Virginie Roux1, Erwan Salaun1,2, Christophe Tribouilloy3, Sandrine Hubert1,2, Yohann Bohbot3, Jean-Paul Casalta2, Pierre-Antoine Barral4, Dan Rusinaru3, Frederique Gouriet2, Cecile Lavoute1,2, Julie Haentjens1, Mathieu Di Biscegli4, Aurelie Dehaene4, Sebastien Renard1, Anne-Claire Casalta1, Julie Pradier1, Jean-Francois Avierinos1, Alberto Riberi1,2, Marc Lambert1, Frederic Collart1, Alexis Jacquier4, Franck Thuny5,6, Laurence Camoin-Jau2,7, Hubert Lepidi2,8, Didier Raoult2, Gilbert Habib1,2.
Abstract
OBJECTIVE: Acute coronary syndromes (ACS) are a rare complication of infective endocarditis (IE). Only case reports and small studies have been published to date. We report the largest series of ACS in IE. The aim of our study was to describe the incidence and mechanisms of ACS associated with IE, to assess their prognostic impact and to describe their management.
METHODS: In a bicentre prospective observational cohort study, all patients with a definite diagnosis of IE were prospectively included. The incidence, mechanism and prognosis of patients with ACS were studied.
RESULTS: Among 1210 consecutive patients with definite IE, 26 patients (2.2%) developed an ACS. Twenty-three patients (88%) had a coronary embolism. Two patients had coronary compression by an abscess or a pseudoaneurysm and one patient had an obstruction of his bioprosthesis and left coronary ostium by a large vegetation. Nineteen (73%) patients with ACS developed heart failure and this complication was 2.5 times more frequent than in patients without ACS (p<0.0001). In the ACS population, mortality rate was twice than the population without ACS.
CONCLUSIONS: ACS is a rare complication of IE but is associated with an increased risk of heart failure and high mortality rate. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
OBJECTIVE: Acute coronary syndromes (ACS) are a rare complication of infective endocarditis (IE). Only case reports and small studies have been published to date. We report the largest series of ACS in IE. The aim of our study was to describe the incidence and mechanisms of ACS associated with IE, to assess their prognostic impact and to describe their management.
METHODS: In a bicentre prospective observational cohort study, all patients with a definite diagnosis of IE were prospectively included. The incidence, mechanism and prognosis of patients with ACS were studied.
RESULTS: Among 1210 consecutive patients with definite IE, 26 patients (2.2%) developed an ACS. Twenty-three patients (88%) had a coronary embolism. Two patients had coronary compression by an abscess or a pseudoaneurysm and one patient had an obstruction of his bioprosthesis and left coronary ostium by a large vegetation. Nineteen (73%) patients with ACS developed heart failure and this complication was 2.5 times more frequent than in patients without ACS (p<0.0001). In the ACS population, mortality rate was twice than the population without ACS.
CONCLUSIONS: ACS is a rare complication of IE but is associated with an increased risk of heart failure and high mortality rate. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Entities:
Keywords:
acute coronary syndromes; endocarditis
Mesh：
Year: 2017
PMID： 28642290 DOI： 10.1136/heartjnl-2017-311624
Source DB: PubMed Journal: Heart ISSN： 1355-6037 Impact factor: 5.994