Infective Endocarditis With Subarachnoid Hemorrhage Linked to Higher Risk of Stroke, Mortality

The following article is part of conference coverage from the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the AAN 2021 Virtual Annual Meeting.

Patients with infective endocarditis (IE) and subarachnoid hemorrhage (SAH) were at increased risk for mortality from acute ischemic stroke (AIS), according to study findings presented at the American Academy of Neurology 2021 Virtual Annual Meeting, held April 17 to 22, 2021.

Researchers from New York Medical College sourced data from the National Inpatient Sample, Agency for Healthcare Research and Quality, and Healthcare Cost and Utilization Project for this study. Patients (N=82,844) with IE hospitalized between 2010 and 2015 were assessed for clinical outcomes and mortality on the basis of SAH status.

Few patients with IE had concurrent SAH (n=641). The patients with IE and SAH were associated with a more complicated disease course and poorer outcomes, including an increased risk for mortality (odds ratio [OR], 4.65; 95% CI, 3.9-5.5; P <.001).

Endovascular therapy due to mycotic aneurysm was performed among 3.6% (n=23) of the patients with SAH.

SAH was associated with increased risk for ventriculitis (OR, 7.1; 95% CI, 4.2-11.9; P <.001) and AIS (OR, 6.3; 95% CI, 5.4-7.4; P <.001).

The rate of AIS was 41.5% (n=266) among patients with SAH, which was substantially higher than among patients without SAH (10.1%; n=8267). Mechanical thrombectomy was required by 0.8% of all patients with AIS, and among 1.9% of the patients with AIS and SAH comorbidities (P =.05).

Patients with IE and SAH were more likely to undergo endovascular therapy or mechanical thrombectomy, to have a mycotic aneurysm, or to have ventriculitis. Ultimately, study researchers concluded that patients with IE “are at risk for numerous complications” and those with IE and concurrent SAH had “significant increase in the mortality and risk of AIS” compared with patients without SAH.

Disclosure: An author declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Sursal T, Karimov Z, Nazarenko A, et al. Significant increase in mortality and risk of acute ischemic stroke in infective endocarditis patients with subarachnoid hemorrhage