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Cancer and Infective Endocarditis: Characteristics and Prognostic Impact

Bernard Cosyns 1, * Bram Roosens 2 Patrizio Lancellotti 3 Cécile Laroche 4 Raluca Dulgheru 3 Valentina Scheggi 5 Isidre Vilacosta 6 Agnès Pasquet 7, 8 Cornelia Piper 9 Graciela Reyes 10 Essam Mahfouz 11 Zhanna Kobalava 12 Lionel Piroth Jarosław Kasprzak 13 Antonella Moreo 14 Jean-François Faucher 15, 16 Julien Ternacle 17 Marwa Meshaal 18 Aldo Maggioni 4, 19 Bernard Iung 20 Gilbert Habib 21
Abstract : Background: The interplay between cancer and IE has become of increasing interest. This study sought to assess the prevalence, baseline characteristics, management, and outcomes of IE cancer patients in the ESC EORP EURO-ENDO registry. Methods: Three thousand and eighty-five patients with IE were identified based on the ESC 2015 criteria. Three hundred and fifty-nine (11.6%) IE cancer patients were compared to 2,726 (88.4%) cancer-free IE patients. Results: In cancer patients, IE was mostly community-acquired (74.8%). The most frequently identified microorganisms were S. aureus (25.4%) and Enterococci (23.8%). The most frequent complications were acute renal failure (25.9%), embolic events (21.7%) and congestive heart failure (18.1%). Theoretical indication for cardiac surgery was not significantly different between groups (65.5 vs. 69.8%, P = 0.091), but was effectively less performed when indicated in IE patients with cancer (65.5 vs. 75.0%, P = 0.002). Compared to cancer-free IE patients, in-hospital and 1-year mortality occurred in 23.4 vs. 16.1%, P = 0.006, and 18.0 vs. 10.2%; P < 0.001, respectively. In IE cancer patients, predictors of mortality by multivariate analysis were creatinine > 2 mg/dL, congestive heart failure and unperformed cardiac surgery (when indicated). Conclusions: Cancer in IE patients is common and associated with a worse outcome. This large, observational cohort provides new insights concerning the contemporary profile, management, and clinical outcomes of IE cancer patients across a wide range of countries.
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Soumis le : jeudi 10 février 2022 - 16:09:15
Dernière modification le : samedi 26 mars 2022 - 04:24:36

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Bernard Cosyns, Bram Roosens, Patrizio Lancellotti, Cécile Laroche, Raluca Dulgheru, et al.. Cancer and Infective Endocarditis: Characteristics and Prognostic Impact. Frontiers in Cardiovascular Medicine, Frontiers Media, 2021, 8, pp.766996. ⟨10.3389/fcvm.2021.766996⟩. ⟨hal-03564842⟩

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