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Native aortic versus mitral valve infective endocarditis : A nationwide registry study

Van Vlasselaer, Abel; Rasmussen, Magnus LU ; Nilsson, Johan LU ; Olaison, Lars and Ragnarsson, Sigurdur LU (2019) In Open Heart 6(1).
Abstract

Background Native aortic and mitral valve infective endocarditis (AVE and MVE, respectively) are usually grouped together as left-sided native valve infective endocarditis (LNVE), while the differences between AVE and MVE have not yet been properly investigated. We aimed to compare AVE and MVE in regard to patient characteristics, microbiology and determinants of survival. Methods We conducted a retrospective study using the Swedish national registry on infective endocarditis, which contains nationwide patient data. The study period was 2007-2017, and included cases were patients who had either AVE or MVE. Results We included 649 AVE and 744 MVE episodes. Staphylococcus aureus was more often the causative pathogen in MVE (41% vs 31%,... (More)

Background Native aortic and mitral valve infective endocarditis (AVE and MVE, respectively) are usually grouped together as left-sided native valve infective endocarditis (LNVE), while the differences between AVE and MVE have not yet been properly investigated. We aimed to compare AVE and MVE in regard to patient characteristics, microbiology and determinants of survival. Methods We conducted a retrospective study using the Swedish national registry on infective endocarditis, which contains nationwide patient data. The study period was 2007-2017, and included cases were patients who had either AVE or MVE. Results We included 649 AVE and 744 MVE episodes. Staphylococcus aureus was more often the causative pathogen in MVE (41% vs 31%, p<0.001), whereas enterococci were more often the causative pathogen in AVE (14% vs 7.4%, p<0.001). Perivalvular involvement occurred more frequently in AVE (8.5% vs 3.5%, p<0.001) and brain emboli more frequently in MVE (21% vs 13%, p<0.001). Surgery for IE was performed more often (35% vs 27%, p<0.001) and sooner after diagnosis (6.5 days vs 9 days, p=0.012) in AVE than in MVE. Several risk predictors differed between the two groups. Conclusions The microbiology seems to differ between AVE and MVE. The causative pathogen was not associated with mortality in AVE. The between-group differences regarding clinical presentation and predictors of survival indicate that it may be important to differentiate AVE from MVE in the treatment of LNVE.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
endocarditis, left-sided native valve infective endocarditis, microbiology, outcome, surgery
in
Open Heart
volume
6
issue
1
publisher
BMJ Publishing Group
external identifiers
  • scopus:85062286784
ISSN
2053-3624
DOI
10.1136/openhrt-2018-000926
language
English
LU publication?
yes
id
18c7c5dc-f255-4210-a465-4bc14abc70b8
date added to LUP
2019-03-13 12:49:12
date last changed
2019-03-13 12:49:12
@article{18c7c5dc-f255-4210-a465-4bc14abc70b8,
  abstract     = {<p>Background Native aortic and mitral valve infective endocarditis (AVE and MVE, respectively) are usually grouped together as left-sided native valve infective endocarditis (LNVE), while the differences between AVE and MVE have not yet been properly investigated. We aimed to compare AVE and MVE in regard to patient characteristics, microbiology and determinants of survival. Methods We conducted a retrospective study using the Swedish national registry on infective endocarditis, which contains nationwide patient data. The study period was 2007-2017, and included cases were patients who had either AVE or MVE. Results We included 649 AVE and 744 MVE episodes. Staphylococcus aureus was more often the causative pathogen in MVE (41% vs 31%, p&lt;0.001), whereas enterococci were more often the causative pathogen in AVE (14% vs 7.4%, p&lt;0.001). Perivalvular involvement occurred more frequently in AVE (8.5% vs 3.5%, p&lt;0.001) and brain emboli more frequently in MVE (21% vs 13%, p&lt;0.001). Surgery for IE was performed more often (35% vs 27%, p&lt;0.001) and sooner after diagnosis (6.5 days vs 9 days, p=0.012) in AVE than in MVE. Several risk predictors differed between the two groups. Conclusions The microbiology seems to differ between AVE and MVE. The causative pathogen was not associated with mortality in AVE. The between-group differences regarding clinical presentation and predictors of survival indicate that it may be important to differentiate AVE from MVE in the treatment of LNVE.</p>},
  articleno    = {e000926},
  author       = {Van Vlasselaer, Abel and Rasmussen, Magnus and Nilsson, Johan and Olaison, Lars and Ragnarsson, Sigurdur},
  issn         = {2053-3624},
  keyword      = {endocarditis,left-sided native valve infective endocarditis,microbiology,outcome,surgery},
  language     = {eng},
  month        = {02},
  number       = {1},
  publisher    = {BMJ Publishing Group},
  series       = {Open Heart},
  title        = {Native aortic versus mitral valve infective endocarditis : A nationwide registry study},
  url          = {http://dx.doi.org/10.1136/openhrt-2018-000926},
  volume       = {6},
  year         = {2019},
}