Incidence and outcomes of prosthetic valve endocarditis in adults with congenital heart disease
Authors' conclusion
PVE was common in CHD patients with prosthetic valves and was associated with all-cause mortality. These findings highlight the prognostic implications of prosthetic valve implantation in patients with CHD, and the need for new criteria for risk stratification in order to improve outcomes.
Study context
- Population
- Adults with congenital heart disease (CHD) and prior prosthetic valve implantation (2003–2023)patients with prosthetic valves, of 9161 patients
- Participants
- 3,150 adults
- Exposure
- Prosthetic valve endocarditis (PVE) group vs reference group
- PVE groupn = 86
- Outcome
- Incidence of PVE
Main finding
As reported in the abstract
Patients with prosthetic valve who developed PVE
86
2.7%
Incidence (95% CI 4.8-1-5.6) events per 1000 patient-years
5.2
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted hazard ratio (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality | 2.21 (1.33–3.68) | P = 0.002 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- All-cause mortality: after adjustment for demographic/anatomic indices, and comorbidities
Characteristics of the 86 patients with PVE
- Average age at PVE diagnosis
- 35 ± 9 years
- Average interval between prosthetic valve implantation and PVE
- 91 ± 27 months
- Mean duration of follow-up
- 11.6 ± 4.9 years
Risk factors for PVE
- Male sex, younger age, type 2 diabetes, multiple prosthetic valves, and Melody bioprosthetic valve implantation
Deaths among patients with PVE · during follow-up
- Of 86 patients with PVE, died
- 21 (24%)
Mortality after diagnosis of PVE · 30-day, 1-year, and 5-year
- 30-day
- 1.6%
- 1-year
- 12%
- 5-year
- 15%
PVE-related complications
- Of 86 patients with PVE, developed PVE-related complications
- 39 (45%)
- PVE-related complications
- 47
- Perivalvular abscess
- n = 21
- Septic emboli
- n = 26
- PVE-related complications were associated with all-cause mortality
Original publication
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