Article (Scientific journals)
Cardiac device-related infective endocarditis need for lead extraction whatever the device according to the ESC EORP EURO-ENDO registry.
Donal, Erwan; Tribouilloy, Christophe; Sadeghpour, Anita et al.
2023In European Heart Journal Open, 3 (4), p. 064
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Keywords :
Cardiac device; Implantable defibrillator; Infective endocarditis; Pacemaker; Prognosis; staphylococci
Abstract :
[en] AIMS: Cardiac device-related infective endocarditis (CDRIE) is a severe complication of cardiac device (CD) implantation and is usually treated by antibiotic therapy and percutaneous device extraction. Few studies report the management and prognosis of CDRIE in real life. In particular, the rate of device extraction in clinical practice and the management of patients with left heart infective endocarditis (LHIE) and an apparently non-infected CD (LHIE+CDRIE-) are not well described. METHODS AND RESULTS: We sought to study in EURO-ENDO, the characteristics, prognosis, and management of 483 patients with a CD included in the European Society of Cardiology EurObservational Research Programme EURO-ENDO registry. Three populations were compared: 280 isolated CDRIE (66.7 ± 14.3 years), 157 patients with LHIE and an apparently non-infected CD (LHIE+CDRIE-) (71.1 ± 13.6), and 46 patients with both LHIE and CDRIE (LHIE+CDRIE+) (70.2 ± 10.1). Echocardiography was not always transoesophageal echography (TOE); it was transthoracic echography (TTE) for isolated CDRIE in 88.4% (TOE = 67.6%), for LHIE+CDRIE- TTE = 93.0% (TOE = 58.6%), and for CDRIE+LHIE+ TTE = 87.0% (TOE = 63.0%). Nuclear imaging was performed in 135 patients (positive for 75.6%). In-hospital mortality was lower in isolated CDRIE 13.2% vs. 22.3% and 30.4% for LHIE+CDRIE- and LHIE+CDRIE+ (P = 0004). Device extraction was performed in 62.1% patients with isolated CDRIE, 10.2% of LHIE+CDRIE- patients, and 45.7% of CDRIE+LHIE+ patients. Device extraction was associated with a better prognosis [hazard ratio 0.59 (0.40-0.87), P = 0.0068] even in the LHIE+CDRIE- group (P = 0.047). CONCLUSION: Prognosis of endocarditis in patients with a CD remains poor, particularly in the presence of an associated LHIE. Although recommended by guidelines, device extraction is not always performed. Device removal was associated with better prognosis, even in the LHIE+CDRIE- group.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Donal, Erwan ;  Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes-1, hopital pontchaillou, 35000 Rennes, France.
Tribouilloy, Christophe ;  Department of Cardiology, Amiens University Hospital Amiens, Amiens 80000, France.
Sadeghpour, Anita ;  Echocardiography Research Centre, Rajaie Cardiovascular Medical and Research Centre, Iran University of Medical Sciences, Tehran, Iran.
Laroche, Cécile;  European Society of Cardiology, EORP, Sophia-Antipolis, France.
Tude Rodrigues, Ana Clara;  servico de Echocardiografia-InRad-HC-Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil.
Pereira Nunes, Maria do Carmo;  Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Kang, Duk-Hyun ;  Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-dong, Songpa-gu, Seoul 138-736, Korea.
Hernadez-Meneses, Marta ;  Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
Kobalava, Zhanna ;  Department of Cardiology, RUDN Univerisity, Moscow, Russia.
De Bonis, Michele ;  Cardiac Surgery, Innovation and Research, 'Vita-Salute' San Raffaele University Hospital, Milan 20132, Italy.
Dworakowski, Rafal ;  Department of Cardiology, Kings College Hospital and King's College London, Denmark Hill, London SE5 9RS, UK.
Ivanovic, Branislava ;  Clinical Center of Serbia, Clinic of Cardiology, Belgrade, Serbia.
Holicka, Maria ;  Department of Cardiology, University Hospital Brno, Jihlavska 20, Brno 62500, Czech Republic.
Kitai, Takeshi ;  Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
Cruz, Ines ;  Departamento de Cardiologia, Hospital Garcia de Orta, Almada, Portugal.
Huttin, Olivier ;  F-CRIN INI-CRCT Cardiovascular and Renal Clinical Trialists Network, INSERM 1116, CHRU de Nancy, Nancy, France.
Colonna, Paolo ;  Department of Cardiology, Polyclinic of Bari-Hospital, Bari 70124, Italy.
Lancellotti, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie ; Department of Cardiology, Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
Habib, Gilbert ;  APHM, Cardiology Department, La Timone Hospital, Marseille, France. ; IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University, Marseille, France.
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Language :
Title :
Cardiac device-related infective endocarditis need for lead extraction whatever the device according to the ESC EORP EURO-ENDO registry.
Publication date :
July 2023
Journal title :
European Heart Journal Open
Publisher :
Oxford University Press, Oxford, Gb
Volume :
Issue :
Pages :
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.
Available on ORBi :
since 18 January 2024


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