The following is a summary of “Incidence and predictive factors of mortality of infective endocarditis in adults with congenital heart disease: A systematic review and meta-analysis,” published in the June 2024 issue of Cardiology by Ong et al.

Congenital heart diseases (CHD) with abnormal blood flow face a high risk of infective endocarditis (IE), which can be fatal despite improved treatments.

Researchers conducted a retrospective study to determine the incidence of IE and mortality related to it among adults CHD (ACHD).

They reviewed literature from PubMed, SCOPUS, and Ovid SP to retrieve relevant studies. The robust R programming was used to calculate pooled estimates and predictors of mortality using the random-effects generic inverse variance method, ensuring the validity and reliability of the results. 

The results showed that in the meta-analysis of 12 studies with 3,738 patients with ACHD, the overall incidence of IE was 1.26 per 1000 patient-years (0.55-1.96). About 60% (46-72%) of patients underwent surgery for IE. The mortality ratio of IE was 9% (7-12%). Predictors of mortality included conservative management (OR: 5.07, [4.63-5.57]), renal dysfunction (OR: 4.15, [2.92-5.88]), cerebral complications (OR: 3.59, [1.78-7.23]), abscesses/valve complications (OR: 2.67, [1.71-4.16]), Staphylococcus aureus infection (OR: 2.32 [1.33-4.06]), emboli (OR: 2.03, [1.47-2.79]), BMI (OR: 1.10, [1.01-1.21]), age (OR: 1.02, [1.00-1.04]) and previous IE (OR: 1.02 [1.00-1.04]). 

Investigators concluded that while the mortality rate of IE in ACHD was low, opting for conservative management poses the highest risk of mortality.

Source: internationaljournalofcardiology.com/article/S0167-5273(24)00859-3/abstract#%20