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Echocardiographic Findings Predict In-Hospital and One-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: An Analysis from The International Collaboration on Endocarditis-Prospective Echo Cohort Study

Identifieur interne : 001D11 ( Pmc/Curation ); précédent : 001D10; suivant : 001D12

Echocardiographic Findings Predict In-Hospital and One-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: An Analysis from The International Collaboration on Endocarditis-Prospective Echo Cohort Study

Auteurs : Trine K. Lauridsen [États-Unis, Danemark] ; Lawrence Park [États-Unis] ; Steven Y. C. Tong [Australie] ; Christine Selton-Suty [France] ; Gail Peterson [États-Unis] ; Enrico Cecchi [Italie] ; Luis Afonso [États-Unis] ; Gilbert Habib [France] ; Carlos Paré [Espagne] ; Syahidah Tamin [Malaisie] ; Stuart Dickerman [États-Unis] ; Arnold S. Bayer [États-Unis] ; Magnus C. Johansson [Suède] ; Vivian H. Chu [États-Unis] ; Zainab Samad [États-Unis] ; Niels E. Bruun [Danemark] ; Vance G. Fowler [États-Unis] ; Anna Lisa Crowley [États-Unis]

Source :

RBID : PMC:4503384

Abstract

Background

Staphylococcus (S.) aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S. aureus LNVIE is unknown.

Methods and Results

Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without S. aureus IE were matched to those with S. aureus IE by the propensity of having S. aureus. Survival differences were determined using log-rank significance tests. Independent echocardiographic predictors of mortality were identified using Cox-proportional hazards models that included inverse probability of treatment weighting and surgery as a time-dependent covariate. Of 727 subjects with LNVIE and 1-year follow-up, 202 had S. aureus IE. One-year survival rates were significantly lower for patients with S. aureus IE overall (57% S. aureus IE vs. 80% non-S. aureus IE, p<0.001) and in the propensity-matched cohort (59% S. aureus IE vs. 68% non-S. aureus IE, p<0.05). Intracardiac abscess (HR 2.93; 95%CI 1.52–5.40, p<0.001) and left ventricular ejection fraction (LVEF)<40% (OR 3.01; 95%CI 1.35–6.04, p=0.004) were the only independent echocardiographic predictors of in-hospital mortality in S. aureus LNVIE. Valve perforation (HR 2.16; 95% CI 1.21–3.68, p=0.006) and intracardiac abscess (HR 2.25; 95%CI 1.26–3.78, p=0.004) were the only independent predictors of one-year mortality.

Conclusions

S. aureus is an independent predictor of one-year mortality in subjects with LNVIE. In S. aureus LNVIE, intracardiac abscess and LVEF<40% independently predicted in-hospital mortality and intracardiac abscess and perforation independently predicted one-year mortality.


Url:
DOI: 10.1161/CIRCIMAGING.114.003397
PubMed: 26162783
PubMed Central: 4503384

