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Infective endocarditis in hypertrophic cardiomyopathy: A multicenter, prospective, cohort study
Fernando Dominguez1, Antonio Ramos, Emilio Bouza
1aDepartment of Cardiology, Heart Failure and Inherited Cardiac Diseases Unit, Hospital Universitario Puerta de Hierro bInfectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Puerta de Hierro cClinical Microbiology and Infectious Diseases Unit, Hospital General Universitario Gregorio Marañón dHealth Research Institute Gregorio Marañón, CIBER Respiratory Diseases-CIBERES (CB06/06/0058), Medical School, Complutense University, Madrid eInfectious Diseases Unit, Hospital Universitario Marqués de Valdecilla fDepartment of Cardiology, Hospital Universitario Marqués de Valdecilla gDepartment of Cardiology, Hospital de Sierrallana, Santander hInfectious Diseases Unit, Hospital Clinic-IDIBAPS, Barcelona University iDepartment of Cardiology, Hospital Clinic-IDIBAPS, Barcelona University, Barcelona jDepartment of Infectious Diseases, Hospital Universitario Virgen del Rocío, Seville kInfectious Diseases Unit, Complejo Hospitalario Universitario A Coruña, A Coruña lDepartment of Cardiology, Hospital Virgen de la Victoria, Málaga mInfectious Diseases Unit, Hospital Universitario Cruces, País Vasco University, Bilbao nDepartment of Internal Medicine, Hospital Costa del Sol, Marbella, Málaga oDepartment of Internal Medicine-Infectious Diseases, Hospital Universitario Virgen de la Arrixaca, Medical School, Murcia University, Murcia pMyocardial Biology Programme, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
Infective endocarditis in hypertrophic cardiomyopathy patients has a high mortality rate. This suggests that these patients may benefit from antibiotic prophylaxis, despite current guidelines not recommending it.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Background:
- Infective endocarditis (IE) complicating hypertrophic cardiomyopathy (HCM) is uncommon.
- Current guidelines do not recommend IE antibiotic prophylaxis (IEAP) for HCM patients, but this is debated.
Purpose of the Study:
- To describe the clinical course of IE in a large series of HCM patients.
- To compare IE in HCM patients with IE in patients who have or do not have an indication for IEAP.
Main Methods:
- Data from the GAMES IE registry (27 Spanish hospitals, 2008-2013) were analyzed.
- 2000 consecutive IE patients were included; 34 with IE HCM were studied.
- IE HCM patients were compared to 1807 non-device IE patients categorized by IEAP indication.
Main Results:
- One-year mortality for IE HCM was 42% in this study (22% in literature).
- IE HCM patients had more predisposing factors (62%) and previous dental procedures (23%) than other groups.
- Streptococcus infections were more frequent in IE HCM patients (39%).
Conclusions:
- IE in HCM patients, with or without obstruction, carries a high mortality.
- Increased predisposing factors, dental procedures, and Streptococcus infections in IE HCM suggest potential benefit from IEAP.
- Further research is warranted to evaluate IEAP in HCM patients.
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