What are the recommendations for patients with mechanical valve IE who have experienced a CNS embolic event?
Discontinuation of all forms of anticoagulation in patients with mechanical valve IE who have experienced a CNS embolic event for at least 2 weeks is reasonable (Class IIa; Level of Evidence C). Initiation of aspirin or other antiplatelet agents as adjunctive therapy in IE is not recommended (Class III; Level of Evidence B). The continuation of long-term antiplatelet therapy at the time of development of IE with no bleeding complications may be considered (Class IIb; Level of Evidence B).