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Infective endocarditis in adult patients with congenital heart disease

Joost P van Melle1, Jolien W Roos-Hesselink2, Manish Bansal3

  • 1Center for Congenital Heart Diseases, Department of Cardiology, University Medical Center Groningen, University of Groningen, the Netherlands.

International Journal of Cardiology
|October 23, 2022
PubMed

Insights

Congenital heart disease patients with infective endocarditis have a better survival rate. Further research is needed on antibiotic prophylaxis efficacy in these patients, especially after dental procedures.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Clinical Research

Background:

  • Congenital Heart Disease (CHD) increases susceptibility to Infective Endocarditis (IE).
  • Limited data exists on the characteristics and outcomes of IE in CHD patients.

Purpose of the Study:

  • To characterize adult patients with CHD and IE.
  • To compare their baseline characteristics and mortality with non-CHD patients.

Main Methods:

  • Prospective international study (ESC-EORP-EURO-ENDO) of 3111 IE patients.
  • Analysis of 365 adult CHD patients compared to 2746 non-CHD patients.
  • Comparison of baseline characteristics and mortality rates.

Main Results:

  • CHD patients were younger, had fewer comorbidities, and a higher incidence of prior dental procedures and Streptococcus viridans infections.
  • In-hospital mortality was lower in CHD patients (9.0% vs 18.1%).
  • Favorable survival in CHD patients during 700-day follow-up (HR 0.68), with mortality predictors including fistula, cerebral embolus, renal insufficiency, Staphylococcus aureus, and missed surgery.

Conclusions:

  • CHD patients with IE demonstrate improved overall mortality outcomes.
  • High rates of pre-IE dental procedures suggest a need to re-evaluate antibiotic prophylaxis guidelines for CHD patients.
Abstract

Keywords:
Adult congenital heart diseaseEndocarditis

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