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Pilar Tornos - One of the best experts on this subject based on the ideXlab platform.
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clinical presentation aetiology and outcome of Infective Endocarditis results of the esc eorp euro endo european Infective Endocarditis registry a prospective cohort study
European Heart Journal, 2019Co-Authors: Gilbert Habib, Paola Anna Erba, Bernard Prendergast, Bernard Iung, Erwan Donal, Bernard Cosyns, Cecile Laroche, Bogdan A Popescu, Pilar TornosAbstract:Aims: The EURO-ENDO registry aimed to study the management and outcomes of patients with Infective Endocarditis (IE). Methods and results: Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective Endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective Endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion: Infective Endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.
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Candida Infective Endocarditis: an observational cohort study with a focus on therapy
Antimicrobial Agents and Chemotherapy, 2015Co-Authors: Christopher J. Arnold, Jose M Miro, Melissa Johnson, Arnold S. Bayer, Suzanne Bradley, Efthymia Giannitsioti, Pilar Tornos, Pierre Tattevin, Jacob Strahilevitz, Denis SpelmanAbstract:Candida Infective Endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida Infective Endocarditis. This prospective cohort study was based on 70 cases of Candida Infective Endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous Infective Endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida Infective Endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.
Paola Anna Erba - One of the best experts on this subject based on the ideXlab platform.
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clinical presentation aetiology and outcome of Infective Endocarditis results of the esc eorp euro endo european Infective Endocarditis registry a prospective cohort study
European Heart Journal, 2019Co-Authors: Gilbert Habib, Paola Anna Erba, Bernard Prendergast, Bernard Iung, Erwan Donal, Bernard Cosyns, Cecile Laroche, Bogdan A Popescu, Pilar TornosAbstract:Aims: The EURO-ENDO registry aimed to study the management and outcomes of patients with Infective Endocarditis (IE). Methods and results: Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective Endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective Endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion: Infective Endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.
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2015 esc guidelines for the management of Infective Endocarditis
European Heart Journal, 2015Co-Authors: Gilbert Habib, Paola Anna Erba, Jeanpaul Casalta, Patrizio Lancellotti, Manuel J Antunes, Maria Grazia Bongiorni, Jose M Miro, Barbara J M Mulder, Pilar Tornos Mas, Jose Luis ZamoranoAbstract:3D : three-dimensional AIDS : acquired immune deficiency syndrome b.i.d. : bis in die (twice daily) BCNIE : blood culture-negative Infective Endocarditis CDRIE : cardiac device-related Infective Endocarditis CHD : congenital heart disease CIED : cardiac implantable electronic device
Martin H. Thornhill - One of the best experts on this subject based on the ideXlab platform.
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incidence of Infective Endocarditis in england 2000 13 a secular trend interrupted time series analysis
The Lancet, 2015Co-Authors: Mark J Dayer, Bernard D Prendergast, Martin H. Thornhill, Peter B. Lockhart, Simon Jones, Larry M. BaddourAbstract:Summary Background Antibiotic prophylaxis given before invasive dental procedures in patients at risk of developing Infective Endocarditis has historically been the focus of Infective Endocarditis prevention. Recent changes in antibiotic prophylaxis guidelines in the USA and Europe have substantially reduced the number of patients for whom antibiotic prophylaxis is recommended. In the UK, guidelines from the National Institute for Health and Clinical Excellence (NICE) recommended complete cessation of antibiotic prophylaxis for prevention of Infective Endocarditis in March, 2008. We aimed to investigate changes in the prescribing of antibiotic prophylaxis and the incidence of Infective Endocarditis since the introduction of these guidelines. Methods We did a retrospective secular trend study, analysed as an interrupted time series, to investigate the effect of antibiotic prophylaxis versus no prophylaxis on the incidence of Infective Endocarditis in England. We analysed data for the prescription of antibiotic prophylaxis from Jan 1, 2004, to March 31, 2013, and hospital discharge episode statistics for patients with a primary diagnosis of Infective Endocarditis from Jan 1, 2000, to March 31, 2013. We compared the incidence of Infective Endocarditis before and after the introduction of the NICE guidelines using segmented regression analysis of the interrupted time series. Findings Prescriptions of antibiotic prophylaxis for the prevention of Infective Endocarditis fell substantially after introduction of the NICE guidance (mean 10 900 prescriptions per month [Jan 1, 2004, to March 31, 2008] vs 2236 prescriptions per month [April 1, 2008, to March 31, 2013], p Interpretation Although our data do not establish a causal association, prescriptions of antibiotic prophylaxis have fallen substantially and the incidence of Infective Endocarditis has increased significantly in England since introduction of the 2008 NICE guidelines. Funding Heart Research UK, Simplyhealth, and US National Institutes of Health.
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incidence of Infective Endocarditis in england 2000 13 a secular trend interrupted time series analysis
The Lancet, 2015Co-Authors: Mark J Dayer, Bernard D Prendergast, Martin H. Thornhill, Peter B. Lockhart, Simon Jones, Larry M. BaddourAbstract:Summary Background Antibiotic prophylaxis given before invasive dental procedures in patients at risk of developing Infective Endocarditis has historically been the focus of Infective Endocarditis prevention. Recent changes in antibiotic prophylaxis guidelines in the USA and Europe have substantially reduced the number of patients for whom antibiotic prophylaxis is recommended. In the UK, guidelines from the National Institute for Health and Clinical Excellence (NICE) recommended complete cessation of antibiotic prophylaxis for prevention of Infective Endocarditis in March, 2008. We aimed to investigate changes in the prescribing of antibiotic prophylaxis and the incidence of Infective Endocarditis since the introduction of these guidelines. Methods We did a retrospective secular trend study, analysed as an interrupted time series, to investigate the effect of antibiotic prophylaxis versus no prophylaxis on the incidence of Infective Endocarditis in England. We analysed data for the prescription of antibiotic prophylaxis from Jan 1, 2004, to March 31, 2013, and hospital discharge episode statistics for patients with a primary diagnosis of Infective Endocarditis from Jan 1, 2000, to March 31, 2013. We compared the incidence of Infective Endocarditis before and after the introduction of the NICE guidelines using segmented regression analysis of the interrupted time series. Findings Prescriptions of antibiotic prophylaxis for the prevention of Infective Endocarditis fell substantially after introduction of the NICE guidance (mean 10 900 prescriptions per month [Jan 1, 2004, to March 31, 2008] vs 2236 prescriptions per month [April 1, 2008, to March 31, 2013], p Interpretation Although our data do not establish a causal association, prescriptions of antibiotic prophylaxis have fallen substantially and the incidence of Infective Endocarditis has increased significantly in England since introduction of the 2008 NICE guidelines. Funding Heart Research UK, Simplyhealth, and US National Institutes of Health.
Gilbert Habib - One of the best experts on this subject based on the ideXlab platform.
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clinical presentation aetiology and outcome of Infective Endocarditis results of the esc eorp euro endo european Infective Endocarditis registry a prospective cohort study
European Heart Journal, 2019Co-Authors: Gilbert Habib, Paola Anna Erba, Bernard Prendergast, Bernard Iung, Erwan Donal, Bernard Cosyns, Cecile Laroche, Bogdan A Popescu, Pilar TornosAbstract:Aims: The EURO-ENDO registry aimed to study the management and outcomes of patients with Infective Endocarditis (IE). Methods and results: Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective Endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective Endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion: Infective Endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.
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challenges in Infective Endocarditis
Journal of the American College of Cardiology, 2017Co-Authors: Thomas J Cahill, Larry M. Baddour, Gilbert Habib, Bruno Hoen, Erwan Salaun, Gosta B Pettersson, Hans Joachim Schafers, Bernard PrendergastAbstract:Infective Endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by Infective Endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations. There is a lack of research infrastructure and funding, with few randomized controlled trials to guide practice. Longstanding controversies such as the timing of surgery or the role of antibiotic prophylaxis have not been resolved. The present article reviews the challenges posed by Infective Endocarditis and outlines current and future strategies to limit its impact.
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2015 esc guidelines for the management of Infective Endocarditis
European Heart Journal, 2015Co-Authors: Gilbert Habib, Paola Anna Erba, Jeanpaul Casalta, Patrizio Lancellotti, Manuel J Antunes, Maria Grazia Bongiorni, Jose M Miro, Barbara J M Mulder, Pilar Tornos Mas, Jose Luis ZamoranoAbstract:3D : three-dimensional AIDS : acquired immune deficiency syndrome b.i.d. : bis in die (twice daily) BCNIE : blood culture-negative Infective Endocarditis CDRIE : cardiac device-related Infective Endocarditis CHD : congenital heart disease CIED : cardiac implantable electronic device
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imaging investigations in Infective Endocarditis current approach and perspectives
Archives of Cardiovascular Diseases, 2013Co-Authors: Franck Thuny, J Y Gaubert, A Jacquier, Laetitia Tessonnier, Serge Cammilleri, Didier Raoult, Gilbert HabibAbstract:Summary Infective Endocarditis is a serious disease that needs rapid diagnosis and accurate risk stratification to offer the best therapeutic strategy. Echocardiography plays a key role in the management of the disease but may be limited in some clinical situations. Moreover, this method is insensitive for very early detection of the infection and assessment of therapeutic response because it does not provide imaging at the molecular and cellular levels. Recently, several novel morphological, molecular and hybrid imaging modalities have been investigated in Infective Endocarditis and offer new perspectives for better management of the disease.
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recommendations for the practice of echocardiography in Infective Endocarditis
European Journal of Echocardiography, 2010Co-Authors: Gilbert Habib, Jose Luis Zamorano, Bernard Cosyns, Luigi P Badano, Christophe Tribouilloy, Isidre Vilacosta, Maurizio Galderisi, Jensuwe Voigt, Rosa Sicari, K FoxAbstract:Echocardiography plays a key role in the assessment of Infective Endocarditis (IE). It is useful for the diagnosis of Endocarditis, the assessment of the severity of the disease, the prediction of short- and long-term prognosis, the prediction of embolic events, and the follow-up of patients under specific antibiotic therapy. Echocardiography is also useful for the diagnosis and management of the complications of IE, helping the physician in decision-making, particularly when a surgical therapy is considered. Finally, intraoperative echocardiography must be performed in IE to help the surgeon in the assessment and management of patients with IE during surgery. The current ‘recommendations for the practice of echocardiography in Infective Endocarditis’ aims to provide both an updated summary concerning the value and limitations of echocardiography in
Sadeghpour Anita - One of the best experts on this subject based on the ideXlab platform.
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The ESC-EORP EURO-ENDO (European Infective Endocarditis) registry
'Oxford University Press (OUP)', 2021Co-Authors: Habib Gilbert, Lancellotti Patrizio, Erba Paola-anna, Sadeghpour Anita, Meshaal Marwa, Sambola Antonia, Furnaz Shumaila, Citro Rodolfo, Ternacle Julien, Donal ErwanAbstract:Aims: The European Society of cardiology (ESC) EURObservational Research Programme (EORP) European Endocarditis (EURO-ENDO) registry aims to study the care and outcomes of patients diagnosed with Infective Endocarditis and compare findings with recommendations from the 2015 ESC Clinical Practice Guidelines for the management of Infective Endocarditis and data from the 2001 Euro Heart Survey. Methods and results: Patients (n=3116) aged over 18 years with a diagnosis of Infective Endocarditis based on the ESC 2015 Infective Endocarditis diagnostic criteria were prospectively identified between January 1st, 2016 and March 31st, 2018. Individual patient data were collected across 156 centres and 40 countries. The primary end-point is all-cause mortality in hospital and at 1-year. Secondary end-points are 1-year morbidity (all-cause hospitalisation, any cardiac surgery and Infective Endocarditis relapse), the clinical, epidemiological, microbiological, and therapeutic characteristics of patients, the number and timing of non-invasive imaging techniques, and adherence to recommendations as stated in the 2015 ESC Clinical Practice Guidelines for the management of Infective Endocarditis. Conclusion: EURO-ENDO is an international registry of care and outcomes of patients hospitalised with Infective Endocarditis which will provide insights into the contemporary profile and management of patients with this challenging disease
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Clinical presentation, aetiology and outcome of Infective Endocarditis. Results of the ESC-EORP EURO-ENDO (European Infective Endocarditis) registry a prospective cohort study
Oxford University Press (OUP): Policy B, 2019Co-Authors: Habib Gilbert, Donal Erwan, Tornos Pilar, Erba, Paola Anna, Iung Bernard, Cosyns Bernard, Laroche Cécile, Popescu, Bogdan A, Prendergast Bernard, Sadeghpour AnitaAbstract:International audienceAims - The EURO-ENDO registry aimed to study the management and outcomes of patients with Infective Endocarditis (IE). Methods and results - Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective Endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective Endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion - Infective Endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles
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Cohort profile The ESC-EORP EURO-ENDO (European Infective Endocarditis) registry
'Oxford University Press (OUP)', 2019Co-Authors: Habib Gilbert, Lancellotti Patrizio, Erba Paola-anna, Sadeghpour Anita, Meshaal Marwa, Sambola Antonia, Furnaz Shumaila, Citro Rodolfo, Ternacle Julien, Donal ErwanAbstract:International audienceAims - The European Society of cardiology (ESC) EURObservational Research Programme (EORP) European Endocarditis (EURO-ENDO) registry aims to study the care and outcomes of patients diagnosed with Infective Endocarditis and compare findings with recommendations from the 2015 ESC Clinical Practice Guidelines for the management of Infective Endocarditis and data from the 2001 Euro Heart Survey. Methods and results - Patients (n = 3116) aged over 18 years with a diagnosis of Infective Endocarditis based on the ESC 2015 Infective Endocarditis diagnostic criteria were prospectively identified between January 1st, 2016 and March 31st, 2018. Individual patient data were collected across 156 centres and 40 countries. The primary end-point is all-cause mortality in hospital and at 1-year. Secondary end-points are 1-year morbidity (all-cause hospitalisation, any cardiac surgery and Infective Endocarditis relapse), the clinical, epidemiological, microbiological, and therapeutic characteristics of patients, the number and timing of non-invasive imaging techniques, and adherence to recommendations as stated in the 2015 ESC Clinical Practice Guidelines for the management of Infective Endocarditis. Conclusion - EURO-ENDO is an international registry of care and outcomes of patients hospitalised with Infective Endocarditis which will provide insights into the contemporary profile and management of patients with this challenging disease
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Clinical presentation, aetiology and outcome of Infective Endocarditis. Results of the ESC-EORP EURO-ENDO (European Infective Endocarditis) registry: a prospective cohort study
'Oxford University Press (OUP)', 2019Co-Authors: Habib Gilbert, Donal Erwan, Tornos Pilar, Erba, Paola Anna, Iung Bernard, Cosyns Bernard, Laroche Cécile, Popescu, Bogdan A, Prendergast Bernard, Sadeghpour AnitaAbstract:The EURO-ENDO registry aimed to study the management and outcomes of patients with Infective Endocarditis (IE). AIMS: The EURO-ENDO registry aimed to study the management and outcomes of patients with Infective Endocarditis (IE). METHODS AND RESULTS: Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective Endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective Endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. CONCLUSION: Infective Endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles
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Clinical presentation, aetiology and outcome of Infective Endocarditis. Results of the ESC-EORP EURO-ENDO (European Infective Endocarditis) registry: a prospective cohort study.
'Oxford University Press (OUP)', 2019Co-Authors: Habib Gilbert, Donal Erwan, Tornos Pilar, Erba, Paola Anna, Iung Bernard, Cosyns Bernard, Laroche Cécile, Popescu, Bogdan A, Prendergast Bernard, Sadeghpour AnitaAbstract:peer reviewedAIMS: The EURO-ENDO registry aimed to study the management and outcomes of patients with Infective Endocarditis (IE). METHODS AND RESULTS: Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective Endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective Endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. CONCLUSION: Infective Endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles
