Chia-Jen Shih1, Hsi Chu1, Pei-Wen Chao1, Yi-Jung Lee1, Shu-Chen Kuo1, Szu-Yuan Li1, Der-Cherng Tarng1, Chih-Yu Yang1, Wu-Chang Yang1, Shuo-Ming Ou2, Yung-Tai Chen2. 1. From the School of Medicine (C-J.S., H.C., Y-J.L., S.-C.K., S.-Y.L., D.-C.T., C.-Y.Y., W.-C.Y., S.-M.O., Y.-T.C.) and Institute of Clinical Medicine (S.-M.O.), National Yang-Ming University, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan (C.-J.S.); Division of Respiratory Medicine, Department of Chest (H.C.), and Division of Nephrology, Department of Medicine (Y.-T.C.), Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan; School of Medicine and Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (P.-W.C.); Department of Neurology, Neurological Institute (Y.-J.L.), Division of Infectious Diseases (S.-C.K.), and Division of Nephrology, Department of Medicine (S.-Y.L., D.-C.T., C.-Y.Y., W.-C.Y., S.-M.O.), Taipei Veterans General Hospital, Taipei, Taiwan; and National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan (S.-C.K.). 2. From the School of Medicine (C-J.S., H.C., Y-J.L., S.-C.K., S.-Y.L., D.-C.T., C.-Y.Y., W.-C.Y., S.-M.O., Y.-T.C.) and Institute of Clinical Medicine (S.-M.O.), National Yang-Ming University, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan (C.-J.S.); Division of Respiratory Medicine, Department of Chest (H.C.), and Division of Nephrology, Department of Medicine (Y.-T.C.), Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan; School of Medicine and Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (P.-W.C.); Department of Neurology, Neurological Institute (Y.-J.L.), Division of Infectious Diseases (S.-C.K.), and Division of Nephrology, Department of Medicine (S.-Y.L., D.-C.T., C.-Y.Y., W.-C.Y., S.-M.O.), Taipei Veterans General Hospital, Taipei, Taiwan; and National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan (S.-C.K.). ytchen0117@gmail.com okokyytt@gmail.com.
Abstract
BACKGROUND: Substantial infective endocarditis (IE)-related morbidity and mortality may occur even after successful treatment. However, no previous study has explored long-term hard end points (ie, stroke, myocardial infarction, heart failure, cardiovascular death) in addition to all-cause mortality in IE survivors. METHODS AND RESULTS: A nationwide population-based cohort study was conducted among IE survivors identified with the use of the Taiwan National Health Insurance Research Database during 2000 to 2009. IE survivors were defined as those who survived after discharge from first hospitalization with a diagnosis of IE. A total of 10 116 IE survivors were identified. IE survivors were matched to control subjects without IE at a 1:1 ratio through the use of propensity scores. The primary outcomes were stroke, myocardial infarction, readmission for heart failure, and sudden cardiac death or ventricular arrhythmia. The secondary outcomes were repeat IE and all-cause mortality. Compared with the matched cohort, IE survivors had higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.59; 95% confidence interval [CI], 1.40-1.80), hemorrhagic stroke (aHR, 2.37; 95% CI, 1.90-2.96), myocardial infarction (aHR, 1.44; 95% CI, 1.17-1.79), readmission for heart failure (aHR, 2.24; 95% CI, 2.05-2.43), sudden death or ventricular arrhythmia (aHR, 1.69; 95% CI, 1.44-1.98), and all-cause death (aHR, 2.27; 95% CI, 2.14-2.40). Risk factors for repeat IE were older age, male sex, drug abuse, and valvular replacement after an initial episode of IE. CONCLUSION: Despite treatment, the risk of long-term major adverse cardiac events was substantially increased in IE survivors.
BACKGROUND: Substantial infective endocarditis (IE)-related morbidity and mortality may occur even after successful treatment. However, no previous study has explored long-term hard end points (ie, stroke, myocardial infarction, heart failure, cardiovascular death) in addition to all-cause mortality in IE survivors. METHODS AND RESULTS: A nationwide population-based cohort study was conducted among IE survivors identified with the use of the Taiwan National Health Insurance Research Database during 2000 to 2009. IE survivors were defined as those who survived after discharge from first hospitalization with a diagnosis of IE. A total of 10 116 IE survivors were identified. IE survivors were matched to control subjects without IE at a 1:1 ratio through the use of propensity scores. The primary outcomes were stroke, myocardial infarction, readmission for heart failure, and sudden cardiac death or ventricular arrhythmia. The secondary outcomes were repeat IE and all-cause mortality. Compared with the matched cohort, IE survivors had higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.59; 95% confidence interval [CI], 1.40-1.80), hemorrhagic stroke (aHR, 2.37; 95% CI, 1.90-2.96), myocardial infarction (aHR, 1.44; 95% CI, 1.17-1.79), readmission for heart failure (aHR, 2.24; 95% CI, 2.05-2.43), sudden death or ventricular arrhythmia (aHR, 1.69; 95% CI, 1.44-1.98), and all-cause death (aHR, 2.27; 95% CI, 2.14-2.40). Risk factors for repeat IE were older age, male sex, drug abuse, and valvular replacement after an initial episode of IE. CONCLUSION: Despite treatment, the risk of long-term major adverse cardiac events was substantially increased in IE survivors.
Authors: Bruno L R Faillace; Micheli Z Galon; Marcos Danillo P Oliveira; Guy F A Prado; Adriano A M Truffa; Expedito E Ribeiro; Pedro A Lemos Journal: Case Rep Cardiol Date: 2015-09-15
Authors: Lawrence P Park; Vivian H Chu; Gail Peterson; Athanasios Skoutelis; Tatjana Lejko-Zupa; Emilio Bouza; Pierre Tattevin; Gilbert Habib; Ren Tan; Javier Gonzalez; Javier Altclas; Jameela Edathodu; Claudio Querido Fortes; Rinaldo Focaccia Siciliano; Orathai Pachirat; Souha Kanj; Andrew Wang Journal: J Am Heart Assoc Date: 2016-04-18 Impact factor: 5.501