Cardio-oncology & otherCohort study
Prognostic impact of vegetation size in infective endocarditis
- registry
Authors' conclusion
In patients with IE, large vegetation size is independently associated with embolic events and increased mortality particularly in those with left-sided IE, suggesting the need for more aggressive management in these patients.
Study context
- Population
- Infective endocarditis (IE) patients from the Spanish IE registry between 2008 and 2024 with documented vegetation size measurementsdocumented vegetation size measurements (55.1%) of 6525 IE patients, 5000 (76.6%) had vegetations
- Participants
- 3,592 patients
- Exposure
- patients with vegetations ≥10 mm compared to patients with small vegetations
- ≥10 mmn = 2,273
- <10 mmn = 1,319reference
Main finding
Embolic events
Odds ratio
1.34
95% CI 1.15–1.55
P < 0.001
By group
≥10 mm vs <10 mm
OR 1.34 (95% CI 1.15–1.55); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | ≥10 mm | <10 mm | Estimate | P value | |
|---|---|---|---|---|---|
| In-hospital mortality · independent predictor | 28.3% | 19.6% | OR 1.6 (95% CI 1.3–1.9) | P < 0.001 | |
| 1-year mortality · independent predictor | 35.6% | 27.5% | hazard ratio 1.32 (95% CI 1.17–1.50) | P < 0.001 | |
| In-hospital mortality by IE side (subgroup) · left-sided IE | OR 1.7 (95% CI 1.4–2.1) | P < 0.001 | |||
| In-hospital mortality by IE side (subgroup) · right-sided IE | OR 1.2 (95% CI 0.7–2.3) | P = 0.50 | |||
| 0.512Ratio (log scale) |
Baseline characteristics and surgery
Age ≥10 mm 68 years · <10 mm 70 years
Right-sided IE
Prosthetic valve IE
Surgical rates
- In-hospital mortality: unadjusted P < 0.001
- 1-year mortality: unadjusted P < 0.001
- Baseline characteristics and surgery: all P < 0.001
Original publication
Prognostic impact of vegetation size in infective endocarditis. Eur Heart J Cardiovasc Imaging. Published 27 February 2026. doi:10.1093/ehjci/jeag061
Summarised from the published abstract; every number is checked against it