Predictors of embolism and death in left-sided infective endocarditis: the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry

ESC EORP EURO-ENDO Registry Investigator Group

doi:10.1093/eurheartj/ehad507

Predictors of embolism and death in left-sided infective endocarditis: the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry

ESC EORP EURO-ENDO Registry Investigator Group

University Hospital Valld'Hebron
Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Department of Orthopedics, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Department of Neurology, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Henri Mondor University Hospital
Hospital Universitario Álvaro Cunqueiro
University Hospital of Amiens
Department of Pediatric Endocrinology and Diabetes, University Hospital Centre Zagreb, University of Zagreb Medical School, Zagreb, Croatia.
Sungkyunkwan University School of Medicine
Maastricht University Medical Centre MUMC, Maastricht, Netherlands
Cardiovascular Research Methods Centre, University of Ottawa Heart Institute , Ottawa, Ontario , Canada.
Department of Ophthalmology and Vision Science, The Hospital for Sick Children, Toronto, Canada; Faculty of Medicine, Department of Ophthalmology, University of Alexandria, Alexandria, Egypt.
Department of Cardiology, DRK Kliniken Berlin, Berlin, Germany and Department of Cardiology, Medical University of Greifswald, Germany.
Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Research Center
Nuclear Medicine Department, Institut Fresnel, APHM, CNRS, Timone Hospital, CERIMED, Aix Marseille Univ, Centrale Marseille, Marseille, France

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background and Even though vegetation size in infective endocarditis (IE) has been associated with embolic events (EEs) and mortality risk, it is unclear Aims whether vegetation size associated with these potential outcomes is different in left-sided IE (LSIE). This study aimed to seek assessing the vegetation cut-off size as predictor of EE or 30-day mortality for LSIE and to determine risk predictors of these outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods The European Society of Cardiology EURObservational Research Programme European Infective Endocarditis is a prospective, multicentre registry including patients with definite or possible IE throughout 2016–18. Cox multivariable logistic regression analysis was performed to assess variables associated with EE or 30-day mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Results There were 2171 patients with LSIE (women 31.5%). Among these affected patients, 459 (21.1%) had a new EE or died in 30 days. The cut-off value of vegetation size for predicting EEs or 30-day mortality was >10 mm [hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.13–1.69, P = .0015]. Other adjusted predictors of risk of EE or death were as follows: EE on admission (HR 1.89, 95% CI 1.54–2.33, P < .0001), history of heart failure (HR 1.53, 95% CI 1.21–1.93, P = .0004), creatinine >2 mg/dL (HR 1.59, 95% CI 1.25–2.03, P = .0002), Staphylococcus aureus (HR 1.36, 95% CI 1.08–1.70, P = .008), congestive heart failure (HR 1.40, 95% CI 1.12–1.75, P = .003), presence of haemorrhagic stroke (HR 4.57, 95% CI 3.08–6.79, P < .0001), alcohol abuse (HR 1.45, 95% CI 1.04–2.03, P = .03), presence of cardiogenic shock (HR 2.07, 95% CI 1.29–3.34, P = .003), and not performing left surgery (HR 1.30 95% CI 1.05–1.61, P = .016) (C-statistic = .68). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusions Prognosis after LSIE is determined by multiple factors, including vegetation size.

Original language	English
Pages (from-to)	4566-4575
Number of pages	10
Journal	European heart journal
Volume	44
Issue number	43
DOIs	https://doi.org/10.1093/eurheartj/ehad507
Publication status	Published - 14 Nov 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Cardiology
Embolism/complications
Endocarditis, Bacterial/complications
Endocarditis/surgery
Female
Humans
Prospective Studies
Registries
Retrospective Studies
Risk Factors

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10.1093/eurheartj/ehad507

Predictors-of-embolism-and-death-in-left-sided-infective-endocarditis.pdfFinal published version, 3.35 MBLicence: Taverne

Cite this

@article{807bd731ea4a4b3f890a3f3778e52168,

title = "Predictors of embolism and death in left-sided infective endocarditis: the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry",