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PMC:4503384

Le document en format XML

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Endocarditis: An Analysis from The International Collaboration on Endocarditis-Prospective Echo Cohort Study</title>
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<name sortKey="Fowler, Vance G" sort="Fowler, Vance G" uniqKey="Fowler V" first="Vance G." last="Fowler">Vance G. Fowler</name>
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<name sortKey="Crowley, Anna Lisa" sort="Crowley, Anna Lisa" uniqKey="Crowley A" first="Anna Lisa" last="Crowley">Anna Lisa Crowley</name>
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<title xml:lang="en" level="a" type="main">Echocardiographic Findings Predict In-Hospital and One-Year Mortality in Left-Sided Native Valve
<italic>Staphylococcus aureus</italic>
Endocarditis: An Analysis from The International Collaboration on Endocarditis-Prospective Echo Cohort Study</title>
<author>
<name sortKey="Lauridsen, Trine K" sort="Lauridsen, Trine K" uniqKey="Lauridsen T" first="Trine K." last="Lauridsen">Trine K. Lauridsen</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Department of Medicine, Duke University, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Department of Medicine, Duke University, Durham</wicri:cityArea>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="A2">Department of Cardiology, Gentofte University, Copenhagen, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Cardiology, Gentofte University, Copenhagen</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Park, Lawrence" sort="Park, Lawrence" uniqKey="Park L" first="Lawrence" last="Park">Lawrence Park</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Department of Medicine, Duke University, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Department of Medicine, Duke University, Durham</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Tong, Steven Y C" sort="Tong, Steven Y C" uniqKey="Tong S" first="Steven Y. C." last="Tong">Steven Y. C. Tong</name>
<affiliation wicri:level="1">
<nlm:aff id="A3">Charles Darwin University, Darwin, Northern Territory, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Charles Darwin University, Darwin, Northern Territory</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Selton Suty, Christine" sort="Selton Suty, Christine" uniqKey="Selton Suty C" first="Christine" last="Selton-Suty">Christine Selton-Suty</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Cardiology Service, CHU Nancy-Brabois, Nancy, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Cardiology Service, CHU Nancy-Brabois, Nancy</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Peterson, Gail" sort="Peterson, Gail" uniqKey="Peterson G" first="Gail" last="Peterson">Gail Peterson</name>
<affiliation wicri:level="2">
<nlm:aff id="A5">Department of Medicine, UT-Southwestern Medical Center, Dallas, TX</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Medicine, UT-Southwestern Medical Center, Dallas</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Cecchi, Enrico" sort="Cecchi, Enrico" uniqKey="Cecchi E" first="Enrico" last="Cecchi">Enrico Cecchi</name>
<affiliation wicri:level="1">
<nlm:aff id="A6">Department of Cardiology, Maria Vittoria Hospital, Torino, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Cardiology, Maria Vittoria Hospital, Torino</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Afonso, Luis" sort="Afonso, Luis" uniqKey="Afonso L" first="Luis" last="Afonso">Luis Afonso</name>
<affiliation wicri:level="2">
<nlm:aff id="A7">Department of Medicine, Wayne State University, Detroit, MI</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Michigan</region>
</placeName>
<wicri:cityArea>Department of Medicine, Wayne State University, Detroit</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Habib, Gilbert" sort="Habib, Gilbert" uniqKey="Habib G" first="Gilbert" last="Habib">Gilbert Habib</name>
<affiliation wicri:level="1">
<nlm:aff id="A8">Faculté de Médecine de Marseille, Marseille, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Faculté de Médecine de Marseille, Marseille</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Pare, Carlos" sort="Pare, Carlos" uniqKey="Pare C" first="Carlos" last="Paré">Carlos Paré</name>
<affiliation wicri:level="1">
<nlm:aff id="A9">Department of Cardiology, University of Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Cardiology, University of Barcelona</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Tamin, Syahidah" sort="Tamin, Syahidah" uniqKey="Tamin S" first="Syahidah" last="Tamin">Syahidah Tamin</name>
<affiliation wicri:level="1">
<nlm:aff id="A10">Department of Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Department of Cardiology, Institut Jantung Negara, Kuala Lumpur</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Dickerman, Stuart" sort="Dickerman, Stuart" uniqKey="Dickerman S" first="Stuart" last="Dickerman">Stuart Dickerman</name>
<affiliation wicri:level="2">
<nlm:aff id="A11">Department of Medicine, NYU, New York, NY</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">État de New York</region>
</placeName>
<wicri:cityArea>Department of Medicine, NYU, New York</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Bayer, Arnold S" sort="Bayer, Arnold S" uniqKey="Bayer A" first="Arnold S." last="Bayer">Arnold S. Bayer</name>
<affiliation wicri:level="2">
<nlm:aff id="A12">Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, UCLA, Los Angeles, CA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Californie</region>
</placeName>
<wicri:cityArea>Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, UCLA, Los Angeles</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Johansson, Magnus C" sort="Johansson, Magnus C" uniqKey="Johansson M" first="Magnus C." last="Johansson">Magnus C. Johansson</name>
<affiliation wicri:level="1">
