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Título: | Multivalvular Endocarditis: A Rare Condition with Poor Prognosis |
Autor: | Álvarez-Zaballos, Sara; González Ramallo, Víctor; Quintana, Eduard; Muñoz, Patricia; Villa, Sofía de la; Fariñas, María del Carmen; Arnaiz-De Las Revillas, Francisco; Alarcón González, Arístides de CSIC ORCID; Rodríguez Esteban, Ángeles; Miró, José María; Goenaga Sánchez, Miguel Ángel; Goikoetxea-Aguirre, Josune; García Vázquez, Elisa; Boix-Palop, Lucía; Martínez-Sellés, Manuel; GAMEs investigators | Palabras clave: | Infective endocarditis Mortality Multivalvular endocarditis Prognosis |
Fecha de publicación: | 13-ago-2022 | Editor: | Multidisciplinary Digital Publishing Institute | Citación: | Journal of Clinical Medicine 11(16): 4736 (2022) | Resumen: | [Background] Infective endocarditis (IE) is a severe condition. Our aim was to describe the profile and prognosis of patients with multivalvular infective endocarditis (MIE) and compare them to single-valve IE (SIE). Methods. We used a retrospective analysis of the Spanish IE Registry (2008−2020). [Results] From 4064 definite cases of valvular IE, 577 (14.2%) had MIE. In patients with MIE, the most common locations were mitral (552, 95.7%) and aortic (550, 95.3%), with mitral-aortic involvement present in 507 patients (87.9%). The most common etiologies were S. viridans (192, 33.3%) and S. aureus (113, 19.6%). MIE involved only native valves in 450 patients (78.0%). Compared with patients with SIE, patients with MIE had a similar age (69 vs. 67 years, respectively, p = 0.27) and similar baseline characteristics, but were more frequently men (67.1% vs. 72.9%, p = 0.005) and had a higher incidence of intracardiac complications (36.2% vs. 50.4%, p < 0.001), heart failure (42.7% vs. 52.9%, p < 0.001), surgical indication (67.7 vs. 85.1%, p < 0.001), surgery (46.3% vs. 56.3%), and in-hospital mortality (26.9% vs. 34.3%, p < 0.001). MIE was an independent predictor of in-hospital mortality (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1−1.7, p = 0.004) but did not have an independent association with 1-year mortality (OR 1.1, 95% CI 0.9−1.4, p = 0.43). [Conclusions] About one-seventh of the valvular IE patients had MIE, mainly due to mitral-aortic involvement. MIE is associated with a poor in-hospital prognosis. An early diagnosis and treatment of IE might avoid its spread to a second valve. |
Versión del editor: | https://doi.org/10.3390/jcm11164736 | URI: | http://hdl.handle.net/10261/306902 | DOI: | 10.3390/jcm11164736 | E-ISSN: | 2077-0383 |
Aparece en las colecciones: | (IBIS) Artículos |
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