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The following is a summary of “Clinical profile, microbiology and outcomes in infective endocarditis treated with aortic valve replacement: a multicenter case-control study,” published in the  September 2024  issue of Infectious Disease by Dingen et al.

Morbidity and mortality rates are often linked with Aortic valve infective endocarditis (IE). 

Researchers conducted a retrospective study to describe clinical profile, risk factors, and predictors of short- and long-term mortality in patients with IE treated with aortic valve replacement (AVR) and compared with controls undergoing AVR for non-infectious valvular heart disease.

They recruited 170 cases of IE treated with AVR and 677 randomly selected non-infectious AVR-treated patients with degenerative aortic valve disease (controls) from 3 tertiary hospitals with cardiothoracic facilities across Scandinavia between January 2008 and December 2013. Cox regression models were used to measure crude and adjusted hazard ratios (HR). 

The results showed the mean age of the IE was 58.5 ± 15.1 years, with 80.0% being men. During a mean follow-up of 7.8 years (IQR 5.1 – 10.8 years), 373 (44.0%) were deaths: 81 (47.6%) in the IE group and 292 (43.1%) among controls. Independent risk factors with IE were male gender, previous heart surgery, wound infection, underweight, positive hepatitis C serology, renal failure, and dental treatment (all P<0.05). IE was linked to an increased risk of short-term (≤ 30 days) (HR 2.86, [1.36 — 5.98], P=0.005) and long-term mortality (HR 2.03, [1.43 — 2.88], P<0.001). Independent predictors of patients with IE of long-term mortality were chronic obstructive pulmonary disease (HR 2.13), underweight (HR 4.47), renal failure (HR 2.05), concomitant mitral valve involvement (HR 2.37), and mediastinitis (HR 3.98). Staphylococcus aureus was the prevalent microbe (21.8%), associated with a 5.2-fold increased risk of early mortality, while enterococci were linked to long-term mortality (HR 1.78).

They concluded IE was associated with increased short- and long-term mortality risk. 

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09782-3