Can Embolic Events Be Predicted by the Properties of Vegetation in Infective Endocarditis? A Single Center Experience

Objective: We aimed to investigate the predisposing factors of embolic events and the role of vegetation properties on the embolic complications for infective endocarditis (IE). Patients and Methods: The archive records of 119 patients with a definite diagnosis of IE between January 1997 and November 2004 were reviewed for clinical, echocardiographic, microbiologic properties and embolic events. Results: Major arterial embolization was observed in 28 (23.5%) of 119 study patients on admission. These patients were included in the embolization group. Parameters such as culture positivity (p=0.017, 95% confidence interval (CI)=1.1-24.6) ejection fraction (EF) (p=0.003, 95% CI=1.1-1.4), presence of vegetation (p=0.013, 95% CI=1.1-1.13), size of vegetation (p=0.002, 95% CI= 1.1-2.1), vegetation mobility (p=0.01, 95% CI=2.1-24.5), and chordal rupture (p=0.041, 95% CI=1.07-7.14) were identified as significant predictors of embolization. Conclusion: In patients with infective endocarditis, culture positivity, EF, presence of vegetation, vegetation mobility, size of vegetation, and the presence of chordal rupture are the variables with predictive value for embolization. Further prospective controlled trials are required in order to identify the predictive value of the presented data and other variables.