Jeroen Tahon1, Pieter-Jan Geselle2, Bert Vandenberk1, Evelyn E Hill1, Willy E Peetermans3, Paul Herijgers4, Stefan Janssens1, Marie-Christine Herregods5. 1. Department of Cardiology, KU Leuven, University Hospitals Leuven, 3000 Leuven, Belgium. 2. Department of Cardiology, St.Joseph Clinic Izegem, 8870 Izegem, Belgium. 3. Department of Internal Medicine-Infectious Diseases, KU Leuven, University Hospitals Leuven, 3000 Leuven, Belgium. 4. Department of Cardiac Surgery, KU Leuven, University Hospitals Leuven, 3000 Leuven, Belgium. 5. Department of Cardiology, KU Leuven, University Hospitals Leuven, 3000 Leuven, Belgium. Electronic address: marie-christine.herregods@uzleuven.be.
Abstract
BACKGROUND: Infective endocarditis (IE) remains a severe disease with high mortality. Most studies report on short-term outcome while real world long-term outcome data are scarce. This study reports reinfection rates and mortality data during long-term follow-up. METHODS: A total of 270 patients meeting the modified Duke criteria for definite IE admitted to a tertiary care center between July 2000 and June 2007 were analyzed retrospectively. Early reinfection was defined as a new IE episode within 6 months; late reinfection as a new IE episode beyond 6 months follow-up. RESULTS: Median follow-up was 8.5 years. Early reinfection occurred in 10 patients (3.7%), late reinfection in 18 patients (6.7%). Staphylococci (39.7%) were the most frequent causative microorganisms, followed by Streptococci (30.0%) and Enterococci (17.8%). Independent predictors of any reinfection were heart failure (HR 3.02, 95% CI 1.42-6.41), peripheral embolization (HR 4.00, 95% CI 1.58-10.17) and implanted pacemakers (HR 3.43, 95% CI 1.25-9.36). Survival rates were 71.1%, 55.2% and 43.3% at respectively 1-, 5- and 10-years follow-up. Independent predictors for mortality were age (HR 1.03, 95% CI 1.01-1.04), diabetes mellitus (HR 2.24, 95% CI 1.46-3.45), hemodialysis (HR 2.70, 95% CI 1.37-5.29), heart failure (HR 1.64, 95% CI 1.19-2.26), stroke (HR 1.73, 95% CI 1.18-2.52), antimicrobial treatment despite surgical indication (HR 5.53, 95% CI 3.59-8.49) and non-Streptococci causative microorganisms (HR 1.84, 95% CI 1.28-2.64). CONCLUSIONS: Contemporary mortality rates of infective endocarditis remain high, irrespective of reinfection. Heart failure, peripheral embolization and presence of a pacemaker were predictors of reinfection.
BACKGROUND:Infective endocarditis (IE) remains a severe disease with high mortality. Most studies report on short-term outcome while real world long-term outcome data are scarce. This study reports reinfection rates and mortality data during long-term follow-up. METHODS: A total of 270 patients meeting the modified Duke criteria for definite IE admitted to a tertiary care center between July 2000 and June 2007 were analyzed retrospectively. Early reinfection was defined as a new IE episode within 6 months; late reinfection as a new IE episode beyond 6 months follow-up. RESULTS: Median follow-up was 8.5 years. Early reinfection occurred in 10 patients (3.7%), late reinfection in 18 patients (6.7%). Staphylococci (39.7%) were the most frequent causative microorganisms, followed by Streptococci (30.0%) and Enterococci (17.8%). Independent predictors of any reinfection were heart failure (HR 3.02, 95% CI 1.42-6.41), peripheral embolization (HR 4.00, 95% CI 1.58-10.17) and implanted pacemakers (HR 3.43, 95% CI 1.25-9.36). Survival rates were 71.1%, 55.2% and 43.3% at respectively 1-, 5- and 10-years follow-up. Independent predictors for mortality were age (HR 1.03, 95% CI 1.01-1.04), diabetes mellitus (HR 2.24, 95% CI 1.46-3.45), hemodialysis (HR 2.70, 95% CI 1.37-5.29), heart failure (HR 1.64, 95% CI 1.19-2.26), stroke (HR 1.73, 95% CI 1.18-2.52), antimicrobial treatment despite surgical indication (HR 5.53, 95% CI 3.59-8.49) and non-Streptococci causative microorganisms (HR 1.84, 95% CI 1.28-2.64). CONCLUSIONS: Contemporary mortality rates of infective endocarditis remain high, irrespective of reinfection. Heart failure, peripheral embolization and presence of a pacemaker were predictors of reinfection.
Authors: Jinnam Kim; Jung Ho Kim; Hi Jae Lee; Se Ju Lee; Ki Hyun Lee; Eun Hwa Lee; Yae Jee Baek; Jin Young Ahn; Su Jin Jeong; Nam Su Ku; Seung Hyun Lee; Jun Yong Choi; Joon-Sup Yeom Journal: Infect Dis Ther Date: 2022-04-30
Authors: Ana Lopez-de-Andres; Rodrigo Jimenez-Garcia; Valentin Hernández-Barrera; Javier de-Miguel-Díez; Jose M de-Miguel-Yanes; David Martinez-Hernandez; David Carabantes-Alarcon; Jose J Zamorano-Leon; Concepción Noriega Journal: Cardiovasc Diabetol Date: 2022-09-30 Impact factor: 8.949