Temporal Trends, Characteristics, and Outcomes of Infective Endocarditis After Transcatheter Aortic Valve Replacement
Clin. infect. dis
; 73(11): 3750-e:3758, Dec. 2021. graf, tab
Article
in English
| CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1353336
Responsible library:
BR79.1
ABSTRACT
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.
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Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Other circulatory Diseases
Database:
CONASS
/
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Endocarditis
/
Transcatheter Aortic Valve Replacement
Type of study:
Observational study
Language:
English
Journal:
Clin. infect. dis
Year:
2021
Document type:
Article
Institution/Affiliation country:
ASST-Spedali Civili di Brescia/IT
/
Azienda Ospedaliera Santa Croce e Carle/IT
/
Bichat Hôpital/FR
/
CIBERCV, Hospital Clinico Universitario de Valladolid/ES
/
Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC/ES
/
Cedars-Sinai Heart Institute/US
/
Centre Hospitalier Universitaire de Rennes/FR
/
Centre Hospitalier de l'Universite de Montreal/CA
/
Cleveland Clinic/US
/
Clinique Pasteur/FR