Infective endocarditis after left-sided heart valve replacement occurred in 5.2% of patients at 10 years, with male sex and bioprosthetic valves increasing risk in both MVR and AVR.
Cohort (n=18,041)
Yes
What is the incidence and what are the risk factors associated with infective endocarditis in patients undergoing left-sided heart valve replacement?
Infective endocarditis occurs in approximately 5.2% of patients over 10 years following left-sided heart valve replacement, with male sex and bioprosthetic valves being significant risk factors.
Aims: Patients with left-sided heart valve replacement are considered at high-risk of infective endocarditis (IE). However, data on the incidence and risk factors associated with IE are sparse. Methods and results: Through Danish administrative registries, we identified patients who underwent left-sided heart valve replacement from January 1996 to December 2015. Patients were categorized in mitral and aortic valve replacement (MVR and AVR) and followed until: 12 years after valve surgery, end of study, death, emigration, or hospitalization due to IE, whichever came first. Multivariable adjusted Cox proportional hazard analysis was used to investigate which baseline characteristics were associated with IE. A total of 18 041 patients were included. The cumulative IE risk at 10 years follow-up was 5.2% in both MVR and AVR patients. In patients with MVR, male sex hazard ratio (HR) = 1.68, 95% confidence interval (95% CI) 1.06-2.68, bioprosthetic valve (HR = 1.91, 95% CI 1.08-3.37), and heart failure (HR = 1.69, 95% CI 1.06-2.68) were among factors associated with an increased risk of IE. In AVR patients, male sex (HR = 1.59, 95% CI 1.33-1.89), bioprosthetic valve (HR = 1.70, 95% CI 1.35-2.15), and cardiac implantable electronic device (CIED) (HR = 1.57, 95% CI 1.19-2.06) were among factors associated with an increased risk of IE. Conclusion: Infective endocarditis after left-sided heart valve replacement is not uncommon and occurs in about 1/20 over 10 years. Male, bioprosthetic valve, and heart failure were among factors associated with IE in MVR patients while male, bioprosthetic valve, and CIED were among factors associated with IE in AVR patients.
Østergaard et al. (Sat,) conducted a cohort in Left-sided heart valve replacement (n=18,041). Left-sided heart valve replacement was evaluated on Infective endocarditis. Infective endocarditis after left-sided heart valve replacement occurred in 5.2% of patients at 10 years, with male sex and bioprosthetic valves increasing risk in both MVR and AVR.