Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study

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ID: 307176
2019
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Abstract
The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE).Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated.Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.
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Authors Gilbert Habib, Paola Anna Erba, Bernard Iung, Erwan Donal, Bernard Cosyns, Cécile Laroche, Bogdan A. Popescu, Bernard Prendergast, Pilar Tornos, Anita Sadeghpour, Léopold Oliver, Jolanta-Justina Vaškelytė, Rouguiatou Sow, Olivier Axler, Aldo P. Maggioni, Patrizio Lancellotti, Chris P Gale, B. Beleslin, Andrzej Budaj, Ovidiu Chioncel, Nikolaos Dagres, Nicolas Danchin, Jonathan Emberson, David Erlinge, Michael Glikson, Adam Gray, Meral Kayıkçıoğlu, V K Nagy, А. О. Недошивин, A-S Petronio, Jolien W. Roos‐Hesselink, Lars Wallentin, Uwe Zeymer, P. Tornos, Maryna Andarala, C Berle, A Brunel-Lebecq, E Fiorucci, C Laroche, V. Missiamenou, Clare Taylor, Nora Nabila Ali Tatar-Chentir, Mouaz H. Al‐Mallah, Meriam Åström Aneq, George Athanassopoulos, Luigi P. Badano, S. Benyoussef, Erick Calderón-Aranda, Nuno Cardim, KL Chan, Isabel Cruz, Thor Edvardsen, Georg Goliasch, Andreas Hagendorff, Krasimira Hristová, Otto Kamp, D-H Kang, William Kong, С.Т. Мацкеплишвили, Marwa Sayed Meshaal, M Mirocevic, Aleksandar Nešković, Michal Pazderník, Edyta Płońska‐Gościniak, Maha Raissouni, Ricardo Ronderos, Leyla Elif Sade, Antonia Sambola, Shantanu P. Sengupta, J Separovic-Hanzevacki, Masami Takeuchi, Edwin S. Tucay, Ana Clara Tude Rodrigues, Andréa Varga, J. Vaskelyte, Kazufumi Yamagata, K Yiangou, H. Zaky, Isabel Granada, M Mahia, S Ressi, Francisco Nacinovich, Ana Iribarren, P. Fernandez Oses
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Journal european heart journal
Year 2019
DOI
10.1093/eurheartj/ehz620
URL
https://academic.oup.com/eurheartj/article-pdf/40/39/3222/30491623/ehz620.pdf
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