Title |
Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis
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Published in |
Circulation: Cardiovascular Imaging, July 2015
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DOI | 10.1161/circimaging.114.003397 |
Pubmed ID | |
Authors |
Trine K Lauridsen, Lawrence Park, Steven Y C Tong, Christine Selton-Suty, Gail Peterson, Enrico Cecchi, Luis Afonso, Gilbert Habib, Carlos Paré, Syahidah Tamin, Stuart Dickerman, Arnold S Bayer, Magnus C Johansson, Vivian H Chu, Zainab Samad, Niels E Bruun, Vance G Fowler, Anna Lisa Crowley |
Abstract |
Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown. Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without S aureus IE were matched to those with S aureus IE by the propensity of having S aureus. Survival differences were determined using log-rank significance tests. Independent echocardiographic predictors of mortality were identified using Cox-proportional hazards models that included inverse probability of treatment weighting and surgery as a time-dependent covariate. Of 727 subjects with LNVIE and 1-year follow-up, 202 had S aureus IE. One-year survival rates were significantly lower for patients with S aureus IE overall (57% S aureus IE versus 80% non-S aureus IE; P<0.001) and in the propensity-matched cohort (59% S aureus IE versus 68% non-S aureus IE; P<0.05). Intracardiac abscess (hazard ratio, 2.93; 95% confidence interval, 1.52-5.40; P<0.001) and left ventricular ejection fraction <40% (odds ratio, 3.01; 95% confidence interval, 1.35-6.04; P=0.004) were the only independent echocardiographic predictors of in-hospital mortality in S aureus LNVIE. Valve perforation (hazard ratio, 2.16; 95% confidence interval, 1.21-3.68; P=0.006) and intracardiac abscess (hazard ratio, 2.25; 95% confidence interval, 1.26-3.78; P=0.004) were the only independent predictors of 1-year mortality. S aureus is an independent predictor of 1-year mortality in subjects with LNVIE. In S aureus LNVIE, intracardiac abscess and left ventricular ejection fraction <40% independently predicted in-hospital mortality and intracardiac abscess and valve perforation independently predicted 1-year mortality. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Spain | 6 | 23% |
United States | 4 | 15% |
Peru | 3 | 12% |
Argentina | 2 | 8% |
India | 2 | 8% |
Canada | 1 | 4% |
Mexico | 1 | 4% |
Netherlands | 1 | 4% |
Unknown | 6 | 23% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 17 | 65% |
Practitioners (doctors, other healthcare professionals) | 5 | 19% |
Science communicators (journalists, bloggers, editors) | 2 | 8% |
Scientists | 2 | 8% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Denmark | 1 | 2% |
Unknown | 44 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 7 | 16% |
Researcher | 6 | 13% |
Student > Bachelor | 4 | 9% |
Student > Ph. D. Student | 4 | 9% |
Other | 3 | 7% |
Other | 7 | 16% |
Unknown | 14 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 28 | 62% |
Immunology and Microbiology | 1 | 2% |
Nursing and Health Professions | 1 | 2% |
Unknown | 15 | 33% |