted to hospital or very severe strokes where the patient died before being admitted.…”

Culture-negative endocarditis with neurologic presentations and dramatic response to heparin: a case report

“…Finally, the authors concluded that thrombolysis was not successful generally and may be associated with an increased risk of stroke in the patient [18]. Over a 6year period, Davis et al [19] studied more than 250 patients with IE. Sixteen patients (6.2%) had negative blood cultures and 50 patients received adjuvant treatment with heparin.…”

The management of infective endocarditis complicated by stroke

“…Hart et al reviewed 212 consecutive episodes of IE in 203 patients across six hospitals and concluded that there is no need for anticoagulation for primary or secondary prevention of stroke complicating IE . Similarly, Davis et al showed in their 258 patient retrospective study that pre‐existing anti‐coagulation had no impact on the risk of developing a stroke, intracranial haemorrhage or mortality at 10 weeks following an episode of IE …”

“…44 Similarly, Davis et al showed in their 258 patient retrospective study that pre-existing anti-coagulation had no impact on the risk of developing a stroke, intracranial haemorrhage or mortality at 10 weeks following an episode of IE. 45 In clinical practice, the indication for the use of anticoagulation in IE is the same as for those patients without IE such that in patients with metallic valves, continued anticoagulation is advised acknowledging haemorrhagic risks. 45…”

“…In clinical practice, the indication for the use of anticoagulation in IE is the same as for those patients without IE such that in patients with metallic valves, continued anticoagulation is advised acknowledging haemorrhagic risks …”