Key result
Absence of clinical predictors in patients with suspected IE and negative TTE identified a subgroup with a 1.2% IE prevalence (1 of 81 patients), suggesting TEE might be safely avoided.
Why the study?
Extensive use of TEE has been suggested for suspected IE, but it was unclear whether subgroups with negative TTE can be identified in whom TEE can be safely avoided or delayed.
Can clinical predictors identify patients with suspected infective endocarditis and negative TTE in whom TEE can be safely avoided?
Population
375 patients with suspected IE and negative TTE undergoing TEE
Comparison
Predictors of IE vs absence of predictors
Design
Retrospective study
Authors
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May support deferring TEE in select low-risk patients with negative TTE; leaves open whether this approach is safe pending prospective validation.
Observational (n=375)
Can clinical predictors identify patients with suspected infective endocarditis and negative TTE in whom TEE can be safely avoided?
In patients with suspected infective endocarditis and a negative TTE, the absence of specific clinical predictors (positive blood culture, embolism, bioprosthetic valve, thrombocytopenia) identifies a low-risk subgroup where TEE may be safely avoided.
Cambise et al. (2025) conducted an observational in Suspected infective endocarditis (n=375). Clinical predictors (positive blood culture, embolism, bioprosthetic valves, low platelets) vs. Absence of clinical predictors was evaluated on Diagnosis of infective endocarditis. Absence of clinical predictors in patients with suspected IE and negative TTE identified a subgroup with a 1.2% IE prevalence (1 of 81 patients), suggesting TEE might be safely avoided.
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