Clinical Presentation and Multi-Parametric Screening Surrogates of Ischemic Stroke Patients Suffering from Infective Endocarditis
| Autor: | Stephan Stöbe, Andreas Hagendorff, Carsten Hobohm, Dominik Michalski, Sarah Budig, Dominik Fritzsch, Sandra Schulz |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Body Temperature Brain Ischemia Leukocyte Count Internal medicine medicine Humans Mass Screening Endocarditis Thrombolytic Therapy Registries Stroke Mass screening Aged Retrospective Studies Aged 80 and over Heart Murmurs biology Myoglobin Cerebral infarction business.industry C-reactive protein Retrospective cohort study Cerebral Infarction Endocarditis Bacterial Thrombolysis medicine.disease Troponin C-Reactive Protein Neurology Echocardiography Infective endocarditis Disease Progression Cardiology biology.protein Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal |
| Zdroj: | Cerebrovascular Diseases. 41:60-67 |
| ISSN: | 1421-9786 1015-9770 |
| DOI: | 10.1159/000442005 |
| Popis: | Background: Infective endocarditis (IE) represents a life-threatening condition due to complications like cardiac failure and thromboembolism. In ischemic stroke, IE formally excludes patients from approaches addressing the recanalization of occluded vessels, challenging decision-making in the early phase of hospitalization. This study aimed at the rate and clinical course of stroke patients with IE and explored clinical, imaging-based and serum parameters, which would allow early identification. Methods: A hospital-based registry containing 1,531 ischemic stroke patients was screened for IE identified by echocardiography. In addition to clinical parameters, patterns of cerebral manifestation as well as a variety of inflammatory serum and myocardial markers were analyzed concerning their predictive impact for identifying affected patients. Results: IE was found in 26 patients (1.7%) and was associated with an increased body temperature and cardiac murmurs. Patients suffering from IE demonstrated a more severe clinical affection at hospital discharge and an impaired symptom decline during hospitalization, further deteriorated by the use of systemic thrombolysis. Distribution of cerebral infarction patterns did not differ between the groups. C-reactive protein (CRP) and leukocyte count as well as troponin and myoglobin, taken at hospital admission, were found to be significantly associated with IE. Conclusions: IE in stroke patients is associated with worse clinical outcome, complicated by intravenously applied thrombolysis, and therefore needs to be screened during the early phase of hospitalization. Increased serum levels of CRP and leukocyte count in combination with an increased body temperature or abnormal cardiac murmurs should entail rapid initiation of further diagnostics, that is, transoesophageal echocardiography. |
| Databáze: | OpenAIRE |
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