Key result
Early prosthetic infective endocarditis accounts for ~32% of cases, with stable mortality over 27 years.
Why the study?
The study aimed to analyse the temporal trends in early prosthetic infective endocarditis over the last 27 years and evaluate the main associated prognostic factors.
Cohort (n=229)
Yes
Over the last 27 years, the proportion, microbiological profile, and in-hospital mortality of early prosthetic infective endocarditis have remained stable despite an increasingly older and more comorbid patient population, with cardiac surgery serving as a protective factor.
Stable early prosthetic IE burden despite rising comorbidities signals prevention gaps; leaves open targeted perioperative strategies in high-risk cohorts.
Background The aim of the study was to analyse the temporal trends in early prosthetic infective endocarditis (IE) over the last 27 years and to evaluate the main associated prognostic factors. Methods Prospective cohort of a total of 1,745 patients with left-sided IE in three tertiary hospitals between 1998 and 2024. Of the total, patients with prosthetic IE (n=711) were selected, of whom 32.2% (n=229) presented early. Temporal trends in the epidemiological, clinical, microbiological, and prognostic profiles were evaluated, and a univariate analysis was performed to identify predictors of in-hospital mortality. Results During the study period, there were no significant changes in the proportion of early prosthetic IE out of the total number of prosthetic IE, with percentages remaining between 27% and 35% (p=0.184). During this time, the age of patients increased significantly. In addition, there was an increase in patients referred from other hospitals and a higher prevalence of comorbidities such as cancer and anaemia. There were no significant changes in the frequency of the main microorganisms, but there was an increase in the presence of vegetations and severe valve regurgitation. There were also no significant changes in the percentage of periannular complications, in-hospital complications, or rates of cardiac surgery or in-hospital mortality (Table). Comorbidities such as COPD and Staphylococcus aureus infections were identified as risk factors for higher in-hospital mortality. Periannular complications, the presence of vegetations, and in-hospital complications were also associated with higher mortality, as were higher surgical risk scores and failure to perform indicated cardiac surgery. Cardiac surgery was a protective factor (Figure). Conclusions The percentage of patients with early prosthetic IE has remained stable over the last 27 years. Despite the epidemiological changes described in recent decades in the overall IE patient population, most of the epidemiological, clinical, microbiological, and prognostic characteristics of patients with early prosthetic IE have not changed significantly.
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Landín et al. (2026) conducted a cohort in Early prosthetic infective endocarditis (n=229). Early prosthetic infective endocarditis over time (1998-2024) was evaluated on Proportion of early prosthetic infective endocarditis and in-hospital mortality (p=0.184). Early prosthetic infective endocarditis accounted for 32.2% of prosthetic IE cases, remaining stable between 27% and 35% over 27 years (p=0.184) with unchanged in-hospital mortality.
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