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 language | English |
---|---|
Article number | e003397 |
Pages (from-to) | 1-10 |
Number of pages | 10 |
Journal | Circulation. Cardiovascular imaging |
Volume | 8 |
Issue number | 7 |
DOIs | |
Publication status | Published - 10 Jul 2015 |