Platelet count was significantly lower in PVE patients caused by S. aureus (p = 0.039). HT was more common and hemoglobin level was lower in the S. aureus group, but no statistically significant differences were identified (67% vs. 35%, p = 0.169; 11.2 mg/dL vs. 9.4 mg/dL, p = 0.050, respectively). Table 4 Comparison
between stroke patients caused by PH-797804 mw Staphylococcus aureus and other Inhibitors,research,lifescience,medical organisms Discussion The current study demonstrated that 1) embolic stroke was seen in about a quarter of patients with PVE (26/111 patients, 23%), 2) nearly half of embolic strokes in PVE patients were accompanied by HT (11/26 patients, 42%), 3) in-hospital mortality of PVE patients with embolic stroke was 15% (4/26 patients), 4) in-hospital mortality appeared higher in patients with HT compared to those without HT (27% vs. 7%), although statistically significant differences were not identified likely due to the limited Inhibitors,research,lifescience,medical number of patients identified for study, and 5) predictors for HT of ischemic stroke were not identified from the present study, even though we recruited patients through a multicenter study. Stroke remains a debilitating complication
of left-sided IE in 20-40% of patients and has been associated with poor outcomes.17) In the present study, stroke was seen in 23% of PVE patients, a proportion similar to previous reports of IE patients.9) As a result, Inhibitors,research,lifescience,medical we speculate that the risk of stroke may not be influenced by the type of infected valve (native vs. prosthetic). Not surprisingly, HT was Inhibitors,research,lifescience,medical observed in nearly half of embolic patients as prior evidence demonstrated increased frequency of HT in embolic stroke than in non-embolic stroke patients. Mortality rate for our overall data was 11% and 15% in stroke patients. Interestingly,
mortality rate of stroke patients without HT appeared much lower than stroke patients with HT (7% vs. 37%). Therefore, Inhibitors,research,lifescience,medical stroke following IE of mechanical heart valves might represent a poor prognostic factor, specifically when associated with HT. PT values were not different between stroke patients with and without HT both at the onset of IE and at stroke presentation. Although most of the patients with HT had supratherapeutic CYTH4 PT values (PT/INR > 3), HT also occurred in 2 patients with suboptimal PT levels. Therefore, other factors yet to be uncovered may also be associated with the development of HT in PVE. PT levels remained prolonged even after discontinuing anticoagulation in most of our patients – perhaps due to uncontrolled infection – suggesting that the clinical benefits of stopping anticoagulants in PVE patients with elevated PT values remain unknown. In our population, 8 of 11 stroke patients (73%) were complicated with HT at the time of stroke diagnosis, demonstrating the difficulty in preventing HT by discontinuing anticoagulation. IE caused by S. aureus has the worst prognosis and has a high rate of embolic episodes with subsequent neurologic involvement.