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Clinical significance of congestive heart failure in prosthetic valve endocarditis. A multicenter study with 257

Javier López1, Teresa Sevilla1, Isidre Vilacosta2

  • 1Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain.

Revista Espanola De Cardiologia (English Ed.)
|April 30, 2014
PubMed

Insights

Congestive heart failure significantly increases in-hospital mortality risk by threefold in patients with prosthetic valve endocarditis. Key mortality factors include persistent infection, aortic involvement, abscess, and diabetes mellitus, while cardiac surgery improves outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Prosthetic valve endocarditis (PVE) is a serious infection with significant morbidity and mortality.
  • Congestive heart failure (CHF) is a common complication of cardiac conditions, but its specific impact on PVE outcomes has been understudied.

Purpose of the Study:

  • To investigate the incidence and prognostic significance of CHF in patients with PVE.
  • To analyze the outcomes of PVE patients with CHF based on therapeutic strategies.
  • To identify independent risk factors for in-hospital mortality in PVE patients with CHF.

Main Methods:

  • Prospective enrollment of 639 left-sided endocarditis episodes, with 257 confirmed as prosthetic valve endocarditis.
  • Assessment of CHF in 145 (56%) of PVE patients.
  • Multivariate logistic regression analysis to determine the prognostic significance of CHF and identify mortality predictors.

Main Results:

  • CHF is a strong independent predictor of in-hospital mortality in PVE, increasing risk threefold (OR=3).
  • Persistent infection (OR=3.6) and CHF (OR=3) are the strongest predictors of in-hospital mortality.
  • Independent risk factors for mortality in PVE with CHF include persistent infection, aortic involvement, abscess, and diabetes mellitus.

Conclusions:

  • The incidence of CHF in PVE is high, significantly elevating in-hospital mortality risk.
  • Persistent infection, aortic involvement, abscess, and diabetes mellitus are independent risk factors for mortality in PVE patients with CHF.
  • Cardiac surgery demonstrates a protective effect, decreasing mortality in this patient group.
Abstract

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