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Infective endocarditis in a Finnish teaching hospital: a study on 326 episodes treated during 1980-2004
M Heiro1, H Helenius, S Mäkilä
1Department of Medicine, Turku University Hospital, Finland. maija.heiro@tyks.fi
Heart (British Cardiac Society)
|April 29, 2006
Summary
Infective endocarditis (IE) patterns shifted over 25 years, driven by increased intravenous drug use (IVDU). While patient age rose, outcomes for non-IVDU patients remained stable, with changes in causative agents and affected valves.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Understanding temporal trends in IE is crucial for adapting clinical management and public health strategies.
Purpose of the Study:
- To analyze changes in the clinical characteristics, causative agents, affected valves, and outcomes of infective endocarditis (IE) over a 25-year period.
Main Methods:
- A retrospective evaluation of 326 IE episodes in 303 patients treated between 1980 and 2004.
- Analysis of clinical data, including patient demographics, causative pathogens, valve involvement, predisposing conditions, complications, and treatment outcomes.
Main Results:
- The mean patient age increased significantly. A notable rise in IE associated with intravenous drug use (IVDU) was observed after 1996.
- Staphylococcus aureus became the predominant pathogen, replacing Viridans streptococci. Mitral and tricuspid valve involvement increased, while aortic valve IE decreased, largely due to IVDU.
- The incidence of lung emboli rose significantly, primarily in IVDU patients. However, neurological complications, heart failure, surgical treatment rates, and mortality remained unchanged.
Conclusions:
- Significant shifts in IE epidemiology occurred over 25 years, primarily linked to an increase in IVDU-associated cases.
- Changes in causative agents and valve predilection were observed, with a rise in Staphylococcus aureus and increased involvement of mitral and tricuspid valves.
- Despite evolving clinical features, the overall outcomes and mortality for infective endocarditis remained stable, with non-addicted patient presentations largely unchanged.