Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus aureus endocarditis: Analysis from the international collaboration on endocarditis-prospective echo cohort study

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

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: 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. Methods and Results: 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. Conclusions: 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.

Original languageEnglish (US)
Article numbere003397
JournalCirculation: Cardiovascular Imaging
Volume8
Issue number7
DOIs
StatePublished - May 1 2015

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Endocarditis
Staphylococcus aureus
Cohort Studies
Mortality
Abscess
Confidence Intervals
Hospital Mortality
Stroke Volume
Proportional Hazards Models
Survival Rate
Odds Ratio
Survival

Keywords

  • Echocardiography
  • Endocarditis
  • Odds ratio
  • Risk factors
  • Survival analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus aureus endocarditis : Analysis from the international collaboration on endocarditis-prospective echo cohort study. / Lauridsen, Trine K.; Park, Lawrence; Tong, Steven Y C; Selton-Suty, Christine; Peterson, Gail; Cecchi, Enrico; Afonso, Luis; Habib, Gilbert; Paré, Carlos; Tamin, Syahidah; Dickerman, Stuart; Bayer, Arnold S.; Johansson, Magnus C.; Chu, Vivian H.; Samad, Zainab; Bruun, Niels E.; Fowler, Vance G.; Crowley, Anna Lisa.

In: Circulation: Cardiovascular Imaging, Vol. 8, No. 7, e003397, 01.05.2015.

Research output: Contribution to journalArticle

Lauridsen, TK, Park, L, Tong, SYC, Selton-Suty, C, Peterson, G, Cecchi, E, Afonso, L, Habib, G, Paré, C, Tamin, S, Dickerman, S, Bayer, AS, Johansson, MC, Chu, VH, Samad, Z, Bruun, NE, Fowler, VG & Crowley, AL 2015, 'Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus aureus endocarditis: Analysis from the international collaboration on endocarditis-prospective echo cohort study', Circulation: Cardiovascular Imaging, vol. 8, no. 7, e003397. https://doi.org/10.1161/CIRCIMAGING.114.003397
Lauridsen, Trine K. ; Park, Lawrence ; Tong, Steven Y C ; Selton-Suty, Christine ; Peterson, Gail ; Cecchi, Enrico ; Afonso, Luis ; Habib, Gilbert ; Paré, Carlos ; Tamin, Syahidah ; Dickerman, Stuart ; Bayer, Arnold S. ; Johansson, Magnus C. ; Chu, Vivian H. ; Samad, Zainab ; Bruun, Niels E. ; Fowler, Vance G. ; Crowley, Anna Lisa. / Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus aureus endocarditis : Analysis from the international collaboration on endocarditis-prospective echo cohort study. In: Circulation: Cardiovascular Imaging. 2015 ; Vol. 8, No. 7.
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abstract = "Background: 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. Methods and Results: 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. Conclusions: 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.",
keywords = "Echocardiography, Endocarditis, Odds ratio, Risk factors, Survival analysis",
author = "Lauridsen, {Trine K.} and Lawrence Park and Tong, {Steven Y C} and Christine Selton-Suty and Gail Peterson and Enrico Cecchi and Luis Afonso and Gilbert Habib and Carlos Par{\'e} and Syahidah Tamin and Stuart Dickerman and Bayer, {Arnold S.} and Johansson, {Magnus C.} and Chu, {Vivian H.} and Zainab Samad and Bruun, {Niels E.} and Fowler, {Vance G.} and Crowley, {Anna Lisa}",
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T1 - Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus aureus endocarditis

T2 - Analysis from the international collaboration on endocarditis-prospective echo cohort study

AU - Lauridsen, Trine K.

AU - Park, Lawrence

AU - Tong, Steven Y C

AU - Selton-Suty, Christine

AU - Peterson, Gail

AU - Cecchi, Enrico

AU - Afonso, Luis

AU - Habib, Gilbert

AU - Paré, Carlos

AU - Tamin, Syahidah

AU - Dickerman, Stuart

AU - Bayer, Arnold S.

AU - Johansson, Magnus C.

AU - Chu, Vivian H.

AU - Samad, Zainab

AU - Bruun, Niels E.

AU - Fowler, Vance G.

AU - Crowley, Anna Lisa

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background: 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. Methods and Results: 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. Conclusions: 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.

AB - Background: 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. Methods and Results: 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. Conclusions: 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.

KW - Echocardiography

KW - Endocarditis

KW - Odds ratio

KW - Risk factors

KW - Survival analysis

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