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V S Moiseev1, Z D Kobalava, A S Pisaryuk

  • 1Peoples Friendship University of Russia. fake@neicon.ru.

Kardiologiia
|January 10, 2019
PubMed
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Molecular Biological Methods in The Etiological Diagnostics of Infective Endocarditis.

Kardiologiia·2025

Infective endocarditis (IE) in older patients with comorbidities, often healthcare-associated, presents a worse prognosis. Prompt surgery significantly improves long-term survival in IE patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Infective endocarditis (IE) is a serious infection affecting heart valves.
  • Understanding IE's clinical course and outcomes based on infection source is crucial for effective management.
  • Predicting mortality in IE patients is vital for resource allocation and treatment strategies.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of infective endocarditis (IE) based on the source of infection.
  • To identify predictors of mortality in IE patients within a general hospital setting.
  • To evaluate the impact of healthcare-associated IE on patient prognosis.

Main Methods:

  • A retrospective study of 176 patients with definite or possible IE (Duke criteria) admitted between 2010-2017.

Related Experiment Videos

  • Patients categorized into three groups based on infection source: healthcare-associated, intravenous drug use-associated, and community-acquired.
  • Standard clinical and laboratory assessments, echocardiography, blood cultures, and PCR with sequencing were performed; in-hospital and 1-year outcomes were tracked.

    • Main Results:

    • Healthcare-associated IE (43.9%) was more prevalent in older patients (>60 years) with higher comorbidity, leading to complicated clinical courses and worse outcomes.
    • Intravenous drug use-associated IE (28.4%) showed a predilection for tricuspid valve involvement, high embolic complication rates, and lower in-hospital mortality.
    • Independent predictors of in-hospital death included MRSA infection, persistent infection, and prolonged fever; history of stroke and heart failure predicted 1-year mortality. Surgery was associated with significantly reduced 1-year mortality.

    Conclusions:

    • Healthcare-associated IE is common in elderly patients with comorbidities, associated with increased complications and poorer outcomes.
    • Uncontrolled infection emerged as a key factor influencing unfavorable outcomes in IE.
    • Surgical intervention demonstrated a significant benefit in reducing long-term mortality for IE patients.