One-year outcome following biological or mechanical valve replacement for infective endocarditis

International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background Nearly half of patients require cardiac surgery during the acute phase of infective endocarditis (IE). We describe the characteristics of patients according to the type of valve replacement (mechanical or biological), and examine whether the type of prosthesis was associated with in-hospital and 1-year mortality.

Methods and results Among 5591 patients included in the International Collaboration on Endocarditis Prospective Cohort Study, 1467 patients with definite IE were operated on during the active phase and had a biological (37%) or mechanical (63%) valve replacement. Patients who received bioprostheses were older (62 vs 54 years), more often had a history of cancer (9% vs 6%), and had moderate or severe renal disease (9% vs 4%); proportion of health care-associated IE was higher (26% vs 17%); intracardiac abscesses were more frequent (30% vs 23%). In-hospital and 1-year death rates were higher in the bioprosthesis group, 20.5% vs 14.0% (p = 0.0009) and 25.3% vs 16.6% (p <.0001), respectively. In multivariable analysis, mechanical prostheses were less commonly implanted in older patients (odds ratio: 0.64 for every 10 years), and in patients with a history of cancer (0.72), but were more commonly implanted in mitral position (1.60). Bioprosthesis was independently associated with 1-year mortality (hazard ratio: 1.298).

Conclusions Patients with IE who receive a biological valve replacement have significant differences in clinical characteristics compared to patients who receive a mechanical prosthesis. Biological valve replacement is independently associated with a higher in-hospital and 1-year mortality, a result which is possibly related to patient characteristics rather than valve dysfunction.

Original languageEnglish (US)
Pages (from-to)117-123
Number of pages7
JournalInternational Journal of Cardiology
Volume178
DOIs
StatePublished - Jan 15 2015

Fingerprint

Endocarditis
Bioprosthesis
Prostheses and Implants
Mortality
Abscess
Thoracic Surgery
Neoplasms
Cohort Studies
Odds Ratio
Prospective Studies
Delivery of Health Care
Kidney

Keywords

  • Infective endocarditis
  • Surgery
  • Valve prosthesis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators (2015). One-year outcome following biological or mechanical valve replacement for infective endocarditis. International Journal of Cardiology, 178, 117-123. https://doi.org/10.1016/j.ijcard.2014.10.125

One-year outcome following biological or mechanical valve replacement for infective endocarditis. / International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators.

In: International Journal of Cardiology, Vol. 178, 15.01.2015, p. 117-123.

Research output: Contribution to journalArticle

International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators 2015, 'One-year outcome following biological or mechanical valve replacement for infective endocarditis', International Journal of Cardiology, vol. 178, pp. 117-123. https://doi.org/10.1016/j.ijcard.2014.10.125
International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators. One-year outcome following biological or mechanical valve replacement for infective endocarditis. International Journal of Cardiology. 2015 Jan 15;178:117-123. https://doi.org/10.1016/j.ijcard.2014.10.125
International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators. / One-year outcome following biological or mechanical valve replacement for infective endocarditis. In: International Journal of Cardiology. 2015 ; Vol. 178. pp. 117-123.
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abstract = "Background Nearly half of patients require cardiac surgery during the acute phase of infective endocarditis (IE). We describe the characteristics of patients according to the type of valve replacement (mechanical or biological), and examine whether the type of prosthesis was associated with in-hospital and 1-year mortality.Methods and results Among 5591 patients included in the International Collaboration on Endocarditis Prospective Cohort Study, 1467 patients with definite IE were operated on during the active phase and had a biological (37{\%}) or mechanical (63{\%}) valve replacement. Patients who received bioprostheses were older (62 vs 54 years), more often had a history of cancer (9{\%} vs 6{\%}), and had moderate or severe renal disease (9{\%} vs 4{\%}); proportion of health care-associated IE was higher (26{\%} vs 17{\%}); intracardiac abscesses were more frequent (30{\%} vs 23{\%}). In-hospital and 1-year death rates were higher in the bioprosthesis group, 20.5{\%} vs 14.0{\%} (p = 0.0009) and 25.3{\%} vs 16.6{\%} (p <.0001), respectively. In multivariable analysis, mechanical prostheses were less commonly implanted in older patients (odds ratio: 0.64 for every 10 years), and in patients with a history of cancer (0.72), but were more commonly implanted in mitral position (1.60). Bioprosthesis was independently associated with 1-year mortality (hazard ratio: 1.298).Conclusions Patients with IE who receive a biological valve replacement have significant differences in clinical characteristics compared to patients who receive a mechanical prosthesis. Biological valve replacement is independently associated with a higher in-hospital and 1-year mortality, a result which is possibly related to patient characteristics rather than valve dysfunction.",
keywords = "Infective endocarditis, Surgery, Valve prosthesis",
author = "{International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators} and Francois Delahaye and Chu, {Vivian H.} and Javier Altclas and Bruno Barsic and Armelle Delahaye and Tomas Freiberger and Gordon, {D. L.} and Hannan, {M. M.} and Bruno Hoen and Kanj, {Souha S.} and Tatjana Lejko-Zupanc and Mestres, {Carlos A.} and Orathai Pachirat and Paul Pappas and Cristiane Lamas and Christine Selton-Suty and Ren Tan and Pierre Tattevin and Andrew Wang and Liliana Clara and Marisa Sanchez and Jos{\'e} Casab{\'e} and Claudia Cortes and Francisco Nacinovich and Oses, {Pablo Fernandez} and Ricardo Ronderos and Adriana Sucari and Jorge Thierer and Silvia Kogan and Denis Spelman and Eugene Athan and Owen Harris and Karina Kennedy and David Gordon and Lito Papanicolas and Damon Eisen and Leeanne Grigg and Alan Street and Tony Korman and Despina Kotsanas and Robyn Dever and Phillip Jones and Pam Konecny and Richard Lawrence and David Rees and Suzanne Ryan and Feneley, {Michael P.} and John Harkness and Bedimo, {Roger J} and Peterson, {Gail E}",
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T1 - One-year outcome following biological or mechanical valve replacement for infective endocarditis

AU - International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators

AU - Delahaye, Francois

AU - Chu, Vivian H.

