{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:36:59Z","timestamp":1792715819093,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Echocardiographic evaluation of vegetations is crucial in infective endocarditis (\n                      <jats:styled-content style=\"fixed-case\">IE<\/jats:styled-content>\n                      ). Although several studies have noted a link between larger vegetations and an increased risk of embolization, a more comprehensive evaluation of vegetation characteristics in a contemporary cohort has not been conducted. Our study aimed to define the short\u2010term risk of symptomatic embolization in patients with\n                      <jats:styled-content style=\"fixed-case\">IE<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The Mayo Clinic\n                      <jats:styled-content style=\"fixed-case\">IE<\/jats:styled-content>\n                      registry was screened to identify patients from 2015 to 2021 who had undergone transesophageal echocardiography. Multivariable subdistribution hazards regression analysis was used to identify factors associated with the cumulative incidence of symptomatic embolism over 30\u2009days accounting for the competing risk of death. Overall, 779 patients with\n                      <jats:styled-content style=\"fixed-case\">IE<\/jats:styled-content>\n                      were included, of whom 517 (66.4%) were men, median age was 65.0 (\n                      <jats:styled-content style=\"fixed-case\">interquartile range,<\/jats:styled-content>\n                      52.9\u201374.8) years, and 89.3% were White. In total, 234 patients had a symptomatic embolic event, a 30\u2010day cumulative incidence of 30.2%. In multivariable analysis, a highly mobile vegetation was the strongest predictor of embolism (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Vegetation length with interaction of\n                      <jats:styled-content style=\"fixed-case\">IE<\/jats:styled-content>\n                      type was also associated with embolic risk (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), with a stronger effect in native valve\n                      <jats:styled-content style=\"fixed-case\">IE<\/jats:styled-content>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      interaction=0.001). Other associated factors included multiple vegetations, younger age, and\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      . A nomogram that incorporated these factors was constructed to facilitate the prediction of embolic risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Highly mobile, larger vegetations are associated with embolic events. Embolic risk could be assessed by evaluating length as a continuous variable, alongside other echocardiographic findings, using a newly developed scoring tool; external validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.036648","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T06:05:56Z","timestamp":1737612356000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Comprehensive Assessment of the Risk of Symptomatic Embolism in Patients With Infective Endocarditis"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3021-8328","authenticated-orcid":false,"given":"Sebastian D.","family":"Santos\u2010Patarroyo","sequence":"first","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine Mayo Clinic College of Medicine and Science Rochester MN 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