Infective endocarditis in adult patients with congenital heart disease

被引：24

作者：

van Melle, Joost P. ^{[1
,19
]}

Roos-Hesselink, Jolien W. ^{[2
]}

Bansal, Manish ^{[3
]}

Kamp, Otto ^{[4
]}

Meshaal, Marwa ^{[5
]}

Pudich, Jiri ^{[6
]}

Luksic, Vlatka Reskovic ^{[7
]}

Rodriguez-Alvarez, Regino ^{[8
]}

Sadeghpour, Anita ^{[9
,10
]}

Hanzevacki, Jadranka Separovic ^{[7
]}

Sow, Rouguiatou ^{[11
]}

Tim, Ana Teresa ^{[12
]}

Morgado, Marisa Trabulo ^{[13
]}

De Bonis, Michele ^{[14
]}

Laroche, Cecile ^{[15
]}

Boersma, Eric ^{[2
]}

Lancellotti, Patrizio ^{[16
,18
]}

Habib, Gilbert ^{[17
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Ctr Congenital Heart Dis, Dept Cardiol, Groningen, Netherlands

[2] Erasmus MC, Dept Cardiol, Rotterdam, Netherlands

[3] The Medicity, Medanta, Gurgaon 120001, Haryana, India

[4] Vrije Univ Amsterdam, Amsterdam UMC, Cardiol, Amsterdam Cardiovasc Sci, Amsterdam, Netherlands

[5] Cairo Univ, Kasr Al Ainy Hosp, Fac Med, Dept Cardiol, Cairo 11562, Egypt

[6] Univ Ostrava, Univ Hosp Ostrava, Fac Med, Dept Cardiovasc Dis, Ostrava, Czech Republic

[7] Univ Zagreb, Univ Hosp Ctr Zagreb, Sch Med, Dept Cardiovasc Dis, Zagreb, Croatia

[8] Cruces Univ Hosp, Infect Dis Unit, Baracaldo, Spain

[9] Rajaie Cardiovasc Med & Res Ctr, Echocardiog Res Ctr, Tehran, Iran

[10] Duke Cardiovasc MR Ctr, Durham, NC USA

[11] Luxembourg Hosp Ctr, Dept Cardiol, Lab Echocardiog, Luxembourg, Luxembourg

[12] Ctr Hosp Univ Lisboa Cent, Santa Marta Hosp, Cardiol Dept, Lisbon, Portugal

[13] St Cruz Hosp, Ctr Hosp Lisboa Ocidental, Cardiol Dept, Lisbon, Portugal

[14] IRCCS San Raffaele Univ Hosp, Cardiac Surg, Milan, Italy

[15] Heart House, EURObservat Res Programme, European Soc Cardiol, 2035 Route Colles CS80179 Biot, F-06903 Sophia Antipolis, France

[16] CHU Sart Tilman, Univ Liege Hosp, Dept Cardiol, GIGA Cardiovasc Sci, Liege, Belgium

[17] Aix Marseille Univ, La Timone Hosp, Cardiol Dept, IRD,APHM,MEPHI,IHU Mediterranee Infect, Marseille, France

[18] Maria Cecilia Hosp, Anthea Hosp, Grp Villa Maria Care & Res, Bari, Italy

[19] Univ Med Ctr Groningen, Ctr Congenital Heart Dis, Dept Cardiol, Hanzepl 1 POB 30 001, NL-9700 RB Groningen, Netherlands

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2023年 / 370卷

关键词：

Adult congenital heart disease; Endocarditis; RISK-FACTORS; MORTALITY; PREDICTORS; GUIDELINES; SURGERY; VALVE;

D O I：

10.1016/j.ijcard.2022.10.136

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Congenital Heart Disease (CHD) predisposes to Infective Endocarditis (IE), but data about charac-terization and prognosis of IE in CHD patients is scarce.Methods: The ESC-EORP-EURO-ENDO study is a prospective international study in IE patients (n = 3111). In this pre-specified analysis, adult CHD patients (n = 365, 11.7%) are described and compared with patients without CHD (n = 2746) in terms of baseline characteristics and mortality.Results: CHD patients (73% men, age 44.8 +/- 16.6 years) were younger and had fewer comorbidities. Of the CHD patients, 14% had a dental procedure before hospitalization versus 7% in non-CHD patients (p < 0.001) and more often had positive blood cultures for Streptococcus viridans (16.4% vs 8.8%, p < 0.001). As in non-CHD patients, IE most often affected the left-sided valves. For CHD patients, in-hospital mortality was 9.0% vs 18.1% in non-CHD patients (p < 0.001), and also, during the entire follow-up of 700 days, survival was more favorable (log -rank p < 0.0001), even after adjustment for age, gender and major comorbidities (Hazard Ratio (HR) 0.68; 95% CI 0.50-0.92). Within the CHD population, multivariable Cox regression revealed the following effects (HR and [95% CI]) on mortality: fistula (HR 6.97 [3.36-14.47]), cerebral embolus (HR 4.64 [2.08-10.35]), renal insuf-ficiency (HR 3.44 [1.48-8.02]), Staphylococcus aureus as causative agent (HR 2.06 [1.11-3.81]) and failure to undertake surgery when indicated (HR 5.93 [3.15-11.18]).

引用

页码：178 / 185

页数：8

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