Predicting stroke in patients with infective endocarditis: A systematic review and meta-analysis of risk factors

Document Type

Article

Publication Date

2-27-2025

Publication Title

Int J Stroke

Abstract

BACKGROUND: Neurological complications in patients with infective endocarditis (IE), such as ischemic and hemorrhagic stroke, are well described; however, predicting which patients are most likely to experience stroke remains uncertain.

AIMS: We conducted a systematic review and meta-analysis to identify the factors associated with the risk of stroke in patients hospitalized with IE.

METHODS: A systematic search of Ovid MEDLINE, EMBASE, and Web of Science up to 27 June 2024 was conducted. Articles evaluating risk of acute ischemic stroke (AIS) or intracranial hemorrhage (ICH) in patients with IE were included. Meta-analysis of odds ratios was feasible for only some predictive factors due to study heterogeneity. Cochrane's Risk of Bias in Non-Randomized Studies of Exposure tool was used for risk-of-bias assessment.

SUMMARY OF REVIEW: Of 3538 studies identified, 35 were included: 9 prospective and 26 retrospective cohort.

CONCLUSION: Our study has identified factors which are associated with increased stroke risk in IE and may help physicians predict risk. While echocardiographic and neuroimaging findings may be particularly informative, underlying comorbidities and various laboratory values may also contribute to predicting IE-associated strokes.

PubMed ID

39924686

ePublication

ePub ahead of print

First Page

17474930251322679

Last Page

17474930251322679

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