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Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: Analysis From the International Collaboration on Endocarditis-Prospective Echo Cohort Study.

Publication ,  Journal Article
Lauridsen, TK; Park, L; Tong, SYC; Selton-Suty, C; Peterson, G; Cecchi, E; Afonso, L; Habib, G; Paré, C; Tamin, S; Dickerman, S; Bayer, AS ...
Published in: Circ Cardiovasc Imaging
July 2015

BACKGROUND: Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown. METHODS AND RESULTS: Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without S aureus IE were matched to those with S aureus IE by the propensity of having S aureus. Survival differences were determined using log-rank significance tests. Independent echocardiographic predictors of mortality were identified using Cox-proportional hazards models that included inverse probability of treatment weighting and surgery as a time-dependent covariate. Of 727 subjects with LNVIE and 1-year follow-up, 202 had S aureus IE. One-year survival rates were significantly lower for patients with S aureus IE overall (57% S aureus IE versus 80% non-S aureus IE; P<0.001) and in the propensity-matched cohort (59% S aureus IE versus 68% non-S aureus IE; P<0.05). Intracardiac abscess (hazard ratio, 2.93; 95% confidence interval, 1.52-5.40; P<0.001) and left ventricular ejection fraction <40% (odds ratio, 3.01; 95% confidence interval, 1.35-6.04; P=0.004) were the only independent echocardiographic predictors of in-hospital mortality in S aureus LNVIE. Valve perforation (hazard ratio, 2.16; 95% confidence interval, 1.21-3.68; P=0.006) and intracardiac abscess (hazard ratio, 2.25; 95% confidence interval, 1.26-3.78; P=0.004) were the only independent predictors of 1-year mortality. CONCLUSIONS: S aureus is an independent predictor of 1-year mortality in subjects with LNVIE. In S aureus LNVIE, intracardiac abscess and left ventricular ejection fraction <40% independently predicted in-hospital mortality and intracardiac abscess and valve perforation independently predicted 1-year mortality.

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Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

July 2015

Volume

8

Issue

7

Start / End Page

e003397

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Staphylococcal Infections
  • Risk Factors
  • Risk Assessment
  • Registries
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Predictive Value of Tests
 

Citation

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Lauridsen, T. K., Park, L., Tong, S. Y. C., Selton-Suty, C., Peterson, G., Cecchi, E., … Crowley, A. L. (2015). Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: Analysis From the International Collaboration on Endocarditis-Prospective Echo Cohort Study. Circ Cardiovasc Imaging, 8(7), e003397. https://doi.org/10.1161/CIRCIMAGING.114.003397
Lauridsen, Trine K., Lawrence Park, Steven Y. C. Tong, Christine Selton-Suty, Gail Peterson, Enrico Cecchi, Luis Afonso, et al. “Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: Analysis From the International Collaboration on Endocarditis-Prospective Echo Cohort Study.Circ Cardiovasc Imaging 8, no. 7 (July 2015): e003397. https://doi.org/10.1161/CIRCIMAGING.114.003397.
Lauridsen TK, Park L, Tong SYC, Selton-Suty C, Peterson G, Cecchi E, Afonso L, Habib G, Paré C, Tamin S, Dickerman S, Bayer AS, Johansson MC, Chu VH, Samad Z, Bruun NE, Fowler VG, Crowley AL. Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: Analysis From the International Collaboration on Endocarditis-Prospective Echo Cohort Study. Circ Cardiovasc Imaging. 2015 Jul;8(7):e003397.

Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

July 2015

Volume

8

Issue

7

Start / End Page

e003397

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Staphylococcal Infections
  • Risk Factors
  • Risk Assessment
  • Registries
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Predictive Value of Tests