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Hubert S., Thuny F., Resseguier N., Giorgi R., Tribouilloy C., Le Dolley Y., Casalta J. P., Riberi A., Chevalier F., Rusinaru D., Malaquin D., Remadi J. P., Ben Ammar A., Avierinos J. F., Collart F., Raoult Didier, Habib G. (2013). Prediction of symptomatic embolism in infective endocarditis. Journal of the American College of Cardiology, 62 (15), 1384-1392. ISSN 0735-1097

Lien direct chez l'éditeur doi:10.1016/j.jacc.2013.07.029

Titre
Prediction of symptomatic embolism in infective endocarditis
Année de publication2013
Type de documentArticle référencé dans le Web of Science WOS:000325005000015
AuteursHubert S., Thuny F., Resseguier N., Giorgi R., Tribouilloy C., Le Dolley Y., Casalta J. P., Riberi A., Chevalier F., Rusinaru D., Malaquin D., Remadi J. P., Ben Ammar A., Avierinos J. F., Collart F., Raoult Didier, Habib G.
SourceJournal of the American College of Cardiology, 2013, 62 (15), p. 1384-1392. ISSN 0735-1097
RésuméObjectives The aim of this study was to develop and validate a simple calculator to quantify the embolic risk (ER) at admission of patients with infective endocarditis. Background Early valve surgery reduces the incidence of embolism in high-risk patients with endocarditis, but the quantification of ER remains challenging. Methods From 1,022 consecutive patients presenting with definite diagnoses of infective endocarditis in a multicenter observational cohort study, 847 were randomized into derivation (n = 565) and validation (n = 282) samples. Clinical, microbiological, and echocardiographic data were collected at admission. The primary endpoint was symptomatic embolism that occurred during the 6-month period after the initiation of treatment. The prediction model was developed and validated accounting for competing risks. Results The 6-month incidence of embolism was similar in the development and validation samples (8.5% in the 2 samples). Six variables were associated with ER and were used to create the calculator: age, diabetes, atrial fibrillation, embolism before antibiotics, vegetation length, and Staphylococcus aureus infection. There was an excellent correlation between the predicted and observed ER in both the development and validation samples. The C-statistics for the development and validation samples were 0.72 and 0.65, respectively. Finally, a significantly higher cumulative incidence of embolic events was observed in patients with high predicted ER in both the development (p < 0.0001) and validation (p < 0.05) samples. Conclusions The risk for embolism during infective endocarditis can be quantified at admission using a simple and accurate calculator. It might be useful for facilitating therapeutic decisions.
Plan de classementSanté : généralités [050]
LocalisationFonds IRD
Identifiant IRDPAR00010934
Lien permanenthttp://www.documentation.ird.fr/hor/PAR00010934

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