Predictors of embolism and death in left-sided infective endocarditis: the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry.
[en] BACKGROUND AND AIMS: Even though vegetation size in infective endocarditis (IE) has been associated with embolic events (EEs) and mortality risk, it is unclear whether vegetation size associated with these potential outcomes is different in left-sided IE (LSIE). This study aimed to seek assessing the vegetation cut-off size as predictor of EE or 30-day mortality for LSIE and to determine risk predictors of these outcomes. METHODS: The European Society of Cardiology EURObservational Research Programme European Infective Endocarditis is a prospective, multicentre registry including patients with definite or possible IE throughout 2016-18. Cox multivariable logistic regression analysis was performed to assess variables associated with EE or 30-day mortality. RESULTS: There were 2171 patients with LSIE (women 31.5%). Among these affected patients, 459 (21.1%) had a new EE or died in 30 days. The cut-off value of vegetation size for predicting EEs or 30-day mortality was >10 mm [hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.13-1.69, P = .0015]. Other adjusted predictors of risk of EE or death were as follows: EE on admission (HR 1.89, 95% CI 1.54-2.33, P < .0001), history of heart failure (HR 1.53, 95% CI 1.21-1.93, P = .0004), creatinine >2 mg/dL (HR 1.59, 95% CI 1.25-2.03, P = .0002), Staphylococcus aureus (HR 1.36, 95% CI 1.08-1.70, P = .008), congestive heart failure (HR 1.40, 95% CI 1.12-1.75, P = .003), presence of haemorrhagic stroke (HR 4.57, 95% CI 3.08-6.79, P < .0001), alcohol abuse (HR 1.45, 95% CI 1.04-2.03, P = .03), presence of cardiogenic shock (HR 2.07, 95% CI 1.29-3.34, P = .003), and not performing left surgery (HR 1.30 95% CI 1.05-1.61, P = .016) (C-statistic = .68). CONCLUSIONS: Prognosis after LSIE is determined by multiple factors, including vegetation size.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Sambola, Antonia ; Department of Cardiology and Research Institute, Cardiac Intensive Care Unit, University Hospital Valld'Hebron, Universitat Autònoma, CIBER Cardiovascular Diseases (CIBER-CV), P° Vall d'Hebron, 119-129, Barcelona 08035, Spain.
Lozano-Torres, Jordi ; Department of Cardiology and Research Institute, Cardiac Intensive Care Unit, University Hospital Valld'Hebron, Universitat Autònoma, CIBER Cardiovascular Diseases (CIBER-CV), P° Vall d'Hebron, 119-129, Barcelona 08035, Spain.
Boersma, Eric ; Department of Cardiology, Erasmus MC Cardiovascular Institute, University Medical Center Rotterdam, BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Olmos, Carmen ; Instituto cardiovascular, Hospital Clínico San Carlos, Instituto de investigación Sanitaria del Hospital Clínico San Carlos, Prof. Martín Lagos s/n, 28040 Madrid, Spain.
Ternacle, Julien ; Department of Cardiology, SOS Endocarditis, Henri Mondor University Hospital, Creteil, France.
Calvo, Francisco ; Department of Cardiology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain.
Tribouilloy, Christophe ; Department of Cardiology, University Hospital of Amiens, Amiens, France.
Reskovic-Luksic, Vlatka ; Department of Cardiovascular Diseases, School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
Separovic-Hanzevacki, Jadranka ; Department of Cardiovascular Diseases, School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
Park, Seung-Woo ; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Bekkers, Sebastiaan ; Cardiovascular Research Institute Maastricht (CAARIM), Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
Chan, Kwan-Leung; University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Almaghraby, Abdallah ; Cardiology Department, Alexandria University Hospital, Alexandria, Egypt.
Iung, Bernard ; Cardiology Department, AP-HP, Hôpital Bichat, Paris, France.
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation ; ANMCO Research Center, Florence, Italy.
Habib, Gilbert ; Cardiology Department, APHM, La Timone Hospital, Marseille, France. ; Aix Marseille University, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.
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