Clinical profile and outcome of recurrent infective endocarditis. Issue 21 (31st May 2022)

• Record Type: Journal Article
• Authors: Citro, Rodolfo; Chan, Kwan-Leung; Miglioranza, Marcelo Haertel; Laroche, Cécile; Benvenga, Rossella Maria; Furnaz, Shumaila; Magne, Julien; Olmos, Carmen; Paelinck, Bernard P.; Pasquet, Agnès; Piper, Cornelia; Salsano, Antonio; Savouré, Arnaud; Park, Seung Woo; Szymański, Piotr; Tattevin, Pierre; Vallejo Camazon, Nuria; Lancellotti, Patrizio; Habib, Gilbert
• Is Part Of: Heart. Volume 108:Issue 21(2022)
• Page Start: 1729
• Page End: 1736
• Publication Date: 2022-05-31
• Subjects: endocarditis -- heart valve diseases -- cardiac surgical procedures; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2021-320652
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Aims: Purpose of this study is to compare the clinical course and outcome of patients with recurrent versus first-episode infective endocarditis (IE). Methods: Patients with recurrent and first-episode IE enrolled in the EUROpean ENDOcarditis (EURO-ENDO) registry including 156 centres were identified and compared using propensity score matching. Recurrent IE was classified as relapse when IE occurred ≤6 months after a previous episode or reinfection when IE occurred >6 months after the prior episode. Results: 3106 patients were enrolled: 2839 (91.4%) patients with first-episode IE (mean age 59.4 (±18.1); 68.3% male) and 267 (8.6%) patients with recurrent IE (mean age 58.1 (±17.7); 74.9% male). Among patients with recurrent IE, 13.2% were intravenous drug users (IVDUs), 66.4% had a repaired or replaced valve with the tricuspid valve being more frequently involved compared with patients with first-episode IE (20.3% vs 14.1%; p=0.012). In patients with a first episode of IE, the aortic valve was more frequently involved (45.6% vs 39.5%; p=0.061). Recurrent relapse and reinfection were 20.6% and 79.4%, respectively. Staphylococcus aureus was the microorganism most frequently observed in both groups (p=0.207). There were no differences in in-hospital and post-hospitalisation mortality between recurrent and first-episode IE. In patients with recurrent IE, in-hospital mortality was higher in IVDU patients. Independent predictors of poorer in-hospital and 1-year outcome, including the occurrence of cardiogenic and septic shock, valvular disease severity and failure to undertake surgery when indicated, were similar for recurrent and first-episode IE. Conclusions: In-hospital and 1-year mortality was similar in patients with recurrent and first-episode IE who shared similar predictors of poor outcome.