Recurrences of the infective endocarditis: clinical features and outcomes. Results from the Polish infective endocarditis registry (POL-ENDO)

Background: Patients with prior infective endocarditis are associated with an increased risk of recurrence. Aims: This study aimed to assess the clinical profile and treatment results of recurrent IE patients in Poland and compare them to European recurrent IE profile. Methods: A prospective multicenter observational cohort study of recurrent IE and first-episode IE patients from 160 medical centers in Poland registered between August 2022 and August 2024 was conducted. Polish recurrent IE cases were compared with those recorded in the ESC-EORP EURO-ENDO registry. Results: Of a total of 1758 IE patients, recurrent IE patients (n = 371) were younger than first-episode IE (n = 1387) patients [58.2 ± 16.6 vs. 62.6 ± 16.2, p < 0.001] and predominated in Poland [21.1 % vs. 8.6 %, p < 0.001]. Dental treatment predisposed to IE recurrence [12.8 % vs. 5.5 %, p < 0.001]. Prosthetic valve IE predominated among recurrent IE patients [33.1 % vs. 19.7 %, p < 0.001]. Fever > 38° was observed less often among recurrent IE cases [34.8 % vs. 54.1 %, p < 0.001]. Negative blood culture predominated among recurrent IE cases [43.3 % vs. 27.2 %, p < 0.001]. Polish recurrent IE patients were rarely operated than European counterparts [55.2 % vs. 64.8 %, p = 0.032]. The embolic surgery indications were less prominent in Poland [0.08 % vs. 20.2 %, p < 0.001]. Conclusions: The IE recurrence rate in Poland is greater. Dental treatment and valve prosthesis predispose to recurrence of IE. Fever > 38° is less often observed among recurrent IE. Surgical treatment is underutilized among Polish recurrent IE patients. Embolic and uncontrolled infection indications for surgery was underrated in Poland. The IE recurrence is not associated with increased in-hospital mortality.