Characteristics and outcome of acute heart failure in infective endocarditis: focus on cardiogenic shock.

Background: Studies investigating the impact of cardiogenic shock (CS) on endocarditis are lacking. Methods: Prospectively collected cohort from 35 Spanish centers (2008-2018). Logistic regression analyses were performed to identify risk factors for developing CS and predictors of mortality. Results...

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Detalhes bibliográficos
Autores: Pericàs, Juan M., Hernández Meneses, Marta, Muñoz, Patricia, Martínez Sellés, Manuel, Álvarez-Uria, Ana, Alarcón, Aristides de, Gutiérrez Carretero, Encarnación, Goenaga Sánchez, Miguel Ángel, Zarauza Navarro, Manuel Jesús, Falces Salvador, Carles, Rodríguez Esteban, María Ángeles, Hidalgo Tenorio, Carmen, Hernández Cabrera, Michele, Miró Meda, José M. (José María), 1956-, Spanish Collaboration on Endocarditis—Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES)
Tipo de documento: artigo
Estado:Versión aceptada para publicación
Data de publicação:2021
País:España
Recursos:Universidad de Oviedo (UNIOVI)
Repositório:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/227347
Acesso em linha:https://hdl.handle.net/2445/227347
Access Level:Acceso aberto
Palavra-chave:Aturada cardíaca
Cirurgia
Endocarditis
Cardiac arrest
Surgery
Descrição
Resumo:Background: Studies investigating the impact of cardiogenic shock (CS) on endocarditis are lacking. Methods: Prospectively collected cohort from 35 Spanish centers (2008-2018). Logistic regression analyses were performed to identify risk factors for developing CS and predictors of mortality. Results: Among 4856 endocarditis patients, 1652 (34%) had acute heart failure (AHF) and 244 (5%) CS. Compared with patients without AHF and AHF but no CS, patients with CS presented higher rates of surgery (40.5%, 52.5%, and 68%; P < .001) and in-hospital mortality (16.3%, 39.1%, and 52.5%). Compared with patients with septic shock, CS patients presented higher rates of surgery (42.5% vs 68%; P < .001) and lower rates of in-hospital and 1-year mortality (62.3% vs 52.5%, P = .008, and 65.3% vs 57.4%, P = .030). Severe aortic and mitral regurgitation (OR [95% CI], 2.47 [1.82-3.35] and 3.03 [2.26-4.07]; both P < .001), left-ventricle ejection fraction <60% (1.72; 1.22-2.40; P = .002), heart block (2.22; 1.41-3.47; P = .001), tachyarrhythmias (5.07; 3.13-8.19; P < .001), and acute kidney failure (2.29; 1.73-3.03; P < .001) were associated with higher likelihood of developing CS. Prosthetic endocarditis (2.03; 1.06 -3.88; P = .032), Staphylococcus aureus (3.10; 1.16 -8.30; P = .024), tachyarrhythmias (3.09; 1.50-10.13; P = .005), and not performing cardiac surgery (11.40; 4.83-26.90; P < .001) were associated with a higher risk of mortality. Conclusions: AHF is common among patients with endocarditis. CS is associated with high mortality and should be promptly identified and assessed for cardiac surgery. Trial registration: ClinicalTrials.gov NCT00871104.

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