<nlm:aff id="A13">Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Institute of Medicine, Sahlgrenska Academy, University of Gothenburg</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Chu, Vivian H" sort="Chu, Vivian H" uniqKey="Chu V" first="Vivian H." last="Chu">Vivian H. Chu</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Department of Medicine, Duke University, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Department of Medicine, Duke University, Durham</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2">
<nlm:aff id="A14">Duke Clinical Research Institute, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Duke Clinical Research Institute, Durham</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Samad, Zainab" sort="Samad, Zainab" uniqKey="Samad Z" first="Zainab" last="Samad">Zainab Samad</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Department of Medicine, Duke University, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Department of Medicine, Duke University, Durham</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Bruun, Niels E" sort="Bruun, Niels E" uniqKey="Bruun N" first="Niels E." last="Bruun">Niels E. Bruun</name>
<affiliation wicri:level="1">
<nlm:aff id="A2">Department of Cardiology, Gentofte University, Copenhagen, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Cardiology, Gentofte University, Copenhagen</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="A15">Aalborg University, Aalborg, Denmark</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Aalborg University, Aalborg</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Fowler, Vance G" sort="Fowler, Vance G" uniqKey="Fowler V" first="Vance G." last="Fowler">Vance G. Fowler</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Department of Medicine, Duke University, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Department of Medicine, Duke University, Durham</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2">
<nlm:aff id="A14">Duke Clinical Research Institute, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Duke Clinical Research Institute, Durham</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Crowley, Anna Lisa" sort="Crowley, Anna Lisa" uniqKey="Crowley A" first="Anna Lisa" last="Crowley">Anna Lisa Crowley</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Department of Medicine, Duke University, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Department of Medicine, Duke University, Durham</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2">
<nlm:aff id="A14">Duke Clinical Research Institute, Durham, NC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Duke Clinical Research Institute, Durham</wicri:cityArea>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Circulation. Cardiovascular imaging</title>
<idno type="ISSN">1941-9651</idno>
<idno type="eISSN">1942-0080</idno>
<imprint>
<date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec id="S1">
<title>Background</title>
<p id="P1">
<italic>Staphylococcus (S.) aureus</italic>
left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in
<italic>S. aureus</italic>
LNVIE is unknown.</p>
</sec>
<sec id="S2">
<title>Methods and Results</title>
<p id="P2">Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without
<italic>S. aureus</italic>
IE were matched to those with
<italic>S. aureus</italic>
IE by the propensity of having
<italic>S. aureus</italic>
. Survival differences were determined using log-rank significance tests. Independent echocardiographic predictors of mortality were identified using Cox-proportional hazards models that included inverse probability of treatment weighting and surgery as a time-dependent covariate. Of 727 subjects with LNVIE and 1-year follow-up, 202 had
<italic>S. aureus</italic>
IE. One-year survival rates were significantly lower for patients with
<italic>S. aureus</italic>
IE overall (57%
<italic>S. aureus</italic>
IE vs. 80% non-
<italic>S. aureus</italic>
IE, p<0.001) and in the propensity-matched cohort (59%
<italic>S. aureus</italic>
IE vs. 68% non-
<italic>S. aureus</italic>
IE, p<0.05). Intracardiac abscess (HR 2.93; 95%CI 1.52–5.40, p<0.001) and left ventricular ejection fraction (LVEF)<40% (OR 3.01; 95%CI 1.35–6.04, p=0.004) were the only independent echocardiographic predictors of in-hospital mortality in
<italic>S. aureus</italic>
LNVIE. Valve perforation (HR 2.16; 95% CI 1.21–3.68, p=0.006) and intracardiac abscess (HR 2.25; 95%CI 1.26–3.78, p=0.004) were the only independent predictors of one-year mortality.</p>
</sec>
<sec id="S3">
<title>Conclusions</title>
<p id="P3">
<italic>S. aureus</italic>
is an independent predictor of one-year mortality in subjects with LNVIE. In
<italic>S. aureus</italic>
LNVIE, intracardiac abscess and LVEF<40% independently predicted in-hospital mortality and intracardiac abscess and perforation independently predicted one-year mortality.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">101479935</journal-id>
<journal-id journal-id-type="pubmed-jr-id">36052</journal-id>
<journal-id journal-id-type="nlm-ta">Circ Cardiovasc Imaging</journal-id>
<journal-id journal-id-type="iso-abbrev">Circ Cardiovasc Imaging</journal-id>
<journal-title-group>
<journal-title>Circulation. Cardiovascular imaging</journal-title>
</journal-title-group>
<issn pub-type="ppub">1941-9651</issn>
<issn pub-type="epub">1942-0080</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26162783</article-id>
<article-id pub-id-type="pmc">4503384</article-id>
<article-id pub-id-type="doi">10.1161/CIRCIMAGING.114.003397</article-id>
<article-id pub-id-type="manuscript">NIHMS702117</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Echocardiographic Findings Predict In-Hospital and One-Year Mortality in Left-Sided Native Valve
<italic>Staphylococcus aureus</italic>
Endocarditis: An Analysis from The International Collaboration on Endocarditis-Prospective Echo Cohort Study</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Lauridsen</surname>
<given-names>Trine K.</given-names>
</name>
<degrees> MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Park</surname>
<given-names>Lawrence</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tong</surname>
