A contemporary picture of enterococcal endocarditis

BACKGROUND: Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking. OBJECTIVES: The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort. METHODS: This was a post h...

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Autores: Pericàs, Juan M., Llopis Pérez, Jaime, Muñoz, Patricia, Gálvez Acebal, Juan, Kestler, Martha, Valerio, Maricela, Hernández-Meneses, Marta, Goneaga, Miguel A., Cobo Belaustegui, Manuel, Montejo, Miguel, Ojeda Burgos, Guillermo, Sousa Regueiro, M. Dolores, Alarcón, Aristides de, Ramos Martínez, Antonio, Miró Meda, José M. (José María), 1956-, GAMES Investigators
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2020
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/164339
Acceso en línea:https://hdl.handle.net/2445/164339
Access Level:acceso abierto
Palabra clave:Endocarditis
Bacteria
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spelling A contemporary picture of enterococcal endocarditisPericàs, Juan M.Llopis Pérez, JaimeMuñoz, PatriciaGálvez Acebal, JuanKestler, MarthaValerio, MaricelaHernández-Meneses, MartaGoneaga, Miguel A.Cobo Belaustegui, ManuelMontejo, MiguelOjeda Burgos, GuillermoSousa Regueiro, M. DoloresAlarcón, Aristides deRamos Martínez, AntonioMiró Meda, José M. (José María), 1956-GAMES InvestigatorsEndocarditisBacteriaEndocarditisBacteriaBACKGROUND: Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking. OBJECTIVES: The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort. METHODS: This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses. RESULTS: Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse. CONCLUSIONS: Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE. Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. KEYWORDS: enterococci; epidemiology; heart failure; infective endocarditis; prosthetic valves; relapsesElsevier B.V.2020202120202020info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion69 p.application/pdfhttps://hdl.handle.net/2445/164339Articles publicats en revistes (Genètica, Microbiologia i Estadística)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: https://doi.org/10.1016/j.jacc.2019.11.047Journal of the American College of Cardiology, 2020, vol. 75, num. 5, p. 482-494https://doi.org/10.1016/j.jacc.2019.11.047cc-by-nc-nd (c) Elsevier B.V., 2020http://creativecommons.org/licenses/by-nc-nd/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1643392026-05-29T05:05:01Z
dc.title.none.fl_str_mv A contemporary picture of enterococcal endocarditis
title A contemporary picture of enterococcal endocarditis
spellingShingle A contemporary picture of enterococcal endocarditis
Pericàs, Juan M.
Endocarditis
Bacteria
Endocarditis
Bacteria
title_short A contemporary picture of enterococcal endocarditis
title_full A contemporary picture of enterococcal endocarditis
title_fullStr A contemporary picture of enterococcal endocarditis
title_full_unstemmed A contemporary picture of enterococcal endocarditis
title_sort A contemporary picture of enterococcal endocarditis
dc.creator.none.fl_str_mv Pericàs, Juan M.
Llopis Pérez, Jaime
Muñoz, Patricia
Gálvez Acebal, Juan
Kestler, Martha
Valerio, Maricela
Hernández-Meneses, Marta
Goneaga, Miguel A.
Cobo Belaustegui, Manuel
Montejo, Miguel
Ojeda Burgos, Guillermo
Sousa Regueiro, M. Dolores
Alarcón, Aristides de
Ramos Martínez, Antonio
Miró Meda, José M. (José María), 1956-
GAMES Investigators
author Pericàs, Juan M.
author_facet Pericàs, Juan M.
Llopis Pérez, Jaime
Muñoz, Patricia
Gálvez Acebal, Juan
Kestler, Martha
Valerio, Maricela
Hernández-Meneses, Marta
Goneaga, Miguel A.
Cobo Belaustegui, Manuel
Montejo, Miguel
Ojeda Burgos, Guillermo
Sousa Regueiro, M. Dolores
Alarcón, Aristides de
Ramos Martínez, Antonio
Miró Meda, José M. (José María), 1956-
GAMES Investigators
author_role author
author2 Llopis Pérez, Jaime
Muñoz, Patricia
Gálvez Acebal, Juan
Kestler, Martha
Valerio, Maricela
Hernández-Meneses, Marta
Goneaga, Miguel A.
Cobo Belaustegui, Manuel
Montejo, Miguel
Ojeda Burgos, Guillermo
Sousa Regueiro, M. Dolores
Alarcón, Aristides de
Ramos Martínez, Antonio
Miró Meda, José M. (José María), 1956-
GAMES Investigators
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Endocarditis
Bacteria
Endocarditis
Bacteria
topic Endocarditis
Bacteria
Endocarditis
Bacteria
description BACKGROUND: Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking. OBJECTIVES: The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort. METHODS: This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses. RESULTS: Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse. CONCLUSIONS: Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE. Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. KEYWORDS: enterococci; epidemiology; heart failure; infective endocarditis; prosthetic valves; relapses
publishDate 2020
dc.date.none.fl_str_mv 2020
2020
2020
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/164339
url https://hdl.handle.net/2445/164339
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.jacc.2019.11.047
Journal of the American College of Cardiology, 2020, vol. 75, num. 5, p. 482-494
https://doi.org/10.1016/j.jacc.2019.11.047
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Elsevier B.V., 2020
http://creativecommons.org/licenses/by-nc-nd/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Elsevier B.V., 2020
http://creativecommons.org/licenses/by-nc-nd/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 69 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier B.V.
publisher.none.fl_str_mv Elsevier B.V.
dc.source.none.fl_str_mv Articles publicats en revistes (Genètica, Microbiologia i Estadística)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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