Characteristics, management, and outcomes of patients with left‐sided infective endocarditis complicated by heart failure: a substudy of the ESC‐EORP EURO‐ENDO (European infective endocarditis) registry. (16th May 2022)

• Record Type: Journal Article
• Authors: Bohbot, Yohann; Habib, Gilbert; Laroche, Cécile; Stöhr, Elisabeth; Chirouze, Catherine; Hernandez‐Meneses, Marta; Melissopoulou, Maria; Mutlu, Bülent; Scheggi, Valentina; Branco, Luísa; Olmos, Carmen; Reyes, Graciela; Pazdernik, Michal; Iung, Bernard; Sow, Rouguiatou; Mirocevic, Maja; Lancellotti, Patrizio; Tribouilloy, Christophe
• Other Names: Gale C.P. investigator.; Beleslin B. investigator.; Budaj A. investigator.; Chioncel O. investigator.; Dagres N. investigator.; Danchin N. investigator.; Emberson J. investigator.; Erlinge D. investigator.; Glikson M. investigator.; Gray A. investigator.; Kayikcioglu M. investigator.; Maggioni A.P. investigator.; Nagy V.K. investigator.; Nedoshivin A. investigator.; Petronio A‐S. investigator.; Roos‐Hesselink J. investigator.; Wallentin L. investigator.; Zeymer U. investigator.; Habib G. investigator.; Lancellotti P. investigator.; Cosyns B. investigator.; Donal E. investigator.; Erba P. investigator.; Iung B. investigator.; Maggioni A.P. investigator.; Popescu B.A. investigator.; Prendergast B. investigator.; Tornos P. investigator.; Andarala M. investigator.; Berle C. investigator.; Brunel‐Lebecq A. investigator.; Fiorucci E. investigator.; Laroche C. investigator.; Missiamenou V. investigator.; Taylor C. investigator.; Ali Tatar‐Chentir N.N. investigator.; Al‐Mallah M. investigator.; Astrom Aneq M. investigator.; Athanassopoulos G. investigator.; Badano L.P. investigator.; Benyoussef S. investigator.; Calderon Aranda E. investigator.; Cardim N.M. investigator.; Chan K‐L. investigator.; Cosyns B. investigator.; Cruz I. investigator.; Edvardsen T. investigator.; Goliasch G. investigator.; Habib G. investigator.; Hagendorff A. investigator.; Hristova K. investigator.; Iung B. investigator.; Kamp O. investigator.; Kang D‐H. investigator.; Kong W. investigator.; Matskeplishvili S. investigator.; Meshaal M. investigator.; Mirocevic M. investigator.; Neskovic A.N. investigator.; Pazdernik M. investigator.; Plonska‐Gosciniak E. investigator.; Popescu B.A. investigator.; Prendergast B. investigator.; Raissouni M. investigator.; Ronderos R. investigator.; Sade L.E. investigator.; Sadeghpour A. investigator.; Sambola A. investigator.; Sengupta S. investigator.; Separovic‐Hanzevacki J. investigator.; Takeuchi M. investigator.; Tucay E. investigator.; Tude Rodrigues A.C. investigator.; Varga A. investigator.; Vaskelyte J. investigator.; Yamagata K. investigator.; Yiangou K. investigator.; Zaky H. investigator.; Granada I. investigator.; Mahia M. investigator.; Ressi S. investigator.; Nacinovich F. investigator.; Iribarren A. investigator.; Fernandez Oses P. investigator.; Avegliano G. investigator.; Filipini E. investigator.; Obregon R. investigator.; Bangher M. investigator.; Dho J. investigator.; Cartasegna L. investigator.; Plastino M.L. investigator.; Novas V. investigator.; Shigel C. investigator.; Reyes G. investigator.; De Santos M. investigator.; Gastaldello N. investigator.; Granillo Fernandez M. investigator.; Potito M. investigator.; Streitenberger G. investigator.; Velazco P. investigator.; Casabé J.H. investigator.; Cortes C. investigator.; Guevara E. investigator.; Salmo F. investigator.; Seijo M. investigator.; Weidinger F. investigator.; Heger M. investigator.; Brooks R. investigator.; Stöllberger C. investigator.; Ho C‐Y. investigator.; Perschy L. investigator.; Puskas L. investigator.; Binder C. investigator.; Rosenhek R. investigator.; Schneider M. investigator.; Winter M‐P. investigator.; Hoffer E. investigator.; Melissopoulou M. investigator.; Lecoq E. investigator.; Legrand D. investigator.; Jacquet S. investigator.; Massoz M. investigator.; Pierard L. investigator.; Marchetta S. investigator.; Dulgheru R. investigator.; D'Emal C. investigator.; Oury C. investigator.; Droogmans S. investigator.; Kerkhove D. investigator.; Plein D. investigator.; Soens L. investigator.; Weytjens C. investigator.; Motoc A. investigator.; Roosens B. investigator.; Lemoine I. investigator.; Rodrigus I. investigator.; Paelinck B. investigator.; Amsel B. investigator.; Unger P. investigator.; Konopnicki D. investigator.; Beauloye C. investigator.; Pasquet A. investigator.; Vanoverschelde J.L. investigator.; Pierard S. investigator.; Vancraeynest D. investigator.; Sinnaeve F. investigator.; Andrade J.L. investigator.; Staszko K. investigator.; Dos Santos Monteiro R. investigator.; Miglioranza M.H. investigator.; Shuha D.L. investigator.; Alcantara M. investigator.; Cravo V. investigator.; Fazzio L. investigator.; Felix A. investigator.; Iso M. investigator.; Musa C. investigator.; Siciliano A.P. investigator.; Villaca Filho F. investigator.; Rodrigues A. investigator.; Vilela F. investigator.; Braga J. investigator.; Silva R. investigator.; Rodrigues D. investigator.; Silva L. investigator.; Morhy S. investigator.; Fischer C. investigator.; Silva R. investigator.; Vieira M. investigator.; Afonso T. investigator.; Abreu J. investigator.; Falcao S.N. investigator.; Moises V.A. investigator.; Gouvea A. investigator.; Mancuso F.J. investigator.; Souza A.C. investigator.; Silva C.Y. investigator.; João G. investigator.; Abboud C.S. investigator.; Bellio de Mattos Barretto R. investigator.; Ramos A. investigator.; Arnoni R. investigator.; Assef J.E. investigator.; Della Togna D.J. investigator.; Le Bihan D. investigator.; Miglioli L. investigator.; Romero Oliveira A.P. investigator.; 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• Is Part Of: European journal of heart failure. Volume 24:Number 7(2022)
• Page Start: 1253
• Page End: 1265
• Publication Date: 2022-05-16
• Subjects: Infective endocarditis -- Congestive heart failure -- Survival -- Outcome -- Early surgery -- EURO‐ENDO; Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1002/ejhf.2525
• Languages: English
• ISSNs: 1388-9842