abstract = "Background and Even though vegetation size in infective endocarditis (IE) has been associated with embolic events (EEs) and mortality risk, it is unclear Aims whether vegetation size associated with these potential outcomes is different in left-sided IE (LSIE). This study aimed to seek assessing the vegetation cut-off size as predictor of EE or 30-day mortality for LSIE and to determine risk predictors of these outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods The European Society of Cardiology EURObservational Research Programme European Infective Endocarditis is a prospective, multicentre registry including patients with definite or possible IE throughout 2016–18. Cox multivariable logistic regression analysis was performed to assess variables associated with EE or 30-day mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Results There were 2171 patients with LSIE (women 31.5\%). Among these affected patients, 459 (21.1\%) had a new EE or died in 30 days. The cut-off value of vegetation size for predicting EEs or 30-day mortality was >10 mm [hazard ratio (HR) 1.38, 95\% confidence interval (CI) 1.13–1.69, P = .0015]. Other adjusted predictors of risk of EE or death were as follows: EE on admission (HR 1.89, 95\% CI 1.54–2.33, P < .0001), history of heart failure (HR 1.53, 95\% CI 1.21–1.93, P = .0004), creatinine >2 mg/dL (HR 1.59, 95\% CI 1.25–2.03, P = .0002), Staphylococcus aureus (HR 1.36, 95\% CI 1.08–1.70, P = .008), congestive heart failure (HR 1.40, 95\% CI 1.12–1.75, P = .003), presence of haemorrhagic stroke (HR 4.57, 95\% CI 3.08–6.79, P < .0001), alcohol abuse (HR 1.45, 95\% CI 1.04–2.03, P = .03), presence of cardiogenic shock (HR 2.07, 95\% CI 1.29–3.34, P = .003), and not performing left surgery (HR 1.30 95\% CI 1.05–1.61, P = .016) (C-statistic = .68). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusions Prognosis after LSIE is determined by multiple factors, including vegetation size.",

keywords = "Cardiology, Embolism/complications, Endocarditis, Bacterial/complications, Endocarditis/surgery, Female, Humans, Prospective Studies, Registries, Retrospective Studies, Risk Factors",

author = "Antonia Sambola and Jordi Lozano-Torres and Eric Boersma and Carmen Olmos and Julien Ternacle and Francisco Calvo and Christophe Tribouilloy and Vlatka Reskovic-Luksic and Jadranka Separovic-Hanzevacki and Seung-Woo Park and Sebastiaan Bekkers and Kwan-Leung Chan and Abdallah Almaghraby and Bernard Iung and Patrizio Lancellotti and Gilbert Habib and \{ESC EORP EURO-ENDO Registry Investigator Group\} and O. Kamp",

note = "Funding Information: This work was supported by Abbott Vascular Int. (2011–21), Amgen Cardiovascular (2009–18), AstraZeneca (2014–21), Bayer AG (2009–18), Boehringer Ingelheim (2009–19), Boston Scientific (2009–12), The Bristol Myers Squibb and Pfizer Alliance (2011–19), Daiichi Sankyo Europe GmbH (2011–20), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2014–17), Edwards (2016–19), Gedeon Richter Plc. (2014–16), Menarini Int. Op. (2009–12), MSD-Merck \& Co. (2011–14), Novartis Pharma AG (2014–20), ResMed (2014–16), Sanofi (2009–11), SERVIER (2009–21), and Vifor (2019–22). Publisher Copyright: {\textcopyright} 2023 Oxford University Press. All rights reserved.",

year = "2023",

month = nov,

day = "14",

doi = "10.1093/eurheartj/ehad507",

language = "English",

volume = "44",

pages = "4566--4575",

journal = "European heart journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "43",

}

Predictors of embolism and death in left-sided infective endocarditis: the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry. / ESC EORP EURO-ENDO Registry Investigator Group.
In: European heart journal, Vol. 44, No. 43, 14.11.2023, p. 4566-4575.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Predictors of embolism and death in left-sided infective endocarditis

T2 - the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry

AU - Sambola, Antonia

AU - Lozano-Torres, Jordi

AU - Boersma, Eric

AU - Olmos, Carmen

AU - Ternacle, Julien

AU - Calvo, Francisco

AU - Tribouilloy, Christophe

AU - Reskovic-Luksic, Vlatka

AU - Separovic-Hanzevacki, Jadranka

AU - Park, Seung-Woo

AU - Bekkers, Sebastiaan

AU - Chan, Kwan-Leung

AU - Almaghraby, Abdallah

AU - Iung, Bernard

AU - Lancellotti, Patrizio

AU - Habib, Gilbert

AU - ESC EORP EURO-ENDO Registry Investigator Group

AU - Kamp, O.

N1 - Funding Information: This work was supported by Abbott Vascular Int. (2011–21), Amgen Cardiovascular (2009–18), AstraZeneca (2014–21), Bayer AG (2009–18), Boehringer Ingelheim (2009–19), Boston Scientific (2009–12), The Bristol Myers Squibb and Pfizer Alliance (2011–19), Daiichi Sankyo Europe GmbH (2011–20), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2014–17), Edwards (2016–19), Gedeon Richter Plc. (2014–16), Menarini Int. Op. (2009–12), MSD-Merck & Co. (2011–14), Novartis Pharma AG (2014–20), ResMed (2014–16), Sanofi (2009–11), SERVIER (2009–21), and Vifor (2019–22). Publisher Copyright: © 2023 Oxford University Press. All rights reserved.

