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)

1 IRCCS - Istituti di Ricovero e Cura a Carattere Scientifico
2 UNISA - Università degli Studi di Salerno = University of Salerno
3 University of Ottawa [Ottawa]
4 UFCSPA - Federal University of Health Sciences of Porto Alegre = Universidade Federal de Ciências da Saúde de Porto Alegre
5 ESC - European Society of Cardiology
6 University of Karachi
7 EpiMaCT - Epidémiologie des Maladies Chroniques en zone tropicale
8 CEBIMER - Plate forme de bioinformatique et biostatistique
9 Service de cardiologie [CHU Limoges]
10 IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
11 UZA - Antwerp University Hospital [Edegem]
12 UCL - Université Catholique de Louvain = Catholic University of Louvain
13 RUB - Ruhr University Bochum = Ruhr-Universität Bochum
14 UniGe - Università degli studi di Genova = University of Genoa
15 CHU Rouen
16 Samsung Medical Center Sungkyunkwan University School of Medicine
17 WARSAW - Cardiology - Institute of Cardiology
18 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
19 BRM - ARN régulateurs bactériens et médecine
20 Fight AIDS and Infectious Diseases Foundation, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
21 CHU Sart Tilman - Centre Hospitalier Universitaire Sart Tilman
22 GIGA [Université Liège]
23 Service de cardiologie Pédiatrique [Marseille]

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.

Mots clés: cardiac surgical procedures; endocarditis; heart valve diseases

Domaines: Santé publique et épidémiologie; Cardiologie et système cardiovasculaire; Maladies infectieuses

Rodolfo Citro, Kwan-Leung Chan, Marcelo Haertel Miglioranza, Cécile Laroche, Rossella Maria Benvenga, et al.. Clinical profile and outcome of recurrent infective endocarditis. Heart, 2022, 108 (21), pp.1729-1736. ⟨10.1136/heartjnl-2021-320652⟩. ⟨hal-03689517⟩