[en] AIMS: Purpose of this study is to compare the clinical course and outcome of patients with recurrent versus first-episode infective endocarditis (IE). METHODS: Patients with recurrent and first-episode IE enrolled in the EUROpean ENDOcarditis (EURO-ENDO) registry including 156 centres were identified and compared using propensity score matching. Recurrent IE was classified as relapse when IE occurred ≤6 months after a previous episode or reinfection when IE occurred >6 months after the prior episode. RESULTS: 3106 patients were enrolled: 2839 (91.4%) patients with first-episode IE (mean age 59.4 (±18.1); 68.3% male) and 267 (8.6%) patients with recurrent IE (mean age 58.1 (±17.7); 74.9% male). Among patients with recurrent IE, 13.2% were intravenous drug users (IVDUs), 66.4% had a repaired or replaced valve with the tricuspid valve being more frequently involved compared with patients with first-episode IE (20.3% vs 14.1%; p=0.012). In patients with a first episode of IE, the aortic valve was more frequently involved (45.6% vs 39.5%; p=0.061). Recurrent relapse and reinfection were 20.6% and 79.4%, respectively. Staphylococcus aureus was the microorganism most frequently observed in both groups (p=0.207). There were no differences in in-hospital and post-hospitalisation mortality between recurrent and first-episode IE. In patients with recurrent IE, in-hospital mortality was higher in IVDU patients. Independent predictors of poorer in-hospital and 1-year outcome, including the occurrence of cardiogenic and septic shock, valvular disease severity and failure to undertake surgery when indicated, were similar for recurrent and first-episode IE. CONCLUSIONS: In-hospital and 1-year mortality was similar in patients with recurrent and first-episode IE who shared similar predictors of poor outcome.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Citro, Rodolfo ; Cardiothoracic and Vascular Department, University Hospital "San Giovanni di Dio ; IRCCS Neurological Institute of Southern Italy Neuromed, Pozzilli, Molise, Italy.
Chan, Kwan-Leung ; Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario
Miglioranza, Marcelo Haertel ; Institute of Cardiology, University Foundation of Cardiology, Porto Alegre, ; Mae de Deus Hospital, Porto Alegre, Brazil. ; Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre
Laroche, Cécile; EurObservational Research Progamme Department, European Society of Cardiology,
Benvenga, Rossella Maria; Cardiothoracic and Vascular Department, University Hospital "San Giovanni di Dio
Furnaz, Shumaila; Department of Research, National Institute of Cardiovascular Diseases, Karachi,
Magne, Julien; Department of Cardiology, University Hospital Centre of Limoges, Dupuytren ; INSERM 1094, Faculté de Médecine de Limoges, Limoges, France.
Olmos, Carmen ; Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación
Paelinck, Bernard P; Cardiac Surgery Department, Antwerp University Hospital, Edegem, Belgium.
Pasquet, Agnès; Division of Cardiology, Department of Cardiovascular Diseases, Cliniques
Piper, Cornelia; Clinic for General and Interventional Cardiology/Angiology, Herz- und
Salsano, Antonio; Division of Cardiac Surgery, IRCCS Ospedale Policlinico San Martino, University
Savouré, Arnaud; Cardiology Department, University Hospital of Rouen, Rouen, France.
Park, Seung Woo; Heart Stroke Vascular Institute, Sungkyunkwan University School of Medicine,
Szymański, Piotr; Noninvasive Cardiovascular Diagnostic Department, Central Clinical Hospital of
Tattevin, Pierre; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital,
Vallejo Camazon, Nuria; Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona,
Lancellotti, Patrizio ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie ; Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, ; Anthea Hospital, Bari, Italy.
Habib, Gilbert; Service de Cardiologie, Insuffisance Cardiaque et Valvulopathie, Hôpital de la
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