TY - JOUR
T1 - Predictors of embolism and death in left-sided infective endocarditis
T2 - the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry
AU - Sambola, Antonia
AU - Lozano-Torres, Jordi
AU - Boersma, Eric
AU - Olmos, Carmen
AU - Ternacle, Julien
AU - Calvo, Francisco
AU - Tribouilloy, Christophe
AU - Reskovic-Luksic, Vlatka
AU - Separovic-Hanzevacki, Jadranka
AU - Park, Seung-Woo
AU - Bekkers, Sebastiaan
AU - Chan, Kwan-Leung
AU - Almaghraby, Abdallah
AU - Iung, Bernard
AU - Lancellotti, Patrizio
AU - Habib, Gilbert
AU - ESC EORP EURO-ENDO Registry Investigator Group
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2023/11/14
Y1 - 2023/11/14
N2 - 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.
AB - 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.
KW - Humans
KW - Female
KW - Prospective Studies
KW - Endocarditis, Bacterial/complications
KW - Endocarditis/surgery
KW - Embolism/complications
KW - Cardiology
KW - Registries
KW - Risk Factors
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85178039187&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehad507
DO - 10.1093/eurheartj/ehad507
M3 - Journal article
C2 - 37592753
SN - 0195-668X
VL - 44
SP - 4566
EP - 4575
JO - European Heart Journal
JF - European Heart Journal
IS - 43
ER -