Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse

Area of Science:

• Cardiology
• Infectious Diseases
• Valvular Heart Disease

Background:

• Limited data exists on infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP).
• Current guidelines do not recommend IE antibiotic prophylaxis (IEAP) for BAV or MVP.
• Understanding IE in these patient groups is crucial for risk stratification and management.

Purpose of the Study:

• To describe clinical and microbiological features of IE in BAV and MVP patients.
• To compare IE in BAV/MVP patients with those with and without IEAP indications.
• To evaluate the potential benefit of IEAP in BAV and MVP patients.

Main Methods:

• Analysis of 3,208 consecutive IE patients from the GAMES registry.
• Classification into high-risk IE with IEAP indication, low/moderate-risk IE without IEAP indication, and IE with BAV or MVP.
• Prospective data collection across 31 Spanish hospitals.

Main Results:

• BAV and MVP patients showed higher rates of viridans group streptococci IE and IE of suspected odontologic origin compared to other groups.
• Intracardiac complications were more frequent in BAV and MVP patients than in the low/moderate-risk group.
• Clinical profiles of IE in BAV/MVP patients resembled those of high-risk IE patients.

Conclusions:

• IE in BAV and MVP patients exhibits characteristics similar to high-risk IE.
• Higher incidence of specific bacterial IE and odontologic origins noted in BAV/MVP.
• BAV and MVP should be considered high-risk IE conditions, necessitating a review of IEAP recommendations.