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Effect of prior antiplatelet therapy on major adverse cardiac events in patients diagnosed with infective endocarditis: Population-based retrospective cohort study

Background: Infective endocarditis (IE) occurs with an incidence of about 3–10 per 100,000 person-years globally. Those with infective endocarditis complicated embolic events have worse outcomes. However, whether antiplatelet therapy could prevent the development of ischemic stroke and myocardial infarction remained unknown. Materials and Methods: We conducted a retrospective cohort study using Taiwan National Health Insurance Research Database to access the effect of prior antiplatelet therapy on major adverse cardiac events in patients diagnosed with infective endocarditis. Results: The clinical characteristics and the risk of subsequent major adverse cardiac events in 901 patients with infective endocarditis with prior antiplatelet therapy and a matched cohort without antiplatelet therapy were retrospectively analyzed. The majority (63%) of the patients with prior antiplatelet therapy were male and 568 (57.7%) had a high (≥3) Charlson Cormorbidity Index score. There was no significant difference in the risk of myocardial infarction, ischemic stroke, and major bleeding between the two groups. The tests of interaction showed the risk of myocardial infarction was contingent on heart failure. Conclusions: Prior antiplatelet therapy did not prevent the cerebral and myocardial infarction in those with infective endocarditis. Neither did them increase the risk of major bleeding in patients with infective endocarditis.