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Infective endocarditis in patients with and without CHD: a meta-analysis of age-specific outcomes

Juan Pinilla1, Brijesh Baral2, Guilherme Rosseto3

  • 1School of Medicine, https://ror.org/037p13h95CES University, Colombia.

Cardiology in the Young
|March 27, 2026
PubMed

Insights

Infective endocarditis outcomes in patients with congenital heart disease (CHD) differ by age. Adults with CHD had lower mortality, while children faced higher risks, necessitating tailored management strategies.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Infective endocarditis (IE) is a severe condition, particularly impacting patients with congenital heart disease (CHD) due to underlying structural issues and medical interventions.
  • Limited comparative data exists on IE outcomes stratified by age in patients with and without CHD.

Purpose of the Study:

  • To compare infective endocarditis outcomes in patients with and without congenital heart disease across different age groups.
  • To identify age-specific differences in mortality and causative pathogens for IE in patients with CHD.

Main Methods:

  • A systematic literature search was conducted across PubMed, Embase, and Cochrane databases.
  • Included studies were observational cohort studies comparing IE outcomes in CHD versus non-CHD populations.
  • Risk ratios (RR) with 95% confidence intervals (CI) were pooled using random-effects models.

Main Results:

  • Six cohort studies involving 180,194 patients (176,882 adults, 3312 children) were analyzed.
  • Congenital heart disease was associated with lower in-hospital mortality in adults (RR 0.42) but higher risk in children (RR 1.59).
  • Streptococcus IE was more frequent in adults with CHD (RR 1.28), while Staphylococcus aureus IE was less common in both adult and pediatric CHD patients.

Conclusions:

  • Mortality patterns for infective endocarditis in congenital heart disease vary significantly with age.
  • Adults with CHD experienced lower mortality, whereas children with CHD faced increased mortality risk.
  • The prevalence of specific pathogens (Streptococcus, Staphylococcus aureus) in IE differs between CHD and non-CHD patients and across age groups, underscoring the need for age-specific management.
Abstract

Keywords:
CHDinfective endocarditismeta-analysis

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