Letter to the Editor
Clinical profile, antibiotic treatment, and risk of stroke in patients with infective endocarditis
Perfil clínico, tratamiento antibiótico y riesgo de ictus en pacientes con endocarditis infecciosa
M. Martínez-Sellés
Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Europea, Universidad Complutense, Madrid, Spain
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Martínez-Sellés" "autores" => array:1 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Martínez-Sellés" "email" => array:1 [ 0 => "mmselles@secardiologia.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Europea, Universidad Complutense, Madrid, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Perfil clínico, tratamiento antibiótico y riesgo de ictus en pacientes con endocarditis infecciosa" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">I read with great interest the article by Rodríguez-Montolio et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0010" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of neurological complications in infective endocarditis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Rodríguez-Montolio" 1 => "D. Meseguer-Gonzalez" 2 => "M. Almeida-Zurita" 3 => "P. Revilla-Martí" 4 => "S. Santos-Lasaosa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nrl.2021.09.013" "Revista" => array:2 [ "tituloSerie" => "Neurologia (Engl Ed)." "fecha" => "2022" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical risk factors for acute ischaemic and haemorrhagic stroke in patients with infective endocarditis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Valenzuela" 1 => "M.D. Hunter" 2 => "K. Sundheim" 3 => "B. Klein" 4 => "L. Dunn" 5 => "R. Sorabella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/imj.13958" "Revista" => array:6 [ "tituloSerie" => "Intern Med J." "fecha" => "2018" "volumen" => "48" "paginaInicial" => "1072" "paginaFinal" => "1080" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29740951" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infective endocarditis in diabetic patients: a different profile with prognostic consequences" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.I. Biezma" 1 => "P. Muñoz" 2 => "S. De la Villa" 3 => "M.C. Fariñas-Álvarez" 4 => "F. Arnáiz de las Revillas" 5 => "E. Gutierrez-Carretero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/jcm11092651" "Revista" => array:5 [ "tituloSerie" => "J Clin Med." "fecha" => "2022" "volumen" => "11" "paginaInicial" => "2651" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35566777" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ICE Investigators. The relationship between the initiation of antimicrobial therapy and the incidence of stroke in infective endocarditis: an analysis from the ICE Prospective Cohort Study (ICE-PCS)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.A. Dickerman" 1 => "E. Abrutyn" 2 => "B. Barsic" 3 => "E. Bouza" 4 => "E. Cecchi" 5 => "A. Moreno" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ahj.2007.07.023" "Revista" => array:6 [ "tituloSerie" => "Am Heart J." "fecha" => "2007" "volumen" => "154" "paginaInicial" => "1086" "paginaFinal" => "1094" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18035080" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003800000006/v1_202306201000/S2173580822000931/v1_202306201000/en/main.assets" "Apartado" => array:4 [ "identificador" => "9409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003800000006/v1_202306201000/S2173580822000931/v1_202306201000/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580822000931?idApp=UINPBA00004N" ]
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