AIMS: To analyse the characteristics of infective endocarditis (IE) in patients with diabetes mellitus (DM), and to evaluate the prognostic significance of DM according to insulin use. METHODS AND RESULTS: A total of 559 patients with definite IE including 75 patients (13%) with DM (insulin use n = 22; oral antidiabetic n = 53) were evaluated. Comparison of insulin-DM, oral-DM, and non-DM patients showed an older age (66 +/- 13, 66 +/- 10, 58 +/- 17, respectively; P = 0.004) in DM patients, and more frequent IE on prosthetic valves (32, 11, and 15%, respectively; P = 0.068) in insulin-DM patients. Oral streptococci (0, 8, and 18%, respectively; P = 0.016) were less frequently the causative organism than staphylococci (64, 26, and 29%, respectively; P = 0.002) in insulin-DM patients. Vegetations, dehiscence, abscess, and regurgitation rates did not differ among the three groups, nor did cardiac surgery rates (32, 47, and 48%, respectively; P = 0.334), but in-hospital mortality was higher in insulin-DM patients (50, 19, and 15%; P < 0.001). In multivariable analysis, independently of other determinants of death (age, IE location, Staphylococcus aureus, history of heart failure, immunosuppression, creatinine serum), insulin-DM was a predictor of death (OR, 4.69; 95% CI, 1.77-12.44), whereas oral-DM was not. CONCLUSION: IE prognosis in insulin-DM patients is poor due to the coexistence of host and pathogen factors. Insulin-DM patients with IE may require specific management.
AIMS: To analyse the characteristics of infective endocarditis (IE) in patients with diabetes mellitus (DM), and to evaluate the prognostic significance of DM according to insulin use. METHODS AND RESULTS: A total of 559 patients with definite IE including 75 patients (13%) with DM (insulin use n = 22; oral antidiabetic n = 53) were evaluated. Comparison of insulin-DM, oral-DM, and non-DMpatients showed an older age (66 +/- 13, 66 +/- 10, 58 +/- 17, respectively; P = 0.004) in DMpatients, and more frequent IE on prosthetic valves (32, 11, and 15%, respectively; P = 0.068) in insulin-DMpatients. Oral streptococci (0, 8, and 18%, respectively; P = 0.016) were less frequently the causative organism than staphylococci (64, 26, and 29%, respectively; P = 0.002) in insulin-DMpatients. Vegetations, dehiscence, abscess, and regurgitation rates did not differ among the three groups, nor did cardiac surgery rates (32, 47, and 48%, respectively; P = 0.334), but in-hospital mortality was higher in insulin-DMpatients (50, 19, and 15%; P < 0.001). In multivariable analysis, independently of other determinants of death (age, IE location, Staphylococcus aureus, history of heart failure, immunosuppression, creatinine serum), insulin-DM was a predictor of death (OR, 4.69; 95% CI, 1.77-12.44), whereas oral-DM was not. CONCLUSION: IE prognosis in insulin-DMpatients is poor due to the coexistence of host and pathogen factors. Insulin-DMpatients with IE may require specific management.
Authors: Vincent Le Moing; François Alla; Thanh Doco-Lecompte; François Delahaye; Lionel Piroth; Catherine Chirouze; Pierre Tattevin; Jean-Philippe Lavigne; Marie-Line Erpelding; Bruno Hoen; François Vandenesch; Xavier Duval Journal: PLoS One Date: 2015-05-28 Impact factor: 3.240
Authors: Cheng-Jei Lin; Sarah Chua; Sheng-Ying Chung; Chi-Ling Hang; Tzu-Hsien Tsai Journal: Int J Environ Res Public Health Date: 2019-06-25 Impact factor: 3.390
Authors: María Isabel Biezma; Patricia Muñoz; Sofía De la Villa; Mª Carmen Fariñas-Álvarez; Francisco Arnáiz de Las Revillas; Encarnación Gutierrez-Carretero; Arístides De Alarcón; Raquel Rodríguez-García; Jaume Llopis; Miguel Ángel Goenaga; Andrea Gutierrez-Villanueva; Antonio Plata; Laura Vidal; Manuel Martínez-Sellés Journal: J Clin Med Date: 2022-05-09 Impact factor: 4.241
Authors: Carmen Olmos; Isidre Vilacosta; Eduardo Pozo; Cristina Fernández; Cristina Sarriá; Javier López; Carlos Ferrera; Luis Maroto; Isabel González; David Vivas; Julián Palacios; José Alberto San Román Journal: Medicine (Baltimore) Date: 2014-03 Impact factor: 1.889
Authors: José M de Miguel-Yanes; Rodrigo Jiménez-García; Valentín Hernández-Barrera; Javier de Miguel-Díez; Manuel Méndez-Bailón; Nuria Muñoz-Rivas; Napoleón Pérez-Farinós; Ana López-de-Andrés Journal: Cardiovasc Diabetol Date: 2019-11-21 Impact factor: 9.951