Abstract Body: Background
Racial disparities have been well described in cardiovascular disease. However, the impact of race on the risk of stroke among infective endocarditis (IE) patients is not well understood.
Objective
This study aims to investigate the racial disparities in the risk of stroke and clinical outcomes among IE patients.
Method
The TriNeTX Global Collaborative Network database was used to identify patients aged ≥18 years of age from January 2000 to May 2023 which included IE patients. Patients were categorized into two groups, one with Black or African American and another with White race patients. Both groups were followed for 12 months. Propensity score-matched analysis (PSM) (1:1) was performed on age, gender, BMI, hypertension, diabetes mellitus, chronic kidney disease, hemoglobin level, LDL level, left ventricular ejection fraction and various drugs including beta blockers, ACEi and ARBi. Primary outcome was ischemic stroke, while secondary outcomes were all-cause mortality, heart failure, cardiogenic shock, MACE (composite of all-cause mortality, heart failure, and ischemic stroke), and acute kidney injury (AKI).

Result
After 1:1 propensity score matching, the study cohort comprised 9, 814 Black patients and 9, 814 White patients. The mean age of patients was comparable between both groups (59.8 and 63.1 years). IE patients were having a comparable risk of ischemic stroke among both the races after 1 month (RR, 1.17 (95% CI: 0.96-1.42), P = 0.11), however, the risk of ischemic stroke was significantly higher among Black patients after 1 year (RR, 1.18 (95% CI:1.02-1.36), P = 0.024) when compared with White patients. Black patients were having a significantly higher risk of all-cause mortality after one month (RR, 0.818 (95% CI: 0.74-0.89), P<0.001), and after 1 year (RR, 0.91 (95% CI: 0.86-0.96), P = 0.001) when compared with White patients. However, the risk of heart failure, cardiogenic shock, MACE, and AKI was found to be comparable between Black and White patients of IE after 1 month and 1 year follow up.

Conclusion:
These findings suggest that Black patients with infective endocarditis were having a higher a long term risk of stroke and mortality.