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Exploring sex differences in infective endocarditis - a prospective, observational study from Western Norway
Stina Jordal1,2, Helga Midtbø3,4, Einar Skulstad Davidsen3
1Section of Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway. stinajordal@gmail.com.
Infective endocarditis (IE) patients who are female face higher mortality rates, particularly with mitral valve involvement. Despite surgery improving survival, females with aortic valve IE receive less timely treatment, indicating potential sex disparities in care.
Area of Science:
- Cardiology
- Infectious Diseases
- Clinical Medicine
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Investigating sex-based differences in IE presentation, treatment, and outcomes is crucial for personalized medicine.
Purpose of the Study:
- To analyze sex disparities in infective endocarditis (IE) among patients in Western Norway.
- To compare clinical characteristics, treatment strategies, and survival rates between female and male IE patients.
Main Methods:
- Prospective observational study of 131 females and 366 males diagnosed with IE (2016-2022).
- Statistical analysis included chi-squared/Fisher's exact tests for characteristics and Kaplan-Meier/Cox regression for survival.
- Follow-up averaged 3.2 years.
Main Results:
- Females exhibited higher 30-day (13% vs. 7%), 90-day (19% vs. 11%), and overall mortality (46% vs. 36%).
- Mitral valve involvement (31% vs. 17%) and Staphylococcus aureus infections (36% vs. 27%) were more common in females.
- Females with aortic valve IE had lower surgery rates (23% vs. 39%) and longer delays (median 25 vs. 21 days).
Conclusions:
- Mitral valve IE in females is linked to significantly higher mortality.
- Sex disparities exist in IE management, with females receiving less timely surgical intervention.
- Further research is needed to address sex-based differences in IE treatment and improve outcomes.
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