<given-names>Steven Y.C.</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Selton-Suty</surname>
<given-names>Christine</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Peterson</surname>
<given-names>Gail</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cecchi</surname>
<given-names>Enrico</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Afonso</surname>
<given-names>Luis</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Habib</surname>
<given-names>Gilbert</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Paré</surname>
<given-names>Carlos</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tamin</surname>
<given-names>Syahidah</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dickerman</surname>
<given-names>Stuart</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bayer</surname>
<given-names>Arnold S.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A12">12</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Johansson</surname>
<given-names>Magnus C.</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A13">13</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chu</surname>
<given-names>Vivian H.</given-names>
</name>
<degrees>MD, MHS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Samad</surname>
<given-names>Zainab</given-names>
</name>
<degrees>MD, MHS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bruun</surname>
<given-names>Niels E.</given-names>
</name>
<degrees>MD, DMSc</degrees>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A15">15</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Fowler</surname>
<given-names>Vance G.</given-names>
<suffix>Jr</suffix>
</name>
<degrees>MD, MHS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Crowley</surname>
<given-names>Anna Lisa</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Department of Medicine, Duke University, Durham, NC</aff>
<aff id="A2">
<label>2</label>
Department of Cardiology, Gentofte University, Copenhagen, Denmark</aff>
<aff id="A3">
<label>3</label>
Charles Darwin University, Darwin, Northern Territory, Australia</aff>
<aff id="A4">
<label>4</label>
Cardiology Service, CHU Nancy-Brabois, Nancy, France</aff>
<aff id="A5">
<label>5</label>
Department of Medicine, UT-Southwestern Medical Center, Dallas, TX</aff>
<aff id="A6">
<label>6</label>
Department of Cardiology, Maria Vittoria Hospital, Torino, Italy</aff>
<aff id="A7">
<label>7</label>
Department of Medicine, Wayne State University, Detroit, MI</aff>
<aff id="A8">
<label>8</label>
Faculté de Médecine de Marseille, Marseille, France</aff>
<aff id="A9">
<label>9</label>
Department of Cardiology, University of Barcelona, Spain</aff>
<aff id="A10">
<label>10</label>
Department of Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia</aff>
<aff id="A11">
<label>11</label>
Department of Medicine, NYU, New York, NY</aff>
<aff id="A12">
<label>12</label>
Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, UCLA, Los Angeles, CA</aff>
<aff id="A13">
<label>13</label>
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden</aff>
<aff id="A14">
<label>14</label>
Duke Clinical Research Institute, Durham, NC</aff>
<aff id="A15">
<label>15</label>
Aalborg University, Aalborg, Denmark</aff>
<author-notes>
<corresp id="cor1">
<bold>Correspondence to</bold>
. Anna Lisa Crowley MD, Box 2805 DUMC, Durham NC 27705, Phone: (919) 668-2796, Fax: (919) 668-3575,
<email>annalisa.crowley@duke.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>25</day>
<month>6</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub">
<month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>01</day>
<month>7</month>
<year>2016</year>
</pub-date>
<volume>8</volume>
<issue>7</issue>
<elocation-id>10.1161/CIRCIMAGING.114.003397 e003397</elocation-id>
<abstract>
<sec id="S1">
<title>Background</title>
<p id="P1">
<italic>Staphylococcus (S.) aureus</italic>
left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in
<italic>S. aureus</italic>
LNVIE is unknown.</p>
</sec>
<sec id="S2">
<title>Methods and Results</title>
<p id="P2">Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without
<italic>S. aureus</italic>
IE were matched to those with
<italic>S. aureus</italic>
IE by the propensity of having
<italic>S. aureus</italic>
. Survival differences were determined using log-rank significance tests. Independent echocardiographic predictors of mortality were identified using Cox-proportional hazards models that included inverse probability of treatment weighting and surgery as a time-dependent covariate. Of 727 subjects with LNVIE and 1-year follow-up, 202 had
<italic>S. aureus</italic>
IE. One-year survival rates were significantly lower for patients with
<italic>S. aureus</italic>
IE overall (57%
<italic>S. aureus</italic>
IE vs. 80% non-
<italic>S. aureus</italic>
IE, p<0.001) and in the propensity-matched cohort (59%
<italic>S. aureus</italic>
IE vs. 68% non-
<italic>S. aureus</italic>
IE, p<0.05). Intracardiac abscess (HR 2.93; 95%CI 1.52–5.40, p<0.001) and left ventricular ejection fraction (LVEF)<40% (OR 3.01; 95%CI 1.35–6.04, p=0.004) were the only independent echocardiographic predictors of in-hospital mortality in
<italic>S. aureus</italic>
LNVIE. Valve perforation (HR 2.16; 95% CI 1.21–3.68, p=0.006) and intracardiac abscess (HR 2.25; 95%CI 1.26–3.78, p=0.004) were the only independent predictors of one-year mortality.</p>
</sec>
<sec id="S3">
<title>Conclusions</title>
<p id="P3">
<italic>S. aureus</italic>
is an independent predictor of one-year mortality in subjects with LNVIE. In
<italic>S. aureus</italic>
LNVIE, intracardiac abscess and LVEF<40% independently predicted in-hospital mortality and intracardiac abscess and perforation independently predicted one-year mortality.</p>
</sec>
</abstract>
<kwd-group>
<kwd>endocarditis</kwd>
<kwd>echocardiography</kwd>
<kwd>valve</kwd>
<kwd>risk factor</kwd>
<kwd>survival analysis</kwd>
<kwd>infective endocarditis</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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