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 - Université Sorbonne Paris Nord Accéder directement au contenu
Article Dans Une Revue European Journal of Heart Failure Année : 2022

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

Luisa Branco
  • Fonction : Auteur

Résumé

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\,≤q\,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.
Fichier principal
Vignette du fichier
hal-03684687.pdf (989.79 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Licence : CC BY NC ND - Paternité - Pas d'utilisation commerciale - Pas de modification

Dates et versions

hal-03740532 , version 1 (01-06-2023)

Licence

Paternité - Pas d'utilisation commerciale - Pas de modification

Identifiants

Citer

Yohann Bohbot, Gilbert Habib, Cécile Laroche, Elisabeth Stöhr, Catherine Chirouze, et al.. 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. European Journal of Heart Failure, 2022, 24 (7), pp.1253-1265. ⟨10.1002/ejhf.2525⟩. ⟨hal-03740532⟩
127 Consultations
54 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More