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Clinical profile and outcome of recurrent infective endocarditis

Rodolfo Citro 1, 2, * Kwan-Leung Chan 3 Marcelo Haertel Miglioranza 4 Cécile Laroche 5 Rossella Maria Benvenga 2 Shumaila Furnaz 6 Julien Magne 7, 8, 9 Carmen Olmos 10 Bernard Paelinck 11 Agnès Pasquet 12 Cornelia Piper 13 Antonio Salsano 1, 14 Arnaud Savouré 15 Seung Woo Park 16 Piotr Szymański 17 Pierre Tattevin 18, 19 Nuria Vallejo Camazon 20 Patrizio Lancellotti 21, 22 Gilbert Habib 23 
Abstract : Aims: Purpose of this study is to compare the clinical course and outcome of patients with recurrent versus first-episode infective endocarditis (IE). Methods: Patients with recurrent and first-episode IE enrolled in the EUROpean ENDOcarditis (EURO-ENDO) registry including 156 centres were identified and compared using propensity score matching. Recurrent IE was classified as relapse when IE occurred ≤6 months after a previous episode or reinfection when IE occurred >6 months after the prior episode. Results: 3106 patients were enrolled: 2839 (91.4%) patients with first-episode IE (mean age 59.4 (±18.1); 68.3% male) and 267 (8.6%) patients with recurrent IE (mean age 58.1 (±17.7); 74.9% male). Among patients with recurrent IE, 13.2% were intravenous drug users (IVDUs), 66.4% had a repaired or replaced valve with the tricuspid valve being more frequently involved compared with patients with first-episode IE (20.3% vs 14.1%; p=0.012). In patients with a first episode of IE, the aortic valve was more frequently involved (45.6% vs 39.5%; p=0.061). Recurrent relapse and reinfection were 20.6% and 79.4%, respectively. Staphylococcus aureus was the microorganism most frequently observed in both groups (p=0.207). There were no differences in in-hospital and post-hospitalisation mortality between recurrent and first-episode IE. In patients with recurrent IE, in-hospital mortality was higher in IVDU patients. Independent predictors of poorer in-hospital and 1-year outcome, including the occurrence of cardiogenic and septic shock, valvular disease severity and failure to undertake surgery when indicated, were similar for recurrent and first-episode IE. Conclusions: In-hospital and 1-year mortality was similar in patients with recurrent and first-episode IE who shared similar predictors of poor outcome.
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Soumis le : mardi 7 juin 2022 - 12:18:25
Dernière modification le : jeudi 1 septembre 2022 - 11:15:15

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Rodolfo Citro, Kwan-Leung Chan, Marcelo Haertel Miglioranza, Cécile Laroche, Rossella Maria Benvenga, et al.. Clinical profile and outcome of recurrent infective endocarditis. Heart, BMJ Publishing Group, 2022, pp.heartjnl-2021-320652. ⟨10.1136/heartjnl-2021-320652⟩. ⟨hal-03689517⟩



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