Recurrent infective endocarditis versus first-time infective endocarditis after heart valve surgery
- PDF / 1,000,881 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 8 Downloads / 198 Views
ORIGINAL PAPER
Recurrent infective endocarditis versus first‑time infective endocarditis after heart valve surgery Eva Havers‑Borgersen1 · Jawad H. Butt1 · Lauge Østergaard1 · Henning Bundgaard1 · Morten Smerup2 · Niels Eske Bruun3,4,5 · Gunnar H. Gislason6 · Christian Torp‑Pedersen7 · Lars Køber1 · Emil L. Fosbøl1 Received: 20 November 2019 / Accepted: 5 March 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Infective endocarditis (IE) may require heart valve surgery. It is well known that heart valve surgery itself and previous IE predispose to IE. However, data are sparse on whether the risk of IE is different among patients undergoing valve surgery due to IE and other causes (i.e. recurrent vs. first-time IE). Methods Using Danish nationwide registries, patients undergoing left-sided heart valve surgery in the course of an IE hospitalization (1996–2017) were identified and matched with controls undergoing left-sided heart valve surgery due to another cause than IE in a 1:1 ratio. Patients were stratified according to type of surgical valve intervention and affected valve. The comparative risk of recurrent vs. first-time IE was assessed by cumulative incidence curves and multivariable Cox regression analyses. Results The study population comprised 971 patients with a first-time admission for IE requiring heart valve surgery matched with 971 controls undergoing heart valve surgery due to other causes than IE. The risk of recurrent IE was significantly higher than the risk of first-time IE following heart valve surgery (5.5% and 3.0% by 10 years, hazard ratio (HR) 1.66, 95% confidence interval (CI) 1.02–2.70). The risk of IE recurrence was not significantly different comparing valve replacement and valve repair (5.5% and 5.3%, respectively, HR 1.60, 95% CI 0.71–3.60). Yet, the risk of IE recurrence was significantly higher among patients with biological versus mechanical prostheses (6.3% and 4.6%, respectively, HR 2.00, 95% CI 1.02–3.70). Conclusions Following heart valve surgery, the risk of recurrent IE was significantly higher than the risk of first-time IE.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00392-020-01628-7) contains supplementary material, which is available to authorized users. * Eva Havers‑Borgersen [email protected] 1
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
2
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
3
Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
4
Clinical Institute, Copenhagen University, Copenhagen, Denmark
5
Clinical Institute, Aalborg University, Aalborg, Denmark
6
Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
7
Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
13
Vol.:(0123456789)
Clinical Research in Cardiology
Graphic abstract
Keywords
Data Loading...
