2017
DOI: 10.1093/eurheartj/ehw591
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Incidence, risk factors, and predictors of infective endocarditis in adult congenital heart disease: focus on the use of prosthetic material

Abstract: This study provides IE incidence estimates, and determinants of IE risk in a nationwide ACHD cohort. Our findings, essentially informing IE prevention guidelines, indicate valve-containing prosthetics as a main determinant of IE risk whereas other prosthetics, including valve-repair, are not associated with increased risk long term after implantation.

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Cited by 72 publications
(85 citation statements)
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“…We found that early postimplantation Melody valve endocarditis is uncommon, that only one third (32%) of cases occur within the first year after TPVI, and that the risk persists thereafter, with 23% of cases developing beyond 3 years after the procedure. This comes in agreement with the findings of a large contemporary study of patients with adult congenital heart disease (n=14 224 patients),40 in whom the presence of valve‐containing prosthetics was independently associated with greater risk of IE that persists in the long‐term (hazard ratio of IE beyond 12 months after prosthesis implantation, 5.3; 95% CI, 3.5–7.9). The authors suggested that this reflects the fact that the risk is likely not attributable only to surgical factors associated with implantation but also to the mere long‐term presence of those prostheses 40…”
Section: Discussionsupporting
confidence: 89%
“…We found that early postimplantation Melody valve endocarditis is uncommon, that only one third (32%) of cases occur within the first year after TPVI, and that the risk persists thereafter, with 23% of cases developing beyond 3 years after the procedure. This comes in agreement with the findings of a large contemporary study of patients with adult congenital heart disease (n=14 224 patients),40 in whom the presence of valve‐containing prosthetics was independently associated with greater risk of IE that persists in the long‐term (hazard ratio of IE beyond 12 months after prosthesis implantation, 5.3; 95% CI, 3.5–7.9). The authors suggested that this reflects the fact that the risk is likely not attributable only to surgical factors associated with implantation but also to the mere long‐term presence of those prostheses 40…”
Section: Discussionsupporting
confidence: 89%
“…In our registry, IE occurred more commonly in males (61.1%) with a ratio of 1.6:1. This gender predilection for IE was previously reported in Saudi Arabia [35], United Kingdom (UK) [36], Japan [37], and other reports [4][5][6]. There are theories about a potential protective role for estrogen against endothelial damage [7,8] and a less likelihood of developing sepsis in females [9][10][11], but the exact mechanism is not fully understood.…”
Section: Discussionmentioning
confidence: 57%
“…Infectious endocarditis is more frequent compared to the general population (11/1,000 vs. 1.5-6/1,000 cases, respectively). The risk increases in complex CHD cases, intracavitary device bearers (pacemakers, valves) [27], associated comorbidities (immunity defects in DiGeorge syndrome), residual lesions, surgical re-interventions and prior endocarditis.…”
Section: What Are the Main Causes Of Decompensation In Adults With Comentioning
confidence: 99%