AU - Altclas, Javier

AU - Barsic, Bruno

AU - Delahaye, Armelle

AU - Freiberger, Tomas

AU - Gordon, D. L.

AU - Hannan, M. M.

AU - Hoen, Bruno

AU - Kanj, Souha S.

AU - Lejko-Zupanc, Tatjana

AU - Mestres, Carlos A.

AU - Pachirat, Orathai

AU - Pappas, Paul

AU - Lamas, Cristiane

AU - Selton-Suty, Christine

AU - Tan, Ren

AU - Tattevin, Pierre

AU - Wang, Andrew

AU - Clara, Liliana

AU - Sanchez, Marisa

AU - Casabé, José

AU - Cortes, Claudia

AU - Nacinovich, Francisco

AU - Oses, Pablo Fernandez

AU - Ronderos, Ricardo

AU - Sucari, Adriana

AU - Thierer, Jorge

AU - Kogan, Silvia

AU - Spelman, Denis

AU - Athan, Eugene

AU - Harris, Owen

AU - Kennedy, Karina

AU - Gordon, David

AU - Papanicolas, Lito

AU - Eisen, Damon

AU - Grigg, Leeanne

AU - Street, Alan

AU - Korman, Tony

AU - Kotsanas, Despina

AU - Dever, Robyn

AU - Jones, Phillip

AU - Konecny, Pam

AU - Lawrence, Richard

AU - Rees, David

AU - Ryan, Suzanne

AU - Feneley, Michael P.

AU - Harkness, John

AU - Bedimo, Roger J

AU - Peterson, Gail E

PY - 2015/1/15

Y1 - 2015/1/15

N2 - Background Nearly half of patients require cardiac surgery during the acute phase of infective endocarditis (IE). We describe the characteristics of patients according to the type of valve replacement (mechanical or biological), and examine whether the type of prosthesis was associated with in-hospital and 1-year mortality.Methods and results Among 5591 patients included in the International Collaboration on Endocarditis Prospective Cohort Study, 1467 patients with definite IE were operated on during the active phase and had a biological (37%) or mechanical (63%) valve replacement. Patients who received bioprostheses were older (62 vs 54 years), more often had a history of cancer (9% vs 6%), and had moderate or severe renal disease (9% vs 4%); proportion of health care-associated IE was higher (26% vs 17%); intracardiac abscesses were more frequent (30% vs 23%). In-hospital and 1-year death rates were higher in the bioprosthesis group, 20.5% vs 14.0% (p = 0.0009) and 25.3% vs 16.6% (p <.0001), respectively. In multivariable analysis, mechanical prostheses were less commonly implanted in older patients (odds ratio: 0.64 for every 10 years), and in patients with a history of cancer (0.72), but were more commonly implanted in mitral position (1.60). Bioprosthesis was independently associated with 1-year mortality (hazard ratio: 1.298).Conclusions Patients with IE who receive a biological valve replacement have significant differences in clinical characteristics compared to patients who receive a mechanical prosthesis. Biological valve replacement is independently associated with a higher in-hospital and 1-year mortality, a result which is possibly related to patient characteristics rather than valve dysfunction.

AB - Background Nearly half of patients require cardiac surgery during the acute phase of infective endocarditis (IE). We describe the characteristics of patients according to the type of valve replacement (mechanical or biological), and examine whether the type of prosthesis was associated with in-hospital and 1-year mortality.Methods and results Among 5591 patients included in the International Collaboration on Endocarditis Prospective Cohort Study, 1467 patients with definite IE were operated on during the active phase and had a biological (37%) or mechanical (63%) valve replacement. Patients who received bioprostheses were older (62 vs 54 years), more often had a history of cancer (9% vs 6%), and had moderate or severe renal disease (9% vs 4%); proportion of health care-associated IE was higher (26% vs 17%); intracardiac abscesses were more frequent (30% vs 23%). In-hospital and 1-year death rates were higher in the bioprosthesis group, 20.5% vs 14.0% (p = 0.0009) and 25.3% vs 16.6% (p <.0001), respectively. In multivariable analysis, mechanical prostheses were less commonly implanted in older patients (odds ratio: 0.64 for every 10 years), and in patients with a history of cancer (0.72), but were more commonly implanted in mitral position (1.60). Bioprosthesis was independently associated with 1-year mortality (hazard ratio: 1.298).Conclusions Patients with IE who receive a biological valve replacement have significant differences in clinical characteristics compared to patients who receive a mechanical prosthesis. Biological valve replacement is independently associated with a higher in-hospital and 1-year mortality, a result which is possibly related to patient characteristics rather than valve dysfunction.

KW - Infective endocarditis

KW - Surgery

KW - Valve prosthesis

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DO - 10.1016/j.ijcard.2014.10.125

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JO - International Journal of Cardiology

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