[Left-sided native valve infective endocarditis: Influence of age and the presence of underlying heart disease].

Autor:	Castillo Bernal FJ; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España. Electronic address: fjcasber@hotmail.com., Anguita Sánchez MP; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España., Castillo Domínguez JC; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España., Carrasco Ávalos F; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España., Ruiz Ortiz M; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España., Delgado Ortega M; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España., Romo Peñas E; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España., Mesa Rubio D; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España., Suárez de Lezo Cruzconde J; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Jazyk:	Spanish; Castilian
Zdroj:	Medicina clinica [Med Clin (Barc)] 2016 Dec 02; Vol. 147 (11), pp. 475-480. Date of Electronic Publication: 2016 Sep 28.
DOI:	10.1016/j.medcli.2016.07.017
Abstrakt:	Introduction and Objectives: Left-sided native valve infective endocarditis (LNVIE) epidemiology has been modified as a result of the increase in average age. The aim of our study is to analyze the influence of age and the presence of predisposing heart disease in the prognosis of these patients. Methods: We analyzed a series of 257 cases of LNVIE depending on their age (greater than or equal to 70 years old), both in the overall series and in the subgroup of patients without predisposing heart disease. Results: Mean age was 54.6 (18.6) years. There was an increase in the percentage of cases of older patients between 1987-2000 and 2001-2014 (9.8 vs. 34.8%, P<.001). These patients present higher prevalence of degenerative valves (50 vs. 22.8%) or not predisposing heart disease (50 vs. 39.9%), P<.001, health-care associated episodes (41.8 vs. 23.6%, P=.016), lower rate of surgery (43.7 vs. 63.8%, P=.005) and higher in-hospital mortality (39.1 vs. 20.7%, P=.003), with no differences in comorbidities. Older patients who did not have predisposing heart disease also suffered higher in-hospital mortality (47 vs. 22%, P=.01). Age greater than or equal to 70 years old is an independent predictor of mortality in patients with LNVIE (OR 2.53, 95% CI 1.24-5.15, P=.011), as in those without previous heart disease (OR 3.98, 95% CI 1.49-10.62, P=.006). Conclusions: Patients of age greater than or equal to 70 years old and who suffer an LNVIE are becoming more frequent and have a worse prognosis with a lower rate of surgery and higher rates of in-hospital mortality. (Copyright © 2016 Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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