Article (Scientific journals)
Infective endocarditis in adult patients with congenital heart disease.
van Melle, Joost P; Roos-Hesselink, Jolien W; Bansal, Manish et al.
2023In International Journal of Cardiology, 370, p. 178-185
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Keywords :
Male; Humans; Adult; Middle Aged; Female; Prospective Studies; Risk Factors; Endocarditis/diagnosis/epidemiology/etiology; Endocarditis, Bacterial/diagnosis/epidemiology/complications; Heart Defects, Congenital/complications/diagnosis/epidemiology; Retrospective Studies; Adult congenital heart disease; Endocarditis
Abstract :
[en] BACKGROUND: Congenital Heart Disease (CHD) predisposes to Infective Endocarditis (IE), but data about characterization and prognosis of IE in CHD patients is scarce. METHODS: The ESC-EORP-EURO-ENDO study is a prospective international study in IE patients (n = 3111). In this pre-specified analysis, adult CHD patients (n = 365, 11.7%) are described and compared with patients without CHD (n = 2746) in terms of baseline characteristics and mortality. RESULTS: CHD patients (73% men, age 44.8 ± 16.6 years) were younger and had fewer comorbidities. Of the CHD patients, 14% had a dental procedure before hospitalization versus 7% in non-CHD patients (p < 0.001) and more often had positive blood cultures for Streptococcus viridans (16.4% vs 8.8%, p < 0.001). As in non-CHD patients, IE most often affected the left-sided valves. For CHD patients, in-hospital mortality was 9.0% vs 18.1% in non-CHD patients (p < 0.001), and also, during the entire follow-up of 700 days, survival was more favorable (log-rank p < 0.0001), even after adjustment for age, gender and major comorbidities (Hazard Ratio (HR) 0.68; 95%CI 0.50-0.92). Within the CHD population, multivariable Cox regression revealed the following effects (HR and [95% CI]) on mortality: fistula (HR 6.97 [3.36-14.47]), cerebral embolus (HR 4.64 [2.08-10.35]), renal insufficiency (HR 3.44 [1.48-8.02]), Staphylococcus aureus as causative agent (HR 2.06 [1.11-3.81]) and failure to undertake surgery when indicated (HR 5.93 [3.15-11.18]). CONCLUSIONS: CHD patients with IE have a better outcome in terms of all-cause mortality. The observed high incidence of dental procedures prior to IE warrants further studies about the current use, need and efficacy of antibiotic prophylaxis in CHD patients.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
van Melle, Joost P;  Center for Congenital Heart Diseases, Department of Cardiology, University
Roos-Hesselink, Jolien W;  Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands.
Bansal, Manish;  Medanta, The Medicity, Gurgaon, Haryana 120001, India.
Kamp, Otto;  Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam Cardiovascular
Meshaal, Marwa;  Department of Cardiology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo
Pudich, Jiri;  Department of Cardiovascular Diseases, University Hospital Ostrava, University of
Luksic, Vlatka Reskovic;  Department of Cardiovascular Diseases, University of Zagreb, School of Medicine
Rodriguez-Alvarez, Regino;  Infectious Diseases Unit, Cruces University Hospital, Barakaldo, Spain.
Sadeghpour, Anita;  Echocardiography Research Center, Rajaie Cardiovascular Medical & Research
Hanzevacki, Jadranka Separovic;  Department of Cardiovascular Diseases, University of Zagreb, School of Medicine
Sow, Rouguiatou;  Department of Cardiology, Laboratory of Echocardiography, Luxembourg Hospital
Timóteo, Ana Teresa;  Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário
Morgado, Marisa Trabulo;  Cardiology Department, Santa Cruz Hospital, Centro Hospitalar de Lisboa
De Bonis, Michele;  Cardiac Surgery, IRCCS San Raffaele University Hospital, Milan, Italy.
Laroche, Cecile;  EURObservational Research Programme, European Society of Cardiology, Heart House.
Boersma, Eric;  Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands.
Lancellotti, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Habib, Gilbert;  La Timone Hospital, Cardiology Department, Aix Marseille Univ, IRD, APHM, MEPHI,
EURO-ENDO Investigators, Group
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Language :
Title :
Infective endocarditis in adult patients with congenital heart disease.
Publication date :
01 January 2023
Journal title :
International Journal of Cardiology
Publisher :
Elsevier, Nl
Volume :
Pages :
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
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since 16 May 2023


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