PY - 2023/11/14

Y1 - 2023/11/14

N2 - Background and Even though vegetation size in infective endocarditis (IE) has been associated with embolic events (EEs) and mortality risk, it is unclear Aims whether vegetation size associated with these potential outcomes is different in left-sided IE (LSIE). This study aimed to seek assessing the vegetation cut-off size as predictor of EE or 30-day mortality for LSIE and to determine risk predictors of these outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods The European Society of Cardiology EURObservational Research Programme European Infective Endocarditis is a prospective, multicentre registry including patients with definite or possible IE throughout 2016–18. Cox multivariable logistic regression analysis was performed to assess variables associated with EE or 30-day mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Results There were 2171 patients with LSIE (women 31.5%). Among these affected patients, 459 (21.1%) had a new EE or died in 30 days. The cut-off value of vegetation size for predicting EEs or 30-day mortality was >10 mm [hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.13–1.69, P = .0015]. Other adjusted predictors of risk of EE or death were as follows: EE on admission (HR 1.89, 95% CI 1.54–2.33, P < .0001), history of heart failure (HR 1.53, 95% CI 1.21–1.93, P = .0004), creatinine >2 mg/dL (HR 1.59, 95% CI 1.25–2.03, P = .0002), Staphylococcus aureus (HR 1.36, 95% CI 1.08–1.70, P = .008), congestive heart failure (HR 1.40, 95% CI 1.12–1.75, P = .003), presence of haemorrhagic stroke (HR 4.57, 95% CI 3.08–6.79, P < .0001), alcohol abuse (HR 1.45, 95% CI 1.04–2.03, P = .03), presence of cardiogenic shock (HR 2.07, 95% CI 1.29–3.34, P = .003), and not performing left surgery (HR 1.30 95% CI 1.05–1.61, P = .016) (C-statistic = .68). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusions Prognosis after LSIE is determined by multiple factors, including vegetation size.

AB - Background and Even though vegetation size in infective endocarditis (IE) has been associated with embolic events (EEs) and mortality risk, it is unclear Aims whether vegetation size associated with these potential outcomes is different in left-sided IE (LSIE). This study aimed to seek assessing the vegetation cut-off size as predictor of EE or 30-day mortality for LSIE and to determine risk predictors of these outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods The European Society of Cardiology EURObservational Research Programme European Infective Endocarditis is a prospective, multicentre registry including patients with definite or possible IE throughout 2016–18. Cox multivariable logistic regression analysis was performed to assess variables associated with EE or 30-day mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Results There were 2171 patients with LSIE (women 31.5%). Among these affected patients, 459 (21.1%) had a new EE or died in 30 days. The cut-off value of vegetation size for predicting EEs or 30-day mortality was >10 mm [hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.13–1.69, P = .0015]. Other adjusted predictors of risk of EE or death were as follows: EE on admission (HR 1.89, 95% CI 1.54–2.33, P < .0001), history of heart failure (HR 1.53, 95% CI 1.21–1.93, P = .0004), creatinine >2 mg/dL (HR 1.59, 95% CI 1.25–2.03, P = .0002), Staphylococcus aureus (HR 1.36, 95% CI 1.08–1.70, P = .008), congestive heart failure (HR 1.40, 95% CI 1.12–1.75, P = .003), presence of haemorrhagic stroke (HR 4.57, 95% CI 3.08–6.79, P < .0001), alcohol abuse (HR 1.45, 95% CI 1.04–2.03, P = .03), presence of cardiogenic shock (HR 2.07, 95% CI 1.29–3.34, P = .003), and not performing left surgery (HR 1.30 95% CI 1.05–1.61, P = .016) (C-statistic = .68). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusions Prognosis after LSIE is determined by multiple factors, including vegetation size.

KW - Cardiology

KW - Embolism/complications

KW - Endocarditis, Bacterial/complications

KW - Endocarditis/surgery

KW - Female

KW - Humans

KW - Prospective Studies

KW - Registries

KW - Retrospective Studies

KW - Risk Factors

UR - https://www.scopus.com/pages/publications/85178039187

U2 - 10.1093/eurheartj/ehad507

DO - 10.1093/eurheartj/ehad507

M3 - Article

C2 - 37592753

SN - 0195-668X

VL - 44

SP - 4566

EP - 4575

JO - European heart journal

JF - European heart journal

IS - 43

ER -

Predictors of embolism and death in left-sided infective endocarditis: the European Society of Cardiology EURObservational Research Programme European Infective Endocarditis registry

Abstract

UN SDGs

Keywords

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