The risk for mortality and concomitant valve infection
was high among a group of patients with cardiac device infective endocarditis.
However, researchers for the International Collaboration on
Endocarditis-Prospective Cohort Study suggest that improvements in survival may
occur at 1 year with early removal of the device.
Data were pooled from the study to evaluate the clinical
characteristics and outcome of cardiac device infective endocarditis among
3,284 patients between June 2000 and August 2006. Cardiac device infective
endocarditis was diagnosed in 177 of 2,760 patients diagnosed with definite
infective endocarditis. The median age of patients with cardiac device
infective endocarditis was 71.2 years.
The cause of most cardiac device infective endocarditis
was staphylococci: 62 were caused by Staphylococcus aureus and 56 by
coagulase-negative staphylococci. Patients also had a high prevalence for
health care-associated infection.
Sixty-six patients had coexisting valve involvement
— predominantly tricuspid valve infection. The in-hospital mortality rate
was 14.7% and 1-year mortality was 23.2%. There was a demonstrated survival
benefit at 1 year for those who underwent device removal during the initial
hospitalization.
“Cardiac device infective endocarditis, similar to
native- and prosthetic-valve endocarditis, is significantly influenced by
health care interventions in its development, microbiology and outcome,”
the researchers wrote. “Given that the numbers of cardiovascular
implantable electronic devices placed are increasing rapidly, further studies
on the prevention and treatment of this serious complication are needed.”
References:
- Athan E. JAMA. 2012;307:1727-1735.
Disclosures:
- The researchers report financial relationships with Abbott,
Astellas, Biosynexus, Boehringer-Ingelheim, Bristol-Myers Squibb, Cubist,
Edwards Life Sciences, Galderma, Gilead Sciences, GlaxoSmithKline, Inhibitex,
Janssen-Cilag, Johnson & Johnson, MedImmune, Merck, MSD, NovaDigm,
Novartis, Pfizer, Roche, Schering-Plough, Targanta, The Medicines Company,
Theravance and ViiV.