Roberto Mateos Gaitán1, Lucía Boix-Palop2, Patricia Muñoz García3, Carlos A Mestres4, Mercedes Marín Arriaza3, Álvaro Pedraz Prieto5, Arístides de Alarcón Gonzalez6, Encarnación Gutiérrez Carretero7, Marta Hernández Meneses8, Miguel Ángel Goenaga Sánchez9, Manuel Cobo Belaustegui10, José Antonio Oteo Revuelta11, Juan Carlos Gainzarain Arana12, Elisa García Vázquez13, Manuel Martínez-Sellés1,14. 1. Department of Cardiology, Hospital General Universitario Gregorio Marañón, CIBERCV, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain. 2. Unit of Infectious Diseases and Microbiology, Department of Internal Medicine, Hospital Universitari Mútua de Terrassa, Barcelona, Spain. 3. Clinical Unit of Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Gregorio Marañón Health Research Institute, CIBER Enfermedades Respiratorias-CIBERES, Madrid, Spain. 4. Department of Cardiovascular Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 5. Department of Cardiovascular Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 6. Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine Infectious Diseases, Research Group Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocío, Sevilla, Spain. 7. Cardiac Surgery Department, University of Sevilla/CSIC/University Hospital Virgen del Rocío Seville, Institute of Biomedicine-Sevilla (IBiS), CIBERCV, Sevilla, Spain. 8. Department of Infectious Diseases, Hospital Clinic Barcelona, Barcelona, Spain. 9. Department of Infectious Diseases, Hospital Universitario Donosti, San Sebastián, Spain. 10. Department of Cardiology, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 11. Department of Infectious Diseases, Hospital Universitario San Pedro, Centre for Biomedical Research La Rioja (CIBIR), Logroño, Spain. 12. Department of Internal Medicine/Infectious Diseases, Hospital Universitario, Álava, Spain. 13. Department of Internal Medicine/Infectious Diseases, Hospital Clínico Universitario Virgen de la Arrixaca, Biohealth Research Institute (IMIB), Faculty of Medicine, Universidad de Murcia, Murcia, Spain. 14. Universidad Europea, Universidad Complutense, Madrid, Spain.
Abstract
AIMS: Patients with infective endocarditis (IE) frequently have cardiac implantable electronic devices (CIEDs). Here, we aim to define the clinical profile and prognostic factors of IE in these patients. METHODS AND RESULTS: Infective endocarditis cases were prospectively identified in the Spanish National Endocarditis Registry. From 3996 IE, 708 (17.7%) had a CIED and 424 CIED-related IE (lead vegetation). Patients with a CIED were older (68 ± 11 vs. 73 ± 8 years); had more comorbidities {pulmonary disease [176 (24.8%) vs. 545 (16.7%)], renal disease [239 (33.8%) vs. 740 (22.7%)], diabetes [248 (35.0%) vs. 867 (26.6%)], and heart failure [348 (49.2%) vs. 978 (29.9%)]}; and fewer complications {intracardiac destruction [106 (15%) vs. 1077 (33.1%)], heart failure [215 (30.3%) vs. 1340 (41.1%)], embolism [107 (15.1%) vs. 714 (21.9%)], and neurological involvement [77 (10.8%) vs. 702 (21.5%)]} (all P-values <0.001) in comparison to subjects without a CIED. In-hospital mortality was similar in patients with and without CIED [171 (24.2%) vs. 881 (27.0%), P = 0.82]. In subjects with a CIED, CIED-related IE was independently associated with in-hospital survival: odds ratio (OR) 0.4 [95% confidence interval (CI) 0.3-0.7, P = 0.001]. Surgery was independently associated with in-hospital survival in CIED-related IE: OR 0.4 (95% CI 0.2-0.7, P = 0.004); but not in subjects with valve IE and no CIED lead involvement: OR 0.9 (95% CI 0.5-1.7, P = 0.77). CONCLUSION: Over a sixth of IE patients have a CIED. This group of patients is older, with more comorbidities and fewer IE-related complications in comparison to subjects without a CIED. In-hospital mortality was similar in patients with and without a CIED. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Patients with infective endocarditis (IE) frequently have cardiac implantable electronic devices (CIEDs). Here, we aim to define the clinical profile and prognostic factors of IE in these patients. METHODS AND RESULTS:Infective endocarditis cases were prospectively identified in the Spanish National Endocarditis Registry. From 3996 IE, 708 (17.7%) had a CIED and 424 CIED-related IE (lead vegetation). Patients with a CIED were older (68 ± 11 vs. 73 ± 8 years); had more comorbidities {pulmonary disease [176 (24.8%) vs. 545 (16.7%)], renal disease [239 (33.8%) vs. 740 (22.7%)], diabetes [248 (35.0%) vs. 867 (26.6%)], and heart failure [348 (49.2%) vs. 978 (29.9%)]}; and fewer complications {intracardiac destruction [106 (15%) vs. 1077 (33.1%)], heart failure [215 (30.3%) vs. 1340 (41.1%)], embolism [107 (15.1%) vs. 714 (21.9%)], and neurological involvement [77 (10.8%) vs. 702 (21.5%)]} (all P-values <0.001) in comparison to subjects without a CIED. In-hospital mortality was similar in patients with and without CIED [171 (24.2%) vs. 881 (27.0%), P = 0.82]. In subjects with a CIED, CIED-related IE was independently associated with in-hospital survival: odds ratio (OR) 0.4 [95% confidence interval (CI) 0.3-0.7, P = 0.001]. Surgery was independently associated with in-hospital survival in CIED-related IE: OR 0.4 (95% CI 0.2-0.7, P = 0.004); but not in subjects with valve IE and no CIED lead involvement: OR 0.9 (95% CI 0.5-1.7, P = 0.77). CONCLUSION: Over a sixth of IE patients have a CIED. This group of patients is older, with more comorbidities and fewer IE-related complications in comparison to subjects without a CIED. In-hospital mortality was similar in patients with and without a CIED. Published on behalf of the European Society of Cardiology. All rights reserved.
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