Infective endocarditis in adult patients with congenital heart disease.

Autor: van Melle JP; Center for Congenital Heart Diseases, Department of Cardiology, University Medical Center Groningen, University of Groningen, the Netherlands. Electronic address: j.p.van.melle@umcg.nl., Roos-Hesselink JW; Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands., Bansal M; Medanta, The Medicity, Gurgaon, Haryana 120001, India., Kamp O; Amsterdam UMC, Vrije Universiteit Amsterdam, Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands., Meshaal M; Department of Cardiology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo 11562, Egypt., Pudich J; Department of Cardiovascular Diseases, University Hospital Ostrava, University of Ostrava, Faculty of Medicine, Czech Republic., Luksic VR; Department of Cardiovascular Diseases, University of Zagreb, School of Medicine and University Hospital Centre Zagreb, Croatia., Rodriguez-Alvarez R; Infectious Diseases Unit, Cruces University Hospital, Barakaldo, Spain., Sadeghpour A; Echocardiography Research Center, Rajaie Cardiovascular Medical & Research Center, Tehran, Iran; Duke Cardiovascular MR Center, Durham, NC, United States of America., Hanzevacki JS; Department of Cardiovascular Diseases, University of Zagreb, School of Medicine and University Hospital Centre Zagreb, Croatia., Sow R; Department of Cardiology, Laboratory of Echocardiography, Luxembourg Hospital Centre, Luxembourg., Timóteo AT; Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal., Morgado MT; Cardiology Department, Santa Cruz Hospital, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal., De Bonis M; Cardiac Surgery, IRCCS San Raffaele University Hospital, Milan, Italy., Laroche C; EURObservational Research Programme, European Society of Cardiology, Heart House. 2035 Route des Colles, CS80179 Biot, 06903 Sophia-Antipolis, France., Boersma E; Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands., Lancellotti P; University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, CHU Sart Tilman, Liège, Belgium; Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Anthea Hospital, Bari, Italy., Habib G; La Timone Hospital, Cardiology Department, Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2023 Jan 01; Vol. 370, pp. 178-185. Date of Electronic Publication: 2022 Oct 21.
DOI: 10.1016/j.ijcard.2022.10.136
Abstrakt: 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.
(Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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