Device-Removal, Reinfection, and Mortality After Staphylococcus aureus Bacteremia in Patients With Cardiac Implantable Electronic Devices

Figures

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  Figure 1. Flowchart of Study Population CIED = cardiac implantable electronic device; SAB = Staphylococcus aureus bacteremia.

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  Figure 2. All-Cause Mortality and CIED Removal 180 days absolute risk of all-cause mortality, cumulative incidence of CIED removal with competing risk of death, and probability of surviving without device removal in patients with CIED and SAB. Patients who underwent CIED removal were still considered at risk of dying. Abbreviations as in Figure 1.

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  Figure 3. All-Cause Mortality and Risk of Reinfection (A) Crude 180 days absolute risk of all-cause mortality following SAB in patients with CIED and controls matched on sex and age at the time of SAB. (B) 180 days cumulative incidence of SAB reinfections accounting for competing risk of death following SAB in patients with CIED and matched controls. Abbreviations as in Figure 1.

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  Central Illustration. Overview of study design and main outcomes Identified from Danish nationwide registers, 1,816 patients with CIED and SAB were compared to 9,080 age- and sex-matched controls with SAB but no CIED. Lower panel: Landmark analysis on prognosis stratified according to CIED removal status at the time of hospital discharge. (Left) Absolute risk of all-cause mortality at 180 days following SAB. (Right) Cumulative incidence of SAB reinfections 180 days accounting for competing risk of death. ∗P < 0.05. Created in BioRender. Bengtsen K (2025), https://BioRender.com/sn9fitx. CIED = cardiac implantable electronic device; SAB = Staphylococcus aureus bacteremia; ICD = implantable cardioverter defibrillator.

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  Figure 4. Risk Group Stratification Absolute risk of 180-day all-cause mortality according to risk groups. Patients were awarded 1 point for each of the following conditions present: Age above 75 years, SAB occurring >6 months from most recent CIED implantation, left-sided valvular disease, alcohol-related hospital contact, and the use of systemic corticosteroids. The sum of points was used for risk group stratification. Cutoffs between groups were set at 1 and 2 points. Abbreviations as in Figure 1.