I read with great interest the article by Rodríguez-Montolio et al.1 on the prevalence of stroke among patients with endocarditis. The authors describe the differences in baseline characteristics between patients with and without stroke; this is an important consideration, as several clinical predictors of acute cerebrovascular accident have been identified in patients with infective endocarditis.2 For instance, in the prospective registry of the Spanish Collaboration on Endocarditis group (GAMES, for its Spanish initials), 17% of diabetic patients presented stroke during hospitalisation due to infective endocarditis, compared to 11% of patients without diabetes.3 Unfortunately, the authors do not include information on diabetes or other clinical characteristics, which would have been valuable, given that this information is easy to obtain. The authors also do not compare the onset of antibiotic treatment in patients with and without stroke. This information is highly relevant, as previous studies have shown a clear association between delayed onset of antibiotic treatment and the risk of stroke.4
Conflicts of interestThe author has no conflicts of interest to declare.
