{
  "abstract": "Background: Ischemic stroke is a common and serious complication of infective bacterial endocarditis. This study aimed to characterize the frequency, clinical and pathological features, treatment strategies, and outcomes of patients with stroke due to infective endocarditis.\n\nMethods: We systematically searched PubMed from database inception to October 2022 for studies reporting on stroke in patients with infective endocarditis and performed a meta-analysis.\n\nResults: A total of 122 studies comprising 270,211 patients with infective endocarditis were included. Ischemic stroke occurred in 21% and hemorrhagic stroke in 5% of patients. Stroke was observed in 32% of patients with mitral valve endocarditis, 25% with aortic valve, and 11% with tricuspid valve endocarditis. Stroke was associated with significantly higher mortality (OR 2.35; 95%CI 1.74–3.16). Staphylococcus and Streptococcus species were most frequently associated with stroke (33% and 25%, respectively). The risk of stroke did not differ significantly between patients with and without pre-existing antithrombotic therapy (37% vs. 24%; OR 1.24, 95%CI 0.75–2.06). Successful reperfusion was achieved in 80% of patients undergoing mechanical thrombectomy, although mortality remained high at 49%.\n\nConclusions: Stroke is a common complication of infective bacterial endocarditis and has a substantial impact on patient outcomes. It occurs most frequently in patients with mitral valve endocarditis and in those with infections caused by staphylococcal pathogens. Stroke risk was not reduced in patients with pre-existing antithrombotic therapy, supporting discontinuation where no other indication exists. Mechanical thrombectomy in patients with endocarditis-related large vessel occlusion achieves high recanalization rates; however, overall clinical outcomes remain poor in this population.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s42466-026-00542-z.",
  "abstract_shown": true,
  "affiliations": [
    "University of Luebeck, Department of Neurology, Luebeck, Germany",
    "Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany",
    "University of Luebeck, Institute of Social Medicine and Epidemiology, Luebeck, Germany",
    "Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany",
    "University of Luebeck, Institute of Cardiogenetics, Luebeck, Germany",
    "partner site North, DZHK (German Center for Cardiovascular Research), Lübeck, Germany",
    "University of Luebeck, Medical Clinic II, University Heart Center Luebeck, Luebeck, Germany"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nils Werring",
      "orcid": "0009-0008-9755-5921"
    },
    {
      "affs": [
        1
      ],
      "name": "Nadine Bonberg"
    },
    {
      "affs": [
        2
      ],
      "name": "Andreas Heidenreich"
    },
    {
      "affs": [
        3
      ],
      "name": "Carolin Beuker"
    },
    {
      "affs": [
        0
      ],
      "name": "Greta Noblejas-Sanchez"
    },
    {
      "affs": [
        0
      ],
      "name": "Michelle Oswald"
    },
    {
      "affs": [
        0
      ],
      "name": "Georg Royl"
    },
    {
      "affs": [
        0
      ],
      "name": "Tobias A. Wagner-Altendorf"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Tanja Zeller"
    },
    {
      "affs": [
        6,
        5
      ],
      "name": "Thomas Stiermaier"
    },
    {
      "affs": [
        6,
        5
      ],
      "name": "Ingo Eitel"
    },
    {
      "affs": [
        2
      ],
      "name": "Alexander Katalinic"
    },
    {
      "affs": [
        1
      ],
      "name": "Heike Minnerup"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Jens Minnerup"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/30892qtan1zhv.bib",
  "cited_by": 0,
  "doi": "10.1186/s42466-026-00542-z",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13712007/",
  "id": "30892qtan1zhv",
  "issns": [
    "2524-3489"
  ],
  "landing_url": "https://doi.org/10.1186/s42466-026-00542-z",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2713|Infective Endocarditis Diagnosis and Management"
    ]
  ],
  "openalex": "W7223681791",
  "pdf_url": "https://link.springer.com/content/pdf/10.1186/s42466-026-00542-z.pdf",
  "pmcid": "PMC13712007",
  "pmid": "42934823",
  "published": "2026-10-26",
  "publisher": "Deutsche Gesellschaft für Neurologie e.V.",
  "ris": "https://research.draconitic.com/paper/30892qtan1zhv.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:41Z",
      "native_id": "PMC13712007",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s42466-026-00542-z"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Infective Endocarditis Diagnosis and Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Characterization and treatment of ischemic stroke in patients with infective endocarditis: a meta‐analysis",
  "title_text": "Characterization and treatment of ischemic stroke in patients with infective endocarditis: a meta‐analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:41Z",
  "url": "https://research.draconitic.com/paper/30892qtan1zhv",
  "venue": "Neurological Research and Practice",
  "versions": []
}