Gasior Tomasz, Woitek Felix J, Schroth Antonia, Abdel-Wahab Mohamed, Crusius Lisa, Haussig Stephan, Kiefer Philipp, Scislo Piotr, Huczek Zenon, Dabrowski Maciej, Witkowski Adam, Olasinska-Wisniewska Anna, Grygier Marek, Protasiewicz Marcin, Hudziak Damian, Kappert Utz, Holzhey David, Wojakowski Wojtek, Linke Axel, Mangner Norman
Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, 01307 Dresden, Germany.
Department of Cardiology, Heart Center Leipzig, University Hospital, 04289 Leipzig, Germany.
J Clin Med. 2023 Feb 24;12(5):1817. doi: 10.3390/jcm12051817.
The two most common organisms found in infective endocarditis following transcatheter aortic valve implantation (TAVI-IE) are (EC-IE) and (SC-IE). We aimed to compare clinical characteristics and outcomes of patients with EC-IE and SC-IE.
TAVI-IE patients from 2007 to 2021 were included in this analysis. The 1-year mortality was the primary outcome measure of this retrospective multi-center analysis.
Out of 163 patients, 53 (32.5%) EC-IE and 69 (42.3%) SC-IE patients were included. Subjects were comparable with regard to age, sex, and clinically relevant baseline comorbidities. Symptoms at admission were not significantly different between groups, except for a lower risk for presenting with septic shock in EC-IE than SC-IE. Treatment was performed in 78% by antibiotics alone and in 22% of patients by surgery and antibiotics, with no significant differences between groups. The rate of any complication, in particular heart failure, renal failure, and septic shock during treatment for IE, was lower in EC-IE compared with SC-IE ( < 0.05). In-hospital (EC-IE: 36% vs. SC-IE: 56%, = 0.035) and 1-year mortality (EC-IE: 51% vs. SC-IE: 70%, = 0.009) were significantly lower in EC-IE compared with SC-IE.
EC-IE, compared with SC-IE, was associated with a lower morbidity and mortality. However, absolute numbers are high, a finding that should trigger further research in appropriate perioperative antibiotic management and improvement of early IE diagnosis in the case of clinical suspicion.
经导管主动脉瓣植入术后感染性心内膜炎（TAVI-IE）中最常见的两种病原体是[具体病原体1]（EC-IE）和[具体病原体2]（SC-IE）。我们旨在比较EC-IE和SC-IE患者的临床特征及预后。
纳入2007年至2021年的TAVI-IE患者进行分析。1年死亡率是这项回顾性多中心分析的主要结局指标。
163例患者中，纳入了53例（32.5%）EC-IE患者和69例（42.3%）SC-IE患者。受试者在年龄、性别和临床相关基线合并症方面具有可比性。入院时症状在两组间无显著差异，但EC-IE患者出现感染性休克的风险低于SC-IE。78%的患者仅接受抗生素治疗，22%的患者接受手术及抗生素治疗，两组间无显著差异。与SC-IE相比，EC-IE在感染性心内膜炎治疗期间任何并发症的发生率，尤其是心力衰竭、肾衰竭和感染性休克的发生率更低（<0.05）。与SC-IE相比，EC-IE的住院死亡率（EC-IE：36% vs. SC-IE：56%，=0.035）和1年死亡率（EC-IE：51% vs. SC-IE：70%，=0.009）显著更低。
与SC-IE相比，EC-IE的发病率和死亡率更低。然而，绝对数字仍然较高，这一发现应促使进一步研究合适的围手术期抗生素管理，并在临床怀疑时改善感染性心内膜炎的早期诊断。
