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Title: Association Between Transcatheter Aortic Valve Replacement and Subsequent Infective Endocarditis and In-Hospital Death.
Authors: Regueiro, Ander
Linke, Axel
Latib, Azeem
Ihlemann, Nikolaj
Urena, Marina
Walther, Thomas
Husser, Oliver
Herrmann, Howard C
Nombela-Franco, Luis
Cheema, Asim N
Le Breton, Hervé
Stortecky, Stefan
Kapadia, Samir
Bartorelli, Antonio L
Sinning, Jan Malte
Amat-Santos, Ignacio
Munoz-Garcia, Antonio
Lerakis, Stamatios
Gutiérrez-Ibanes, Enrique
Abdel-Wahab, Mohamed
Tchetche, Didier
Testa, Luca
Eltchaninoff, Helene
Livi, Ugolino
Castillo, Juan Carlos
Jilaihawi, Hasan
Webb, John G
Barbanti, Marco
Kodali, Susheel
de Brito, Fabio S
Ribeiro, Henrique B
Miceli, Antonio
Fiorina, Claudia
Dato, Guglielmo Mario Actis
Rosato, Francesco
Serra, Vicenç
Masson, Jean-Bernard
Wijeysundera, Harindra C
Mangione, Jose A
Ferreira, Maria-Cristina
Lima, Valter C
Carvalho, Luiz A
Abizaid, Alexandre
Marino, Marcos A
Esteves, Vinicius
Andrea, Julio C M
Giannini, Francesco
Messika-Zeitoun, David
Himbert, Dominique
Kim, Won-Keun
Pellegrini, Costanza
Auffret, Vincent
Nietlispach, Fabian
Pilgrim, Thomas
Durand, Eric
Lisko, John
Makkar, Raj R
Lemos, Pedro A
Leon, Martin B
Puri, Rishi
San Roman, Alberto
Vahanian, Alec
Søndergaard, Lars
Mangner, Norman
Rodés-Cabau, Josep
metadata.dc.subject.mesh: Age Factors
Endocarditis, Bacterial
Follow-Up Studies
Heart Failure
Hospital Mortality
Odds Ratio
Risk Factors
Sex Factors
Staphylococcal Infections
Staphylococcus aureus
Transcatheter Aortic Valve Replacement
Treatment Outcome
Issue Date: 2016
Abstract: Limited data exist on clinical characteristics and outcomes of patients who had infective endocarditis after undergoing transcatheter aortic valve replacement (TAVR). To determine the associated factors, clinical characteristics, and outcomes of patients who had infective endocarditis after TAVR. The Infectious Endocarditis after TAVR International Registry included patients with definite infective endocarditis after TAVR from 47 centers from Europe, North America, and South America between June 2005 and October 2015. Transcatheter aortic valve replacement for incidence of infective endocarditis and infective endocarditis for in-hospital mortality. Infective endocarditis and in-hospital mortality after infective endocarditis. A total of 250 cases of infective endocarditis occurred in 20 006 patients after TAVR (incidence, 1.1% per person-year; 95% CI, 1.1%-1.4%; median age, 80 years; 64% men). Median time from TAVR to infective endocarditis was 5.3 months (interquartile range [IQR], 1.5-13.4 months). The characteristics associated with higher risk of progressing to infective endocarditis after TAVR was younger age (78.9 years vs 81.8 years; hazard ratio [HR], 0.97 per year; 95% CI, 0.94-0.99), male sex (62.0% vs 49.7%; HR, 1.69; 95% CI, 1.13-2.52), diabetes mellitus (41.7% vs 30.0%; HR, 1.52; 95% CI, 1.02-2.29), and moderate to severe aortic regurgitation (22.4% vs 14.7%; HR, 2.05; 95% CI, 1.28-3.28). Health care-associated infective endocarditis was present in 52.8% (95% CI, 46.6%-59.0%) of patients. Enterococci species and Staphylococcus aureus were the most frequently isolated microorganisms (24.6%; 95% CI, 19.1%-30.1% and 23.3%; 95% CI, 17.9%-28.7%, respectively). The in-hospital mortality rate was 36% (95% CI, 30.0%-41.9%; 90 deaths; 160 survivors), and surgery was performed in 14.8% (95% CI, 10.4%-19.2%) of patients during the infective endocarditis episode. In-hospital mortality was associated with a higher logistic EuroSCORE (23.1% vs 18.6%; odds ratio [OR], 1.03 per 1% increase; 95% CI, 1.00-1.05), heart failure (59.3% vs 23.7%; OR, 3.36; 95% CI, 1.74-6.45), and acute kidney injury (67.4% vs 31.6%; OR, 2.70; 95% CI, 1.42-5.11). The 2-year mortality rate was 66.7% (95% CI, 59.0%-74.2%; 132 deaths; 115 survivors). Among patients undergoing TAVR, younger age, male sex, history of diabetes mellitus, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis. Patients who developed endocarditis had high rates of in-hospital mortality and 2-year mortality.
metadata.dc.identifier.doi: 10.1001/jama.2016.12347
Appears in Collections:Producción 2020

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