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Multivalvular vs single-valve infective endocarditis: a systematic review and meta-analysis
Ioannis Kyriakoulis1, Andreas Tzoumas2, Konstantinos G Kyriakoulis3
1Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Future Cardiology
|January 30, 2025
Summary
Multivalvular infective endocarditis (MIE) is linked to worse outcomes than single-valve infective endocarditis (SIE). MIE increases risks for mortality, heart failure, and embolic events, necessitating prompt diagnosis and treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Infective endocarditis (IE) involves heart valve colonization by microorganisms.
- Single-valve infective endocarditis (SIE) is common, while multivalvular infective endocarditis (MIE) affects multiple valves.
- Prognosis and complication risks for MIE versus SIE are not well-established.
Purpose of the Study:
- To compare the clinical outcomes of MIE and SIE.
- To evaluate the association between MIE and adverse events compared to SIE.
Main Methods:
- Systematic literature search of MEDLINE and Scopus databases.
- Inclusion of studies reporting on patients with MIE and SIE.
- Analysis of outcomes including mortality, heart failure, embolic events, and need for surgery.
Main Results:
- MIE was identified in 20.4% of patients across eleven studies.
- MIE significantly increased risks for short-term mortality (RR: 1.29), one-year mortality (RR: 1.20), and heart failure (RR: 1.31).
- MIE was also associated with higher rates of systemic embolic events (RR: 1.12) and need for surgery (RR: 1.22).
Conclusions:
- Multivalvular infective endocarditis portends a poorer prognosis than single-valve infective endocarditis.
- Increased clinical suspicion and timely intervention are crucial for managing MIE.
- Findings highlight the importance of recognizing MIE for improved patient outcomes.