Abstract

Abstract : Aims: To evaluate the current management and survival of patients with left‐sided infective endocarditis (IE) complicated by congestive heart failure (CHF) in the ESC‐EORP European Endocarditis (EURO‐ENDO) registry. Methods and results: Among the 3116 patients enrolled in this prospective registry, 2449 (mean age: 60 years, 69% male) with left‐sided (native or prosthetic) IE were included in this study. Patients with CHF ( n = 698, 28.5%) were older, with more comorbidity and more severe valvular damage (mitro‐aortic involvement, vegetations >10 mm and severe regurgitation/new prosthesis dehiscence) than those without CHF (all p ≤ 0.019). Patients with CHF experienced higher 30‐day and 1‐year mortality than those without (20.5% vs. 9.0% and 36.1% vs. 19.3%, respectively) and CHF remained strongly associated with 30‐day (odds ratio[OR] 2.37, 95% confidence interval [CI] [1.73–3.24; p < 0.001) and 1‐year mortality (hazard ratio [HR] 1.69, 95% CI 1.39–2.05; p < 0.001) after adjustment for established outcome predictors, including early surgery, or after propensity matching for age, sex, and comorbidity ( n = 618 [88.5%] for each group, both p < 0.001). Early surgery, performed on 49% of these patients with IE complicated by CHF, remained associated with a substantial reduction in 30‐day mortality following multivariable analysis, after adjustment for age, sex, Charlson comorbidity index, cerebrovascular accident, Staphylococcus aureus IE, streptococcal IE, uncontrolled infection, vegetation size >10 mm, severe valvular regurgitation and/or new prosthetic dehiscence, perivalvular complication, and prosthetic IE (OR 0.22, 95% CI 0.12–0.38; p < 0.001) and in 1‐year mortality (HR 0.29, 95% CI 0.20–0.41; p < 0.001). Conclusion: Congestive heart failure is common in left‐sided IE and is associated with older age, greater comorbidity, more advanced lesions, and markedly higher 30‐day and 1‐year mortality. Early surgery is strongly associated with lower mortality but is performed on only approximately half of patients with CHF, mainly because of a surgical risk considered prohibitive. Abstract : Characteristics, survival and impact of early surgery in left‐sided infective endocarditis (IE) complicated by congestive heart failure (CHF). CI, confidence interval; HR, hazard ratio.