What is the clinical evidence from this study?

Study design: Cohort. Population: Infective endocarditis (n=847). Intervention: High predicted embolic risk vs. Low predicted embolic risk. Primary outcome: Symptomatic embolism during the 6-month period after the initiation of treatment (C-statistic 0.72 (development) and 0.65 (validation), p=<0.0001).

What question did this study set out to answer?

To develop and validate a simple risk calculator to quantify the risk of symptomatic embolism at hospital admission in patients with infective endocarditis.

September 7, 2026Journal of the American College of CardiologyOpen Access

Prediction of Symptomatic Embolism in Infective Endocarditis

Q: What are the key findings of this study?

A simple calculator based on 6 variables accurately quantified the 6-month risk of symptomatic embolism in patients with infective endocarditis (C-statistic 0.72 in development sample; p<0.0001).

Q: What question did this study set out to answer?

To develop and validate a simple risk calculator to quantify the risk of symptomatic embolism at hospital admission in patients with infective endocarditis.

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Key result

Six-variable risk score predicts 6-month symptomatic embolism in infective endocarditis with ~0.72 C-statistic.

C-statistic 0.72 (development) and 0.65 (validation)
P<0.0001
n=847

Why the study?

Can a simple calculator accurately predict the risk of symptomatic embolism in patients with infective endocarditis at admission?

Key Points

To develop and validate a simple risk calculator to quantify the risk of symptomatic embolism at hospital admission in patients with infective endocarditis.
Analyzed 1,022 consecutive patients with definite infective endocarditis, randomly splitting 847 eligible patients into derivation (n = 565) and validation (n = 282) cohorts.
Evaluated admission clinical, microbiological, and echocardiographic variables to predict symptomatic embolism within 6 months of initiating treatment using competing-risk analysis.
The 6-month incidence of symptomatic embolism was 8.5% in both the development and validation samples.
A 6-variable model (age, diabetes, atrial fibrillation, prior embolism, vegetation length, and Staphylococcus aureus infection) yielded a C-statistic of 0.72 in the development sample and 0.65 in the validation sample.
Patients with high predicted risk showed significantly higher cumulative incidences of embolic events in both the development (p < 0.0001) and validation (p < 0.05) cohorts.

Study Design

Type

Cohort (n=847)

Randomization

Randomized into derivation and validation samples

Multicenter

Yes

Structured PICO

Can a simple calculator accurately predict the risk of symptomatic embolism in patients with infective endocarditis at admission?

Population

847 patients with definite infective endocarditis, followed for 6 months to develop and validate a risk calculator for symptomatic embolism.

Exposure

Risk prediction calculator using 6 variables (age, diabetes, atrial fibrillation, embolism before antibiotics, vegetation length, and Staphylococcus aureus infection)

Outcome

Symptomatic embolism occurring during the 6-month period after the initiation of treatmenthard clinical

Main Result

Effect estimate: C-statistic 0.72 (development) and 0.65 (validation)

p-value: p=<0.0001

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

A novel 6-variable calculator can accurately predict the 6-month risk of symptomatic embolism in patients with infective endocarditis, potentially guiding early surgical decisions.

Cite This Study

Hubert et al. (2013) conducted a cohort in Infective endocarditis (n=847). High predicted embolic risk vs. Low predicted embolic risk was evaluated on Symptomatic embolism during the 6-month period after the initiation of treatment (C-statistic 0.72 (development) and 0.65 (validation), p=<0.0001). A simple calculator based on 6 variables accurately quantified the 6-month risk of symptomatic embolism in patients with infective endocarditis (C-statistic 0.72 in development sample; p<0.0001).

synapsesocial.com/papers/6a9ed5dcae051fe680bc566d https://doi.org/10.1016/j.jacc.2013.07.029

Topics

Atrial fibrillation Persistent AF management Echocardiography

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Implication

A novel 6-variable calculator can accurately predict the 6-month risk of symptomatic embolism in patients with infective endocarditis, potentially guiding early surgical decisions.

Prediction of Symptomatic Embolism in Infective Endocarditis

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Prediction of Symptomatic Embolism in Infective Endocarditis

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider