Infective endocarditis in Europe: lessons from the Euro heart survey.

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Active infective endocarditis (IE) is a serious condition affecting heart valves.
• Understanding the characteristics, treatment, and outcomes of IE is crucial for improving patient care.
• The Euro Heart Survey (EHS) on valvar heart disease (VHD) provides a large-scale European perspective.

Purpose of the Study:

• To describe the clinical characteristics of patients with active IE in Europe.
• To analyze the treatment strategies, including medical and surgical interventions.
• To determine the in-hospital outcomes and mortality rates associated with active IE.

Main Methods:

• A prospective survey of medical practices across 92 centers in 25 European countries.
• Inclusion of 159 adult patients with active IE from the larger EHS on VHD cohort (5001 patients).
• Data collection on patient demographics, IE type (native vs. prosthetic), diagnostic procedures, surgical interventions, and in-hospital outcomes.

Main Results:

• The majority of active IE patients (74%) had native valve IE.
• Surgery was performed in 52% of patients, primarily for heart failure (60%) and persistent sepsis (40%).
• In-hospital mortality was 12.6%, with higher rates in the surgical group (15.6%) compared to the medical group (10.4%).
• Significant deficiencies were noted in obtaining pre-antibiotic blood cultures (71%) and in the application of endocarditis prophylaxis (50% of at-risk patients).

Conclusions:

• Patients with active IE present with high-risk profiles and frequently undergo surgery.
• There are critical gaps in diagnostic procedures (blood cultures) and preventive measures (prophylaxis).
• High mortality rates underscore the need for enhanced patient education and strict adherence to clinical guidelines for IE management.