Anticoagulation in Infective Endocarditis

Despite several advances in the understanding and treatment of infective endocarditis, there still remain controversy and lack of firm recommendations for the use of anticoagulation therapy in some clinical settings. We surveyed cardiology and infectious disease specialists to determine what expert opinions prevail regarding anticoagulation in infective endocarditis. A questionnaire was mailed to 4000 randomly selected cardiologists and infectious disease specialists across the country. The questionnaire contained 2 scenarios: (1) patients with prosthetic valve endocarditis and (2) patients with native valve endocarditis with another compelling indication for anticoagulation. Different choices for continuing or discontinuing anticoagulation were given, and the responses were analyzed. The results of our survey indicate that majority of the cardiology and infectious disease specialists favor anticoagulation in patients with infective endocarditis in these settings.