Back to Search
Start Over
Comparison of Outcome of Possible Versus Definite Infective Endocarditis Involving Prosthetic or Bioprosthetic Heart Valves.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2017 Nov 15; Vol. 120 (10), pp. 1884-1890. Date of Electronic Publication: 2017 Aug 07. - Publication Year :
- 2017
-
Abstract
- The objectives of this study were to describe and compare the clinical characteristics and outcomes of patients with definite and possible infective endocarditis (IE) involving prosthetic heart valve, and to identify prognostic factors for long-term mortality, using data from an unselected cohort of consecutive patients. We studied data from 133 consecutive patients with IE involving prosthetic heart valve seen in an academic institution between 1990 and 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 47, 35%) and patients with definite IE (n = 86, 65%). Overall, 55 patients died over a mean ± SD follow-up of 3.6 ± 4.1 years (median 1.8, interquartile range 4.4 years). Patients with definite IE had a higher risk of death (hazard ratio [HR] 2.21, 95% confidence interval [CI] 1.20 to 4.17 p = 0.01). Independent predictors of long-term mortality were increasing age (HR 1.05, 95% CI 1.02 to 1.08, p = 0.002), Staphylococcus aureus infection (HR 3.40, 95% CI 1.00 to 11.76; p = 0.05), infection with unknown microorganism (HR 12.50, 95% CI 2.97 to 52.63; p = 0.0006), and definite IE (HR 8.70, 95% CI 3.55 to 21.28; p <0.0001), whereas infection on pacemaker or defibrillator (HR 0.30, 95%CI 0.10 to 0.87; p = 0.03) was associated with a better prognosis. Patients with definite IE and those with possible IE who underwent surgery had a nonsignificantly better prognosis than their counterparts with no surgery. In conclusion, patients with definite IE (Duke criteria) on a prosthetic heart valve independently had a worse prognosis than those with possible IE.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Bioprosthesis microbiology
Echocardiography
Endocarditis, Bacterial diagnosis
Endocarditis, Bacterial microbiology
Female
Follow-Up Studies
France epidemiology
Heart Valve Diseases surgery
Heart Valve Prosthesis microbiology
Hospital Mortality trends
Humans
Male
Prognosis
Prosthesis-Related Infections diagnosis
Prosthesis-Related Infections microbiology
Retrospective Studies
Risk Factors
Staphylococcal Infections diagnosis
Staphylococcal Infections microbiology
Survival Rate trends
Time Factors
Bioprosthesis adverse effects
Endocarditis, Bacterial mortality
Heart Valve Prosthesis adverse effects
Prosthesis-Related Infections mortality
Staphylococcal Infections mortality
Staphylococcus aureus isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 120
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 28917497
- Full Text :
- https://doi.org/10.1016/j.amjcard.2017.07.100