Embolic events (EEs) in infective endocarditis worsen prognosis. Searching early signs predicting EEs may change clinical decisions such as surgical timing and reduce mortality. Our study aimed to identify risk factors of embolic events in our population.

This was a prospective study which included all patients diagnosed with infective endocarditis (IE) and hospitalized in the cardiology department of Monastir hospital, Tunisia, between 1983 and 2017. We included patients who were diagnosed with definite infective endocarditis based on the modified Ducke criteria.

Three hundred forty patients were included in this study. The mean age of the patients was 37±17.92 years; 56.4% men were and 33% had rheumatic heart disease. Major predictors of EEs were gram-negative bacillus infection (RR 1.4, 95% CI), mitral valve vegetation (RR 1.3, 95% CI), and vegetation size>10mm (RR 1.6, 95% CI). EEs risk was also higher elevated C reactive protein, renal failure, prosthetic mechanical valve vegetation, and lower with Streptococcus spp. and staphylococcus spp. infection.

Given the serious consequences of embolism, early surgical intervention may be considered in patients with these risk factors.