Comparison of Demographic Profile, Laboratory, Epidemiology and Clinical Outcomes in Patients with Native Valve and Prosthetic Valve Endocarditis
Comparison of Native Valve and Prosthetic Valve Endocarditis
Keywords:infective endocarditis, native valve endocarditis, prosthetic valve endocarditis
Background: Infective endocarditis (IE) is a heterogenous infection that affects the endothelial surface of the intracardiac structures and other implanted intracardiac devices. We aimed to compare demographical characteristics, causative microorganisms, treatment, and prognosis of prosthetic and native valve endocarditis diagnosed in two separate hospitals.
Material and methods: Between 2010 and 2020, patients admitted with the diagnosis of IE were retrospectively included in our multicenter study. Patients' demographic and epidemiological data, clinical characteristics, infected intracardiac structure and sort of valve, culprit microorganisms, laboratory findings, treatment manifestations and in-hospital outcomes with a period of 6 months were obtained from an electronic medical record system.
Results: A total of 173 consecutive patients had diagnosed IE, 60.1% (104 patients) of them native valve endocarditis (NVE) and 39.8 % (69 patients) of them prosthetic valve endocarditis (PVE). Baseline demographic properties were not different except hypertension and atrial fibrillation. Patients with prior hypertension were 25% (26 patients) in NVE; 39.1% (27 patients) in PVE and the difference was statistically significant. Septic shock was significantly higher in the PVE group than the NVE group (7.4% versus 1%;
P = .036), and also recurrent endocarditis occurred more frequently in the PVE group than the NVE group (8.8% versus 1%; P = .016).
Conclusion: In our study, although we detected higher mean age, HT, RDW and atrial fibrillation rates compared with NVE, we did not detect a significant difference in mortality and morbidity.
Aung N, Ling HZ, Cheng AS, Aggarwal S, Flint J, Mendonca M, Rashid M, Kang S, Weissert S, Coats CJ, Richards T, Thomas M, Woldman S, Okonko DO. 2013. Expansion of the red cell distribution width and evolving iron deficiency as predictors of poor outcome in chronic heart failure. Int J Cardiol. Oct 3;168(3):1997-2002.
Baddour LM, Wilson WR, Bayer AS, et al. 2015. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 132(15): 1435-86.
Bor DH, Woolhandler S, Nardin R, Brusch J, Himmelstein DU. 2013. Infective endocarditis in the U.S., 1998-2009: a nationwide study. PLoS One. 8(3):e60033.
Cahill TJ, Prendergast BD. 2016. Infective endocarditis. Lancet. Feb 27;387(10021):882-93.
Durante-Mangoni E, Bradley S, Selton-Suty C, Tripodi MF, Barsic B, Bouza E, Cabell CH, Ramos AI, Fowler V Jr, Hoen B, Koneçny P, Moreno A, Murdoch D, Pappas P, Sexton DJ, Spelman D, Tattevin P, Miró JM, van der Meer JT, Utili R. 2008. International Collaboration on Endocarditis Prospective Cohort Study Group. Current features of infective endocarditis in elderly patients: results of the International Collaboration on Endocarditis Prospective Cohort Study. Arch Intern Med. Oct 27;168(19):2095-103.
Erbay AR, Erbay A, Canga A, Keskin G, Sen N, Atak R, Demir AD, Balbay Y, Duru E. 2010. Risk factors for in-hospital mortality in infective endocarditis: five years' experience at a tertiary care hospital in Turkey. J Heart Valve Dis. Mar;19(2):216-24.
Ferrera C, Vilacosta I, Fernández C, López J, Sarriá C, Olmos C, et al. 2015. Usefulness of thrombocytopenia at admission as a prognostic marker in native valve left-sided infective endocarditis. Am J Cardiol. 115(7):950–5.
Gomes A, Glaudemans AWJM, Touw DJ, van Melle JP, Willems TP, Maass AH, Natour E, Prakken NHJ, Borra RJH, van Geel PP, Slart RHJA, van Assen S, Sinha B. 2017. Diagnostic value of imaging in infective endocarditis: a systematic review. Lancet Infect Dis. Jan;17(1):e1-e14.
Guray Y, Ipek EG, Guray U, Demirkan B, Kafes H, Asarcikli LD, Cabuk G, Yilmaz MB. 2014. Red cell distribution width predicts mortality in infective endocarditis. Arch Cardiovasc Dis. May;107(5):299-307.
Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, Dulgheru R, El Khoury G, Erba PA, Iung B, Miro JM, Mulder BJ, Plonska-Gosciniak E, Price S, Roos-Hesselink J, Snygg-Martin U, Thuny F, Tornos Mas P, Vilacosta I, Zamorano JL. 2015. ESC Scientific Document Group. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. Nov 21;36(44):3075-3128.
Hasbun R, Vikram HR, Barakat LA, Buenconsejo J, Quagliarello VJ. 2003. Complicated left-sided native valve endocarditis. Risk classification for mortality. JAMA. 2003;289(15):1933–40.
Granowitz E, Longworth DL. Risk stratification and bedside prognostication in infective endocarditis. JAMA. 289(15):1991–3.
Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A, Soler-Soler J, Thiene G, von Graevenitz A, Priori SG, Garcia MA, Blanc JJ, Budaj A, Cowie M, Dean V, Deckers J, Fernández Burgos E, Lekakis J, Lindahl B, Mazzotta G, Morais J, Oto A, Smiseth OA, Lekakis J, Vahanian A, Delahaye F, Parkhomenko A, Filipatos G, Aldershvile J, Vardas P. 2004. Task Force Members on Infective Endocarditis of the European Society of Cardiology; ESC Committee for Practice Guidelines (CPG); Document Reviewers. Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary; the task force on infective endocarditis of the European society of cardiology. Eur Heart J. Feb;25(3):267-76.
Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, Kang KW, Kim J, Rhee JE. 2013. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emerg Med. Mar;31(3):545-8.
Lancellotti P, Moura L, Pierard LA, Agricola E, Popescu BA, Tribouilloy C, Hagendorff A, Monin JL, Badano L, Zamorano JL. 2010. European Association of Echocardiography. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr. May;11(4):307-32.
Leone S, Ravasio V, Durante-Mangoni E, Crapis M, Carosi G, Scotton PG, Barzaghi N, Falcone M, Chinello P, Pasticci MB, Grossi P, Utili R, Viale P, Rizzi M, Suter F. 2012. Epidemiology, characteristics, and outcome of infective endocarditis in Italy: the Italian Study on Endocarditis. Infection. Oct;40(5):527-35.
Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, Bashore T, Corey GR. 2000. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. Apr;30(4):633-8.
Loupa C, Mavroidi N, Boutsikakis I, Paniara O, Deligarou O, Manoli H, Saroglou G. 2004. Infective endocarditis in Greece: a changing profile. Epidemiological, microbiological and therapeutic data. Clin Microbiol Infect. Jun;10(6):556-61.
Marques A, Cruz I, Caldeira D, Alegria S, Gomes AC, Broa AL, João I, Pereira H. 2020. Risk Factors for In-Hospital Mortality in Infective Endocarditis. Arq Bras Cardiol. Jan;114(1):1-8.
Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG Jr, Bayer AS, Karchmer AW, Olaison L, Pappas PA, Moreillon P, Chambers ST, Chu VH, Falcó V, Holland DJ, Jones P, Klein JL, Raymond NJ, Read KM, Tripodi MF, Utili R, Wang A, Woods CW, Cabell CH. 2009. International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. Mar 9;169(5):463-73.
Nunes MC, Gelape CL, Ferrari TC. 2010. Profile of infective endocarditis at a tertiary care center in Brazil during a seven-year period: prognostic factors and in-hospital outcome. Int J Infect Dis. May;14(5):e394-8.
Olmos C, Vilacosta I, Fernández C, López J, Sarriá C, Ferrera C, Revilla A, Silva J, Vivas D, González I, San Román JA. 2013. Contemporary epidemiology and prognosis of septic shock in infective endocarditis, European Heart Journal. 34(26):1999-2006.
San Román JA, López J, Vilacosta I, Luaces M, Sarriá C, Revilla A, et al. 2007. Prognostic stratification of patients with left-sided endocarditis determined at admission. Am J Med. 120(4):369.e1–7.
Schulz R, Werner GS, Fuchs JB, Andreas S, Prange H, Ruschewski W, Kreuzer H. 1996. Clinical outcome and echocardiographic findings of native and prosthetic valve endocarditis in the 1990's. Eur Heart J. Feb;17(2):281-8.
Selton-Suty C, Célard M, Le Moing V, Doco-Lecompte T, Chirouze C, Iung B, Strady C, Revest M, Vandenesch F, Bouvet A, Delahaye F, Alla F, Duval X, Hoen B. 2012. AEPEI Study Group. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. May;54(9):1230-9.
Şimşek-Yavuz S, Akar AR, Aydoğdu S, et al. 2019. [Diagnosis, treatment and prevention of infective endocarditis: Turkish consensus report]. Klimik Derg. 32(Suppl. 1): 2-116. Turkish.
Tuğcu A, Yildirimtürk O, Baytaroğlu C, Kurtoğlu H, Köse O, Sener M, Aytekin S. 2009. Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: a review of 68 cases at a tertiary care center in Turkey. Turk Kardiyol Dern Ars. Jan;37(1):9-18.
Wang YL, Hua Q, Bai CR, Tang Q. 2011. Relationship between red cell distribution width and short-term outcomes in acute coronary syndrome in a Chinese population. Intern Med. 50(24):2941-5.
Werdan K, Dietz S, Löffler B, et al. 2014. Mechanisms of infective endocarditis: pathogen–host interaction and risk states. Nat Rev Cardiol. 11, 35–50.
Zoghbi WA. 2010. New recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound. Methodist Debakey Cardiovasc J. Jan-Mar;6(1):20-6.
Zorlu A, Bektasoglu G, Guven FM, Dogan OT, Gucuk E, Ege MR, Altay H, Cinar Z, Tandogan I, Yilmaz MB. 2012. Usefulness of admission red cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism. Am J Cardiol. Jan 1;109(1):128-34.
How to Cite
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).