Related Experiment Video
Updated: Jun 12, 2025
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Outcomes and Predictors of Inpatient Mortality for Marantic Endocarditis Complicating Systemic Lupus Erythematosus:
Krishna Sanaka1, Joanne Mathew2, Asef Raiyan Hoque3
1Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic institute, Cleveland Clinic, Cleveland, OH, USA.
Abstract:
Systemic lupus erythematosus (SLE) patients are susceptible to marantic endocarditis (ME) due to a hypercoagulable state. The literature regarding the epidemiology and outcomes of ME in SLE patients is limited. All patients ≥18 years who had SLE with and without ME between 2007 and 2019 were identified from the National Inpatient Sample in the United States (US). Predictors of inpatient mortality for SLE patients with ME were analyzed. Between 2007 and 2019, there were 508,818 hospitalizations for SLE, of which 785 (0.2%) had ME. Of SLE patients with ME, 33 (4.2%) died while hospitalized over the study period. On multivariate analysis, female sex (adjusted odds ratio (aOR), 95% confidence intervals: 24.72 (3.21, 190.27)), age <34 years (aOR: 6.81 (1.80, 25.79)), anemia (aOR: 3.41 (1.12, 10.40)), antiphospholipid syndrome (aOR: 13.50 (3.83, 47.64)), stroke complicating ME (aOR: 9.64 (3.24, 28.71)), and acute kidney injury (aOR: 3.74 (1.06, 13.20)) were all associated with increased inpatient mortality among SLE patients with ME (P < .05 for all). Between 2007 to 2019, ME occurred in 0.2% of SLE hospitalizations, with a 4.2% average inpatient mortality over the study period. Female sex, antiphospholipid syndrome, and stroke were most strongly associated with increased inpatient mortality.
Insights
Systemic lupus erythematosus patients face a risk of marantic endocarditis. Female sex, antiphospholipid syndrome, and stroke significantly increase inpatient mortality risk in these patients.
Area of Science:
- Rheumatology
- Cardiology
- Internal Medicine
Background:
- Systemic lupus erythematosus (SLE) patients exhibit a hypercoagulable state, increasing susceptibility to marantic endocarditis (ME).
- Limited literature exists on the epidemiology and outcomes of ME in SLE patients.
Purpose of the Study:
- To investigate the incidence and predictors of inpatient mortality for ME in SLE patients.
Main Methods:
- Retrospective analysis of the National Inpatient Sample (US) from 2007-2019.
- Inclusion criteria: patients aged ≥18 years with SLE, with and without ME.
- Multivariate analysis to identify predictors of inpatient mortality in SLE patients with ME.
Main Results:
- ME occurred in 785 (0.2%) of 508,818 SLE hospitalizations.
- Inpatient mortality for SLE patients with ME was 4.2% (33 deaths).
- Predictors of mortality included female sex, age <34, anemia, antiphospholipid syndrome, stroke, and acute kidney injury.
Conclusions:
- Marantic endocarditis is an infrequent but serious complication in SLE hospitalizations.
- Female sex, antiphospholipid syndrome, and stroke are strongly associated with increased inpatient mortality in SLE patients with ME.
Related Concept Videos
01:29Endocarditis IV: Nursing Management
01:18Endocarditis III: Medical Management
01:25Endocarditis II: Clinical features and Diagnostic Tests
01:22Myocarditis IV: Nursing Management
01:14Myocarditis III: Medical Management
01:25Endocarditis I: Introduction