Cardiac implantable electronic device and associated risk of infective endocarditis in patients undergoing aortic valve replacement
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Cardiac implantable electronic device and associated risk of infective endocarditis in patients undergoing aortic valve replacement. / Østergaard, Lauge; Valeur, Nana; Bundgaard, Henning; Gislason, Gunnar; Torp-Pedersen, Christian; Eske Bruun, Niels; Køber, Lars; Fosbøl, Emil Loldrup.
I: Europace, Bind 20, Nr. 10, 2018, s. e164-e170.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Cardiac implantable electronic device and associated risk of infective endocarditis in patients undergoing aortic valve replacement
AU - Østergaard, Lauge
AU - Valeur, Nana
AU - Bundgaard, Henning
AU - Gislason, Gunnar
AU - Torp-Pedersen, Christian
AU - Eske Bruun, Niels
AU - Køber, Lars
AU - Fosbøl, Emil Loldrup
PY - 2018
Y1 - 2018
N2 - Aims: Patients undergoing aortic valve replacement (AVR) are at increased risk of infective endocarditis (IE) as are patients with a cardiac implantable electronic device (CIED). However, few data exist on the IE risk after AVR surgery in patients with a CIED.Methods and results: Using the Danish administrative registries, we identified patients undergoing AVR from January 1996 to December 2015. Patients were categorized by CIED and non-CIED and followed up till hospitalization due to IE, death, 10 years after AVR discharge, end of study period (December 2015) or emigration, whichever came first. Using multivariable-adjusted Cox proportional hazard analysis with time-varying exposure, we investigated whether CIED was associated with an increased risk of IE. We included 15 538 patients (median age 71.4 years, 25th-75th percentiles 63.7-77.1, and 65.2% male). There were 890 patients with a CIED; 531 of these received their device during the AVR hospitalization and 14 648 patients with no CIED. The crude incidence rate of IE was 149.4/10 000 person-years in the CIED group and 74.3/10 000 person-years in the non-CIED group. Overall, CIED was associated with an increased risk of IE (hazard ratio 1.66, 95% confidence interval 1.27-2.17). There was no difference in associated IE according to the timing of CIED (P for interaction = 0.21 for CIED implantation before vs. in conjunction with AVR surgery).Conclusion: Patients with a CIED who underwent surgery for AVR were associated with an increased risk of IE compared with patients without a CIED. The association was independent of the timing of CIED implantation (before or in conjunction with AVR surgery).
AB - Aims: Patients undergoing aortic valve replacement (AVR) are at increased risk of infective endocarditis (IE) as are patients with a cardiac implantable electronic device (CIED). However, few data exist on the IE risk after AVR surgery in patients with a CIED.Methods and results: Using the Danish administrative registries, we identified patients undergoing AVR from January 1996 to December 2015. Patients were categorized by CIED and non-CIED and followed up till hospitalization due to IE, death, 10 years after AVR discharge, end of study period (December 2015) or emigration, whichever came first. Using multivariable-adjusted Cox proportional hazard analysis with time-varying exposure, we investigated whether CIED was associated with an increased risk of IE. We included 15 538 patients (median age 71.4 years, 25th-75th percentiles 63.7-77.1, and 65.2% male). There were 890 patients with a CIED; 531 of these received their device during the AVR hospitalization and 14 648 patients with no CIED. The crude incidence rate of IE was 149.4/10 000 person-years in the CIED group and 74.3/10 000 person-years in the non-CIED group. Overall, CIED was associated with an increased risk of IE (hazard ratio 1.66, 95% confidence interval 1.27-2.17). There was no difference in associated IE according to the timing of CIED (P for interaction = 0.21 for CIED implantation before vs. in conjunction with AVR surgery).Conclusion: Patients with a CIED who underwent surgery for AVR were associated with an increased risk of IE compared with patients without a CIED. The association was independent of the timing of CIED implantation (before or in conjunction with AVR surgery).
U2 - 10.1093/europace/eux360
DO - 10.1093/europace/eux360
M3 - Journal article
C2 - 29294002
VL - 20
SP - e164-e170
JO - Europace
JF - Europace
SN - 1099-5129
IS - 10
ER -
ID: 214338051