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Temporal Trends, Characteristics, and Outcomes of Infective Endocarditis After Transcatheter Aortic Valve Replacement

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  • David Del Val
  • Mohamed Abdel-Wahab
  • Axel Linke
  • Eric Durand
  • Nikolaj Ihlemann
  • Marina Urena
  • Costanza Pellegrini
  • Francesco Giannini
  • Martin Landt
  • Vincent Auffret
  • Jan Malte Sinning
  • Asim Cheema
  • Luis Nombela-Franco
  • Chekrallah Chamandi
  • Francisco Campelo-Parada
  • Antonio Munoz-Garcia
  • Howard C Herrmann
  • Luca Testa
  • Kim Won-Keun
  • Juan Carlos Castillo
  • Alberto Alperi
  • Didier Tchetche
  • Antonio Bartorelli
  • Samir Kapadia
  • Stefan Stortecky
  • Ignacio Amat-Santos
  • Harindra C Wijeysundera
  • John Lisko
  • Enrique Gutiérrez-Ibanes
  • Vicenç Serra
  • Luisa Salido
  • Abdullah Alkhodair
  • Ugolino Livi
  • Tarun Chakravarty
  • Stamatios Lerakis
  • Victoria Vilalta
  • Ander Regueiro
  • Rafael Romaguera
  • Marco Barbanti
  • Jean-Bernard Masson
  • Frédéric Maes
  • Claudia Fiorina
  • Antonio Miceli
  • Susheel Kodali
  • Henrique B Ribeiro
  • Jose Armando Mangione
  • Fabio Sandoli de Brito
  • Guglielmo Mario Actis Dato
  • Francesco Rosato
  • Lars Søndergaard
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BACKGROUND: Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR.

METHODS: Observational study including 552 patients presenting definite IE post-TAVR. Patients were divided in 2 groups according to the timing of TAVR (historical cohort [HC]: before 2014; contemporary cohort [CC]: after 2014).

RESULTS: Overall incidence rates of IE were similar in both cohorts (CC vs HC: 5.45 vs 6.52 per 1000 person-years; P = .12), but the rate of early IE was lower in the CC (2.29‰ vs 4.89‰, P < .001). Enterococci were the most frequent microorganism. Most patients presented complicated IE ( CC: 67.7%; HC: 69.6%; P = .66), but the rate of surgical treatment remained low (CC: 20.7%; HC: 17.3%; P = .32). The CC exhibited lower rates of in-hospital acute kidney injury (35.1% vs 44.6%; P = .036) and in-hospital (26.6% vs 36.4%; P = .016) and 1-year (37.8% vs 53.5%; P < .001) mortality. Higher logistic EuroScore, Staphylococcus aureus etiology, and complications (stroke, heart failure, and acute renal failure) were associated with in-hospital mortality in multivariable analyses (P < .05 for all).

CONCLUSIONS: Although overall IE incidence has remained stable, the incidence of early IE has declined in recent years. The microorganism, high rate of complications, and very low rate of surgical treatment remained similar. In-hospital and 1-year mortality rates were high but progressively decreased over time.

Original languageEnglish
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume73
Issue number11
Pages (from-to)e3750-e3758
ISSN1058-4838
DOIs
Publication statusPublished - 6 Dec 2021

Bibliographical note

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

ID: 72630586