The Global, Regional, and National Burden and Trends of Infective Endocarditis From 1990 to 2019: Results From the Global Burden of Disease Study 2019

Chen, Huilong; Zhan, Yuan; Zhang, Kaimin; Gao, Yiping; Chen, Liyuan; Zhan, Juan; Chen, Zirui; Zeng, Zhilin

doi:10.3389/fmed.2022.774224

Cited by 74 publications

(76 citation statements)

References 49 publications

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“…In the current era, the patient profiles include increasing age, frailty, and comorbidities which occur more frequently. At the same time, Staphylococcus strains became the most widely found causative pathogen, replacing oral streptococci [ 1 , 2 , 4 , 5 ].…”

Section: Special Populations Of Infectious Endocarditis In the 21st C...mentioning

confidence: 99%

“…Of note is that IE that occurs in persons who inject drugs (PWID) is rapidly increasing in the United States (US). Among this population, IE due to the use of heroin, which has established itself as the most common unlawful injected drug in the world, has almost doubled in the US between 2006 and 2013 to 681,000 active users [ 1 , 2 , 3 , 4 , 5 , 6 , 46 , 47 ] ( Figure 2 ).…”

Section: Epidemiologymentioning

confidence: 99%

“…The elderly, often with many comorbidities, who are the most affected patient population, have poorer reserves, and therefore become more unwell than previous cohorts [ 1 , 2 , 3 ]. Virulent staphylococci downgraded the role of streptococci and penicillin sensitivity (a hallmark of streptococcal infection), becoming the most common cause of IE in many high-income countries [ 4 , 5 , 6 ]. The population at risk of contracting IE has increased substantially alongside the risk of staphylococcal bacteremia during healthcare.…”

Section: Introductionmentioning

confidence: 99%

“…There are some key points to consider. The first relates to a substantial discrepancy in the presentation of symptoms and in the course of the disease which does not avoid arousing concern for healthcare professionals [ 5 , 13 ]. One of the biggest challenges has been to create dedicated teams in which many specialists collaborate, including immunopathologists, microbiologists, infectious diseases specialists, cardiologists, cardiothoracic surgeons, and radiologists.…”

Section: Introductionmentioning

confidence: 99%

“…As for clinical presentation, one of the main signs is fever, noted in up to 80% of patients with IE [ 1 , 2 , 3 , 4 , 5 ]. Individuals frequently experience, as reported in vast current case series, a new cardiac murmur or worsening of a known murmur in 48% and 20% of cases, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Infective Endocarditis in High-Income Countries

et al. 2022

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Infective endocarditis remains an illness that carries a significant burden to healthcare resources. In recent times, there has been a shift from Streptococcus sp. to Staphylococcus sp. as the primary organism of interest. This has significant consequences, given the virulence of Staphylococcus and its propensity to form a biofilm, rendering non-surgical therapy ineffective. In addition, antibiotic resistance has affected treatment of this organism. The cohorts at most risk for Staphylococcal endocarditis are elderly patients with multiple comorbidities. The innovation of transcatheter technologies alongside other cardiac interventions such as implantable devices has contributed to the increased risk attributable to this cohort. We examined the pathophysiology of infective endocarditis carefully. Inter alia, the determinants of Staphylococcus aureus virulence, interaction with host immunity, as well as the discovery and emergence of a potential vaccine, were investigated. Furthermore, the potential role of prophylactic antibiotics during dental procedures was also evaluated. As rates of transcatheter device implantation increase, endocarditis is expected to increase, especially in this high-risk group. A high level of suspicion is needed alongside early initiation of therapy and referral to the heart team to improve outcomes.

