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Antibiotics Lower Stroke Risk from Heart Infection

      Volume: 48 (09/01/2008)
A study reported in the American Heart Journal suggests that patients with infective endocarditis benefit from antibiotic therapy in the form of reduced risk of stroke. The study was conducted by researchers from the New York University School of Medicine.

Infective endocarditis is an infection involving the heart valves that is caused by a bacterium called Staphylococcus aureus and other bacterial growth on the valve. The infection increases the risk of stroke as it can cause debris accumulated within the heart to break off and travel through the blood vessels to the brain. This debris can cause a blockage in the brain and rob brain tissues of necessary oxygen. Such strokes are called embolic strokes.

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For their study, Dr. Stuart A. Dickerman from New York University School of Medicine used data on 1,437 patients who received treatment at a hospital for infective endocarditis. Their aim was to determine the frequency of strokes and define the effect of antibiotic therapy on the risk of subsequent strokes.

From the 1,437 volunteers, a total of 299 or 15% of the patients suffered a stroke. Data was however available only on 185 patients for analysis. Half of the strokes occurred prior to antibiotic therapy while the remaining occurred after the therapy.

Analysis of the data revealed that there was a marked decline in the daily rate of stroke once antibiotic treatment was started. The decline in rate continued the longer the drugs were administered. For example, the rate of stroke dropped by 65% if the therapy was continued for two weeks instead of one. Just one week of therapy brought down rates, with only 3.1% of patients experiencing a stroke.

The researchers found no difference in stroke risk between patients with natural heart valves and those with artificial ones. While surgery is often used for treating infective endocarditis, the present study suggests that just one week of treatment with antibiotics might remove the need for such a surgery if its sole purpose is stroke prevention.

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