Tricuspid vs Bicuspid Aortic Valve Endocarditis: Delayed Symptom-Onset-to-Diagnosis Time in Bicuspid Patients Increases Their Complication Burden
Authors' conclusion
BAV-IE patients incur delayed symptom-to-diagnosis time resulting in high IE complication burden, despite predominance of less virulent streptococcal causative microorganisms.
Study context
- Population
- Consecutive adults (≥18 years) with native aortic valve IE, all Mayo Clinic US sites, 2015–2021
- Participants
- 52 vs 244
- Exposure
- Bicuspid aortic valve infective endocarditis (BAV-IE) vs TAV-IE
- BAV-IEn = 52
- TAV-IEn = 244reference
- Outcome
- Symptom-to-diagnosis time and its effect on outcomes (IE-related MACE: perivalvular infection extension, septic embolism, HF and/or surgery)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Symptom-to-diagnosis time
P < 0.0001
Observational data: associations, not effects.
Further findings
IE-related MACE
P < 0.0001
Streptococcal infections
P = 0.0004
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Independent associations with IE-MACEAge · per 10-years | 0.74 (0.59–0.92) | P = 0.006 | |
| Independent associations with IE-MACEBAVvs TAV-IE | 4.91 (1.08–22.38) | P = 0.04 | |
| Independent associations with IE-MACESymptom-to-diagnosis time · per week | 1.23 (1.09–1.38) | P = 0.001 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | BAV-IE | TAV-IE | P value |
|---|---|---|---|
| Suspected dental procedure source | 10 | 2% | P = 0.006 |
- Independent associations with IE-MACE — Linear increase in odds of IE-MACE per week of diagnosis delay
- 23%
4-year survival
- Superior in BAV-IE, but similar after age and sex adjustment
Original publication
Tricuspid vs Bicuspid Aortic Valve Endocarditis: Delayed Symptom-Onset-to-Diagnosis Time in Bicuspid Patients Increases Their Complication Burden. JACC Adv. Published 28 October 2025. doi:10.
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