Incidence, Clinical Characteristics, and Impact of Absent Echocardiographic Signs in Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation
Key result
Absent echocardiographic signs in post-TAVI infective endocarditis are linked to similar 1-year mortality as evident signs.
- HR 1.10
- 95% CI 0.67-1.80
- n=578
Why the study?
Echocardiography is the primary imaging modality for diagnosing infective endocarditis after TAVI, but the characteristics and outcomes of patients with absent echocardiographic signs remain unclear.
Does the absence of echocardiographic signs of infective endocarditis affect mortality in patients with definite TAVI-IE?
Population
578 patients with definite infective endocarditis after TAVI from the Infectious Endocarditis after TAVI International Registry
Comparison
Absent echocardiographic signs of IE vs evident echocardiographic signs of IE
Design
Cohort study
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Similar 1-year mortality in echo-negative TAVI-IE supports clinical suspicion for treatment; leaves open prospective validation of imaging-independent criteria.
Study Design
Type
Cohort (n=578)
Multicenter
Yes
Structured PICO
Does the absence of echocardiographic signs of infective endocarditis affect mortality in patients with definite TAVI-IE?
P
Population
578 patients with definite infective endocarditis after transcatheter aortic valve implantation from an international registry, followed for up to 1 year.
E
Exposure
Absent echocardiographic signs of infective endocarditis (IE-neg)
C
Comparator
Evident echocardiographic signs of infective endocarditis (IE-pos)
O
Outcome
In-hospital mortality and 1-year mortalityhard clinical
Main Result
Hazard Ratio: 1.1 (95% CI 0.67–1.8)
Patients with definite TAVI-IE but negative echocardiographic imaging have a similarly high risk of in-hospital and 1-year mortality as those with positive imaging, emphasizing the need for early treatment based on clinical suspicion and blood cultures.
Cite This Study
Mangner et al. (2022) conducted a cohort in Infective endocarditis after transcatheter aortic valve implantation (TAVI-IE) (n=578). Absent echocardiographic signs of infective endocarditis vs. Evident echocardiographic signs of infective endocarditis was evaluated on 1-year mortality (HR 1.10, 95% CI 0.67-1.80). Absent echocardiographic signs in patients with infective endocarditis after TAVI were associated with similar 1-year mortality compared to evident signs (HR 1.10; 95% CI 0.67-1.80).