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Section: Special Populations Of Infectious Endocarditis In the 21st C...mentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infective Endocarditis in High-Income Countries

et al. 2022

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Recurrence of valvular involvement in Libman–Sacks endocarditis associated with antiphospholipid syndrome: A case report

Masoumi,

Parizad,

Parvizi

et al. 2024

Clinical Case Reports

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Key Clinical MessageRecurrence of valvular involvement may occur after Libman–Sacks endocarditis surgery, emphasizing the need for frequent multivalvular evaluations with echocardiography or more sensitive methods to optimize surgical outcomes.AbstractThis report presented a 32‐year‐old woman, complaining of recurrent fever and chills. Physical examination revealed the presence of a third heart sound (S3), a pan‐systolic murmur (III/VI) at mitral and tricuspid foci, tachycardia, and fine pulmonary crackles. Transesophageal echocardiography (TEE) revealed severe mitral regurgitation (MR) and moderate tricuspid regurgitation (TR) with vegetations on the mitral valve. Initially, intravenous antibiotic therapy was started simultaneously with diagnostic studies. Despite a positive TEE, negative blood cultures on three separate occasions precluded meeting the diagnostic criteria outlined in the modified Duke criteria. Moreover, the patient's condition continued to deteriorate after antibiotic therapy, leading to the diagnosis of Libman–Sacks endocarditis. The patient was considered a candidate for mitral valve surgery. All vegetations were completely debrided and then the mitral valve was reconstructed. Follow‐up post‐surgery echocardiography revealed the absence of MR and mitral stenosis (MS). Four months later, the patient presented again complaining of fatigue, dyspnea, lower extremity edema, and ascites with evidence of pulmonary hypertension and right heart failure on physical examination. TEE was performed, which revealed severe MR, severe TR, detached artificial chordae, and blood leak from the perforated pericardial patch. Therefore, she was necessitated for valvular surgery and underwent mitral and tricuspid valve surgery. The mitral ring and perforated pericardial patch were removed, and a mitral prosthetic valve was implanted. In addition, the tricuspid valve was repaired. Follow‐up post‐surgery echocardiography revealed the absence of MR and TR. To our knowledge, this is the first case of LSE recurrence with multi‐valvular involvement.

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Impact of valvular surgery according to frailty risk in patients with infective endocarditis

Diaz‐Arocutipa,

Moreno,

Vicent

2024

Clinical Cardiology

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BackgroundObservational studies suggest that valvular surgery can reduce mortality in selected patients with infective endocarditis (IE). However, the benefit of this intervention according to frailty levels remains unclear. Our study aims to assess the effect of valvular surgery according to frailty status in this population.MethodsWe performed a retrospective study using the 2016−2019 National Inpatient Sample database. Adult patients with a primary diagnosis of IE were included. Frailty was assessed using the Hospital Frailty Risk Score. Inverse probability of treatment weighting (IPTW) was used to balance baseline differences between groups.ResultsA total of 53,275 patients with IE were included, with 18.3% underwent valvular surgery. The median age was 52 (34−68) years, with 41% females. Overall, 42.7% had low risk of frailty, 53.1% intermediate risk, and 4.2% high risk. After IPTW adjustment, in‐hospital mortality was similar both for the entire cohort between valvular and non‐valvular surgery groups (3.7% vs. 4.1%, p = .483), and low (1% vs. 0.9%, p = .952) or moderate (5.4% vs. 6%, p = .548) risk of frailty. However, patients at high risk of frailty had significantly lower in‐hospital mortality in the valvular surgery group (4.6% vs. 13.9%, p = .016). Renal replacement therapy was similar between groups across frailty status. In contrast, surgery was associated with increased use of mechanical circulatory support and pacemaker implantation.ConclusionsOur findings suggest that there was no difference in survival between valve surgery and medical management in patients at low/intermediate frailty risk, but not for high‐risk individuals.

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The Global, Regional, and National Burden and Trends of Infective Endocarditis From 1990 to 2019: Results From the Global Burden of Disease Study 2019

Cited by 74 publications

References 49 publications

Infective Endocarditis in High-Income Countries

Infective Endocarditis in High-Income Countries

Recurrence of valvular involvement in Libman–Sacks endocarditis associated with antiphospholipid syndrome: A case report

Impact of valvular surgery according to frailty risk in patients with infective endocarditis

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