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Predictors of Recurrence in Infectious Endocarditis
Session:
Posters (Sessão 5 - Écran 8) - Doença Valvular 4 - Foco na Endocardite
Speaker:
Catarina Ribeiro Carvalho
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
16. Infective Endocarditis
Subtheme:
16.2 Infective Endocarditis – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Catarina Ribeiro Carvalho; José João Monteiro; Pedro Rocha Carvalho; Marta Catarina Bernardo; Ana Baptista; José Ilídio Moreira
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction: </strong>Infectious endocarditis (IE) has a high recurrence rate, ranging between 2 and 6%. However, there is a paucity of studies related to the identification of recurrence predictors.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Purpose: </strong>to determine predictors of recurrence in patients with IE.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> this was a retrospective study that included all patients hospitalized in a single centre with diagnosis of IE, between 2000 and 2020. The relationship between clinical, laboratory and echocardiographic variables and the recurrence of IE was evaluated at a mean follow-up of 37.4±46.0 months.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> A total of 157 patients were selected, 66.2% were males, with a mean age of 66.6±16.3 years. IE recurrence rate was 8.9%, occurring on average 37.2±47.4 months after discharge. Recurrent IE involved predominantly prosthetic valve implanted in the previous IE episode (50.0%), followed by native valve (21.4%) and previous prosthetic valve (21.4%). Most frequent agents included Streptococcus (42.9%), Staphylococcus (14.3%), Enterococcus (14.3%) and fungi (14.3%).</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">In a multivariate regression analysis, after adjusting for all the possible confounders, the only significant independent predictors of recurrence were previous history of chronic liver disease (HR = 4.34, 95%CI 1.01-18.69) or chronic kidney disease in peritoneal dialysis program (HR = 23.02, 95%CI 2.67 -198.14) and the isolation of fungi in blood cultures (HR = 10.54, 95%CI 1.82-61.19).</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion: </strong>The present study demonstrated a significant rate of IE recurrence and highlighted the importance of comorbidities on the recurrence risk, namely when involving invasive techniques, as it identified as independent predictors for recurrence the previous history of chronic liver disease or chronic kidney disease in a peritoneal dialysis program, and the isolation of fungi in blood cultures. These high-risk patients might benefit from antibiotic prophylaxis.</span></span></p>
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