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Published on: April 25, 2014
Prognostic impact of previous and new myocardial infarction in patients with infective endocarditis
Marienys Lara-González1, Patricia Muñoz2, Álvaro Pedraz-Prieto3
1Institute of Medicine, Royal College of Physicians of Ireland, St James's Hospital, Dublin, Ireland; Universidad Europea, Madrid, Spain.
Background:
Myocardial infarction (MI) impact in the outcome of infective endocarditis (IE) is unknown. Our aim was to evaluate the prevalence and prognostic influence of previous and new MI in a national cohort of IE.
Methods:
Our data come from the Spanish endocarditis registry. We included 6392 patients with IE between 2008 and 2023.
Results:
A total of 568 patients (8.8%) had a previous MI and 83 (1.3%) presented an acute MI (61 without MI history and 22 with reinfarction). Compared to those without previous MI, patients with previous MI had more advanced age (71 vs. 69 years, p < 0.001), were more frequently male (80.4% vs. 66.4%, p < 0.001), had higher age-adjusted Charlson Comorbidity Index (7 vs. 4, p < 0.001), and higher mortality (in-hospital 29.4% vs. 24.9%, one-year 35.4% vs. 30.7%, both p-values <0.001). However, previous MI was not an independent predictor of mortality (in-hospital odds ratio 0.90, 95% confidence interval [CI] 0.70-1.12, p = 0.42; one-year hazard ratio 0.81, 95% CI 0.64-1.02, p = 0.08). New acute MI was associated with mortality (in-hospital 48.2% vs. 25.0%, one-year 57.8% vs. 30.8%, both p-values <0.001) and was an independent predictor of mortality (in-hospital odds ratio 1.9, 95% CI 1.11-3.32, p = 0.02; one-year hazard ratio 2.26, 95% CI 1.32-3.89, p = 0.003).
Conclusions:
IE patients that have a previous MI present an advanced age and frequent comorbidities, and these are the two main reasons for their high mortality. New acute MI duplicates in-hospital and one-year mortality.
Insights
Infective endocarditis patients with prior myocardial infarction (MI) face higher mortality due to age and comorbidities. New acute MI significantly increases mortality risk in these patients.
Area of Science:
- Cardiology
- Infectious Diseases
Background:
- The impact of myocardial infarction (MI) on infective endocarditis (IE) outcomes is not well understood.
- Previous and new MI may influence prognosis in IE patients.
Purpose of the Study:
- To assess the prevalence of previous and new MI in a national IE cohort.
- To evaluate the prognostic significance of MI in IE patients.
Main Methods:
- Utilized data from the Spanish endocarditis registry.
- Included 6392 patients diagnosed with IE between 2008 and 2023.
Main Results:
- 8.8% of patients had a previous MI; 1.3% presented with new acute MI.
- Previous MI patients were older, more male, had higher comorbidity scores, and increased mortality.
- New acute MI independently predicted higher in-hospital and one-year mortality.
Conclusions:
- Advanced age and comorbidities, not previous MI itself, drive mortality in IE patients with prior MI.
- New acute MI doubles in-hospital and one-year mortality in infective endocarditis patients.
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