TY - JOUR

T1 - Temporal Trends, Characteristics, and Outcomes of Infective Endocarditis After Transcatheter Aortic Valve Replacement

AU - Del Val, David

AU - Abdel-Wahab, Mohamed

AU - Linke, Axel

AU - Durand, Eric

AU - Ihlemann, Nikolaj

AU - Urena, Marina

AU - Pellegrini, Costanza

AU - Giannini, Francesco

AU - Landt, Martin

AU - Auffret, Vincent

AU - Sinning, Jan Malte

AU - Cheema, Asim

AU - Nombela-Franco, Luis

AU - Chamandi, Chekrallah

AU - Campelo-Parada, Francisco

AU - Munoz-Garcia, Antonio

AU - Herrmann, Howard C.

AU - Testa, Luca

AU - Won-Keun, Kim

AU - Castillo, Juan Carlos

AU - Alperi, Alberto

AU - Tchetche, Didier

AU - Bartorelli, Antonio

AU - Kapadia, Samir

AU - Stortecky, Stefan

AU - Amat-Santos, Ignacio

AU - Wijeysundera, Harindra C.

AU - Lisko, John

AU - Gutiérrez-Ibanes, Enrique

AU - Serra, Vicenç

AU - Salido, Luisa

AU - Alkhodair, Abdullah

AU - Livi, Ugolino

AU - Chakravarty, Tarun

AU - Lerakis, Stamatios

AU - Vilalta, Victoria

AU - Regueiro, Ander

AU - Romaguera, Rafael

AU - Barbanti, Marco

AU - Masson, Jean Bernard

AU - Maes, Frédéric

AU - Fiorina, Claudia

AU - Miceli, Antonio

AU - Kodali, Susheel

AU - Ribeiro, Henrique B.

AU - Mangione, Jose Armando

AU - de Brito, Fabio Sandoli

AU - Actis Dato, Guglielmo Mario

AU - Rosato, Francesco

AU - Ferreira, Maria Cristina

AU - Lima, Valter Correa

AU - Colafranceschi, Alexandre Siciliano

AU - Abizaid, Alexandre

AU - Marino, Marcos Antonio

AU - Esteves, Vinicius

AU - Andrea, Julio

AU - Godinho, Roger R.

AU - Eltchaninoff, Helene

AU - Søndergaard, Lars

AU - Himbert, Dominique

AU - Husser, Oliver

AU - Latib, Azeem

AU - Le Breton, Hervé

AU - Servoz, Clement

AU - Pascual, Isaac

AU - Siddiqui, Saif

AU - Olivares, Paolo

AU - Hernandez-Antolin, Rosana

AU - Webb, John G.

AU - Sponga, Sandro

AU - Makkar, Raj

AU - Kini, Annapoorna S.

AU - Boukhris, Marouane

AU - Mangner, Norman

AU - Crusius, Lisa

AU - Holzhey, David

AU - Rodés-Cabau, Josep

N1 - Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR. METHODS: Observational study including 552 patients presenting definite IE post-TAVR. Patients were divided in 2 groups according to the timing of TAVR (historical cohort [HC]: before 2014; contemporary cohort [CC]: after 2014). RESULTS: Overall incidence rates of IE were similar in both cohorts (CC vs HC: 5.45 vs 6.52 per 1000 person-years; P = .12), but the rate of early IE was lower in the CC (2.29‰ vs 4.89‰, P < .001). Enterococci were the most frequent microorganism. Most patients presented complicated IE ( CC: 67.7%; HC: 69.6%; P = .66), but the rate of surgical treatment remained low (CC: 20.7%; HC: 17.3%; P = .32). The CC exhibited lower rates of in-hospital acute kidney injury (35.1% vs 44.6%; P = .036) and in-hospital (26.6% vs 36.4%; P = .016) and 1-year (37.8% vs 53.5%; P < .001) mortality. Higher logistic EuroScore, Staphylococcus aureus etiology, and complications (stroke, heart failure, and acute renal failure) were associated with in-hospital mortality in multivariable analyses (P < .05 for all). CONCLUSIONS: Although overall IE incidence has remained stable, the incidence of early IE has declined in recent years. The microorganism, high rate of complications, and very low rate of surgical treatment remained similar. In-hospital and 1-year mortality rates were high but progressively decreased over time.

AB - BACKGROUND: Procedural improvements combined with the contemporary clinical profile of patients undergoing transcatheter aortic valve replacement (TAVR) may have influenced the incidence and outcomes of infective endocarditis (IE) following TAVR. We aimed to determine the temporal trends, characteristics, and outcomes of IE post-TAVR. METHODS: Observational study including 552 patients presenting definite IE post-TAVR. Patients were divided in 2 groups according to the timing of TAVR (historical cohort [HC]: before 2014; contemporary cohort [CC]: after 2014). RESULTS: Overall incidence rates of IE were similar in both cohorts (CC vs HC: 5.45 vs 6.52 per 1000 person-years; P = .12), but the rate of early IE was lower in the CC (2.29‰ vs 4.89‰, P < .001). Enterococci were the most frequent microorganism. Most patients presented complicated IE ( CC: 67.7%; HC: 69.6%; P = .66), but the rate of surgical treatment remained low (CC: 20.7%; HC: 17.3%; P = .32). The CC exhibited lower rates of in-hospital acute kidney injury (35.1% vs 44.6%; P = .036) and in-hospital (26.6% vs 36.4%; P = .016) and 1-year (37.8% vs 53.5%; P < .001) mortality. Higher logistic EuroScore, Staphylococcus aureus etiology, and complications (stroke, heart failure, and acute renal failure) were associated with in-hospital mortality in multivariable analyses (P < .05 for all). CONCLUSIONS: Although overall IE incidence has remained stable, the incidence of early IE has declined in recent years. The microorganism, high rate of complications, and very low rate of surgical treatment remained similar. In-hospital and 1-year mortality rates were high but progressively decreased over time.

KW - infective endocarditis

KW - prosthetic valve endocarditis

KW - TAVR

KW - transcatheter aortic valve replacement

U2 - 10.1093/cid/ciaa1941

DO - 10.1093/cid/ciaa1941

M3 - Journal article

C2 - 33733675

AN - SCOPUS:85120864039

VL - 73

SP - e3750-e3758

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 11

ER -