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Sex-based differences in infective endocarditis: a real-world study
Session:
Sessão de Posters 57 - Diferenças de género em Cardiologia
Speaker:
Margarida S. Cabral
Congress:
CPC 2024
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.14 Risk Factors and Prevention - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Margarida S. Cabral; Carolina Gonçalves; Mariana Carvalho; Adriana Vazão; André Martins; Catarina Ruivo; João Morais
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Infective endocarditis (IE) is an uncommon but potentially life-threatening disease with a higher incidence in men. Although the causes for this sex-specific difference are not fully understood, it is thought that men have a higher prevalence of pre-disposing cardiac pathology, which could explain the higher incidence of IE in this gender. Conversely, women are classically less likely to receive a guideline-based diagnosis and less invasive treatment. The differences in mortality rates remain controversial. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">This study aimed to analyse sex-based differences in clinical features, microbiological results, complications, treatment, and mortality in patients admitted due to infective endocarditis.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A retrospective study was conducted, and patients diagnosed with definite or possible IE (according to the modified Duke criteria) between January 2015 and March 2023 in a secondary hospital were included. The main outcomes are surgical treatment, in-hospital, and 1-year mortality. Group 1 represents male patients with IE and group 2 includes female ones. Group comparisons and logistic regression were performed. A p-value less than 0.05 is statistically significant.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">We analysed eighty-four patients, 60 men and 24 women. The baseline features were similar between groups (Table 1), except for a higher prevalence of heart failure with preserved ejection fraction in women (p-value=0.02). Clinical presentation, as well as the type of valve affected and microbiological isolation (Tables 2 and 3), did not present differences between groups. Regarding in-hospital complications (Table 4), only local complications, namely intracardiac fistula, were more common in women (p-value=0.03). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Around 30% of patients underwent a surgical procedure, with no differences between groups in both univariate analysis (p-value=0.88) and multivariate analysis that includes local and systemic complications (p-value=0.34). In-hospital mortality was 27.4% (n=23) and 1-year mortality was 41.0% (n=34) (Table 5), similar between genders. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">In conclusion, in our population, women are slightly older (but not significantly), have more heart failure with preserved ejection fraction, and present more intracardiac fistula. Furthermore, we do not observe significant differences regarding referral to surgical treatment, in-hospital and 1-year mortality. So, according to recent guidelines, we should similarly approach both genders. </span></span></p>
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