Severity of anaemia and association with all-cause mortality in patients with medically managed left-sided endocarditis.
Heart
; 108(11): 882-888, 2022 05 12.
Article
in En
| MEDLINE
| ID: mdl-34611042
ABSTRACT
OBJECTIVE:
To assess the prevalence and severity of anaemia in patients with left-sided infective endocarditis (IE) and association with mortality.METHODS:
In the Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis trial, 400 patients with IE were randomised to conventional or partial oral antibiotic treatment after stabilisation of infection, showing non-inferiority. Haemoglobin (Hgb) levels were measured at randomisation. Primary outcomes were all-cause mortality after 6 months and 3 years. Patients who underwent valve surgery were excluded due to competing reasons for anaemia.RESULTS:
Out of 400 patients with IE, 248 (mean age 70.6 years (SD 11.1), 62 women (25.0%)) were medically managed; 37 (14.9%) patients had no anaemia, 139 (56.1%) had mild anaemia (Hgb <8.1 mmol/L in men and Hgb <7.5 mmol/L in women and Hgb ≥6.2 mmol/L) and 72 (29.0%) had moderate to severe anaemia (Hgb <6.2 mmol/L). Mortality rates in patients with no anaemia, mild anaemia and moderate to severe anaemia were 2.7%, 3.6% and 15.3% at 6-month follow-up and 13.5%, 20.1% and 34.7% at 3-year follow-up, respectively. Moderate to severe anaemia was associated with higher mortality after 6 months (HR 4.81, 95% CI 1.78 to 13.0, p=0.002) and after 3 years (HR 2.14, 95% CI 1.27 to 3.60, p=0.004) and remained significant after multivariable adjustment.CONCLUSION:
Moderate to severe anaemia was present in 29% of patients with medically treated IE after stabilisation of infection and was independently associated with higher mortality within the following 3 years. Further investigations are warranted to determine whether intensified treatment of anaemia in patients with IE might improve outcome.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Endocarditis
/
Endocarditis, Bacterial
/
Anemia
Type of study:
Clinical_trials
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Heart
Journal subject:
CARDIOLOGIA
Year:
2022
Type:
Article
Affiliation country:
Denmark