Key result
Prosthetic valves are linked to an eightfold higher endocarditis risk in S. aureus bacteremia.
Why the study?
Infective endocarditis is a severe complication in Staphylococcus aureus bacteraemia and guidelines recommend echocardiography for all patients, but optimal prioritization is unclear.
Which patients with Staphylococcus aureus bacteraemia are most likely to have positive findings for infective endocarditis on echocardiography?
Population
668 patients with Staphylococcus aureus bacteraemia at a major tertiary referral centre
Comparison
Patients with prosthetic heart valves or CRM devices versus those without
Design
Retrospective cohort study
Authors
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May support targeted echocardiography in high-risk SAB; leaves open whether universal screening improves outcomes.
Cohort (n=668)
No
Which patients with Staphylococcus aureus bacteraemia are most likely to have positive findings for infective endocarditis on echocardiography?
Absolute Event Rate: 32% vs 4%
p-value: p=<0.001
Echocardiography in Staphylococcus aureus bacteraemia can be prioritized for high-risk patients (prosthetic valves or cardiac devices), challenging guidelines that recommend imaging for all patients.
Joseph et al. (2012) conducted a cohort in Staphylococcus aureus bacteraemia (n=668). Prosthetic heart valves vs. No prosthetic heart valves was evaluated on Echocardiographic evidence of infective endocarditis (p=<0.001). The presence of prosthetic heart valves (32% vs 4%, P<0.001) or cardiac rhythm management devices (16% vs 3%, P<0.004) were strong risk factors for infective endocarditis in SAB patients.
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