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
DOI:
https://doi.org/10.1532/hsf.3715Keywords:
infective endocarditis, native valve endocarditis, prosthetic valve endocarditisAbstract
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.
References
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.
