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Eur Heart J ; 40(39): 3222-3232, 2019 10 14.
Article in English | MEDLINE | ID: mdl-31504413

ABSTRACT

AIMS: The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). METHODS AND RESULTS: Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. CONCLUSION: Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.


Subject(s)
Embolism/microbiology , Endocarditis, Bacterial/diagnostic imaging , Endocarditis, Bacterial/therapy , Positron Emission Tomography Computed Tomography/statistics & numerical data , Adult , Africa, Northern/epidemiology , Aged , Aged, 80 and over , Asia/epidemiology , Community-Acquired Infections/diagnostic imaging , Community-Acquired Infections/epidemiology , Echocardiography/statistics & numerical data , Endocarditis, Bacterial/epidemiology , Endocarditis, Bacterial/microbiology , Enterococcus , Europe/epidemiology , Female , Fluorodeoxyglucose F18 , Heart Valve Prosthesis/adverse effects , Hospital Mortality , Humans , Male , Middle Aged , Prospective Studies , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/epidemiology , Radiopharmaceuticals , Registries , South America/epidemiology , Staphylococcal Infections/complications , Streptococcal Infections/complications , Treatment Outcome
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