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Pericàs, Juan M; Hernández-Meneses, Marta; Muñoz, Patricia; Martínez-Sellés, Manuel; Álvarez-Uria, Ana; de Alarcón, Arístides; Gutiérrez-Carretero, Encarnación; Goenaga, Miguel A; Zarauza, Manuel J; Falces, Carlos; Rodríguez-Esteban, M Ángeles; Hidalgo-Tenorio, Carmen; Hernández-Cabrera, Michele; Miró, Jose M

Characteristics and Outcome of Acute Heart Failure in Infective Endocarditis: Focus on Cardiogenic Shock

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  • Medientyp: E-Artikel
  • Titel: Characteristics and Outcome of Acute Heart Failure in Infective Endocarditis: Focus on Cardiogenic Shock
  • Beteiligte: Pericàs, Juan M; Hernández-Meneses, Marta; Muñoz, Patricia; Martínez-Sellés, Manuel; Álvarez-Uria, Ana; de Alarcón, Arístides; Gutiérrez-Carretero, Encarnación; Goenaga, Miguel A; Zarauza, Manuel J; Falces, Carlos; Rodríguez-Esteban, M Ángeles; Hidalgo-Tenorio, Carmen; Hernández-Cabrera, Michele; Miró, Jose M
  • Erschienen: Oxford University Press (OUP), 2021
  • Erschienen in: Clinical Infectious Diseases
  • Sprache: Englisch
  • DOI: 10.1093/cid/ciab098
  • ISSN: 1058-4838; 1537-6591
  • Schlagwörter: Infectious Diseases ; Microbiology (medical)
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Studies investigating the impact of cardiogenic shock (CS) on endocarditis are lacking.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Prospectively collected cohort from 35 Spanish centers (2008-2018). Logistic regression analyses were performed to identify risk factors for developing CS and predictors of mortality.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Among 4856 endocarditis patients, 1652 (34%) had acute heart failure (AHF) and 244 (5%) CS. Compared with patients without AHF and AHF but no CS, patients with CS presented higher rates of surgery (40.5%, 52.5%, and 68%; P &amp;lt; .001) and in-hospital mortality (16.3%, 39.1%, and 52.5%). Compared with patients with septic shock, CS patients presented higher rates of surgery (42.5% vs 68%; P &amp;lt; .001) and lower rates of in-hospital and 1-year mortality (62.3% vs 52.5%, P = .008, and 65.3% vs 57.4%, P = .030). Severe aortic and mitral regurgitation (OR [95% CI], 2.47 [1.82-3.35] and 3.03 [2.26-4.07]; both P &amp;lt; .001), left-ventricle ejection fraction &amp;lt;60% (1.72; 1.22-2.40; P = .002), heart block (2.22; 1.41-3.47; P = .001), tachyarrhythmias (5.07; 3.13-8.19; P &amp;lt; .001), and acute kidney failure (2.29; 1.73-3.03; P &amp;lt; .001) were associated with higher likelihood of developing CS. Prosthetic endocarditis (2.03; 1.06 -3.88; P = .032), Staphylococcus aureus (3.10; 1.16 -8.30; P = .024), tachyarrhythmias (3.09; 1.50-10.13; P = .005), and not performing cardiac surgery (11.40; 4.83-26.90; P &amp;lt; .001) were associated with a higher risk of mortality.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>AHF is common among patients with endocarditis. CS is associated with high mortality and should be promptly identified and assessed for cardiac surgery.</jats:p> </jats:sec>
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