Efficacy of the antibacterial envelope to prevent cardiac implantable electronic device infection in a high-risk population
Chaudhry, Uzma LU ; Borgquist, Rasmus LU
; Smith, J Gustav
LU
and Mörtsell, David
LU
(2022)
In Europace
24(12).
p.1973-1980
- Abstract
- Aims
Infection is a serious complication of cardiac implantable electronic device (CIED) therapy. An antibiotic-eluting absorbable envelope has been developed to reduce the infection rate, but studies investigating the efficacy and a reasonable number needed to treat in high-risk populations for infections are limited.
Methods and results
One hundred and forty-four patients undergoing CIED implantation who received the antibacterial envelope were compared with a matched cohort of 382 CIED patients from our institution. The primary outcome was the occurrence of local infection, and secondary outcomes were any CIED-related local or systemic infections, including endocarditis, and all-cause mortality. The results were... (More) - Aims
Infection is a serious complication of cardiac implantable electronic device (CIED) therapy. An antibiotic-eluting absorbable envelope has been developed to reduce the infection rate, but studies investigating the efficacy and a reasonable number needed to treat in high-risk populations for infections are limited.
Methods and results
One hundred and forty-four patients undergoing CIED implantation who received the antibacterial envelope were compared with a matched cohort of 382 CIED patients from our institution. The primary outcome was the occurrence of local infection, and secondary outcomes were any CIED-related local or systemic infections, including endocarditis, and all-cause mortality. The results were stratified by a risk score for CIED infection, PADIT. The envelope group had a higher PADIT score, 5.9 ± 3.1 vs. 3.9 ± 3.0 (P < 0.0001). For the primary endpoint, no local infections occurred in the envelope group, compared with 2.6% in the control group (P = 0.04), with a more pronounced difference in the stratum with a high (>7 points) PADIT score, 0 vs. 9.9% (P = 0.01). The total CIED-related infections were similar between groups, 6.3% compared with 5.0% (P = 0.567). Mortality after 1600 days of follow-up did not differ between groups, 22.9 vs. 26.4%, P = 0.475.
Conclusion
Our study confirms the clinical efficacy of an antibacterial envelope in the prevention of local CIED infection in patients with a higher risk according to the PADIT score. In an effort to improve cost–benefit ratios, ration of use guided by the PADIT score is advocated. Further prospective randomized studies in high-risk populations are called for. (Less)
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https://lup.lub.lu.se/record/2bde0441-5b85-40bd-b73d-9354e3cdf9ed
- author
- Chaudhry, Uzma
LU
; Borgquist, Rasmus
LU
; Smith, J Gustav
LU
and Mörtsell, David
LU
- organization
- publishing date
- 2022-08-22
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac implantable electronic device, Infection, An antibiotic-eluting absorbable envelope, TYRX, Health economy
- in
- Europace
- volume
- 24
- issue
- 12
- pages
- 1973 - 1980
- publisher
- Oxford University Press
- external identifiers
-
- pmid:35989511
- scopus:85143916911
- ISSN
- 1532-2092
- DOI
- 10.1093/europace/euac119
- project
- TYRX i en högrisk population
- language
- English
- LU publication?
- yes
- id
- 2bde0441-5b85-40bd-b73d-9354e3cdf9ed
- date added to LUP
- 2022-08-23 08:01:53
- date last changed
- 2023-03-30 04:11:45
@article{2bde0441-5b85-40bd-b73d-9354e3cdf9ed,
abstract = {{Aims<br/><br/>Infection is a serious complication of cardiac implantable electronic device (CIED) therapy. An antibiotic-eluting absorbable envelope has been developed to reduce the infection rate, but studies investigating the efficacy and a reasonable number needed to treat in high-risk populations for infections are limited.<br/>Methods and results<br/><br/>One hundred and forty-four patients undergoing CIED implantation who received the antibacterial envelope were compared with a matched cohort of 382 CIED patients from our institution. The primary outcome was the occurrence of local infection, and secondary outcomes were any CIED-related local or systemic infections, including endocarditis, and all-cause mortality. The results were stratified by a risk score for CIED infection, PADIT. The envelope group had a higher PADIT score, 5.9 ± 3.1 vs. 3.9 ± 3.0 (P < 0.0001). For the primary endpoint, no local infections occurred in the envelope group, compared with 2.6% in the control group (P = 0.04), with a more pronounced difference in the stratum with a high (>7 points) PADIT score, 0 vs. 9.9% (P = 0.01). The total CIED-related infections were similar between groups, 6.3% compared with 5.0% (P = 0.567). Mortality after 1600 days of follow-up did not differ between groups, 22.9 vs. 26.4%, P = 0.475.<br/>Conclusion<br/><br/>Our study confirms the clinical efficacy of an antibacterial envelope in the prevention of local CIED infection in patients with a higher risk according to the PADIT score. In an effort to improve cost–benefit ratios, ration of use guided by the PADIT score is advocated. Further prospective randomized studies in high-risk populations are called for.}},
author = {{Chaudhry, Uzma and Borgquist, Rasmus and Smith, J Gustav and Mörtsell, David}},
issn = {{1532-2092}},
keywords = {{Cardiac implantable electronic device; Infection; An antibiotic-eluting absorbable envelope; TYRX; Health economy}},
language = {{eng}},
month = {{08}},
number = {{12}},
pages = {{1973--1980}},
publisher = {{Oxford University Press}},
series = {{Europace}},
title = {{Efficacy of the antibacterial envelope to prevent cardiac implantable electronic device infection in a high-risk population}},
url = {{http://dx.doi.org/10.1093/europace/euac119}},
doi = {{10.1093/europace/euac119}},
volume = {{24}},
year = {{2022}},
}