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Echocardiographic Findings Predict In-Hospital and 1 Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis

Lauridsen, Trine K., Tong, Steven Y. C., Selton-Suty, Christine, Peterson, Gail, Cecchi, Enrico, Afonso, Luis, Habib, Gilbert, Paré, Carlos, Tamin, Syahidah, Dickerman, Stuart, Bayer, Arnold S., Johansson, Magnus C., Chu, Vivian H., Samad, Zainab, Bruun, Niele E., Flower, Vance G. and Crowley, Anna L. (2015). Echocardiographic Findings Predict In-Hospital and 1 Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis. Circulation: Cardiovascular Imaging,8(7):e003397.

Document type: Journal Article
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IRMA ID 11381xPUB151
Title Echocardiographic Findings Predict In-Hospital and 1 Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis
Author Lauridsen, Trine K.
Tong, Steven Y. C.
Selton-Suty, Christine
Peterson, Gail
Cecchi, Enrico
Afonso, Luis
Habib, Gilbert
Paré, Carlos
Tamin, Syahidah
Dickerman, Stuart
Bayer, Arnold S.
Johansson, Magnus C.
Chu, Vivian H.
Samad, Zainab
Bruun, Niele E.
Flower, Vance G.
Crowley, Anna L.
Journal Name Circulation: Cardiovascular Imaging
Publication Date 2015
Volume Number 8
Issue Number 7
ISSN 1941-9651   (check CDU catalogue open catalogue search in new window)
eISSN 1942-0080
Scopus ID 2-s2.0-84942844701
Start Page e003397
Place of Publication United States
Publisher Lippincott Williams & Wilkins
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Staphylococcus 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 versus 80% non-S aureus IE; P<0.001) and in the propensity-matched cohort (59% S aureus IE versus 68% non-S aureus IE; P<0.05). Intracardiac abscess (hazard ratio, 2.93; 95% confidence interval, 1.52–5.40; P<0.001) and left ventricular ejection fraction <40% (odds ratio, 3.01; 95% confidence interval, 1.35–6.04; P=0.004) were the only independent echocardiographic predictors of in-hospital mortality in S aureus LNVIE. Valve perforation (hazard ratio, 2.16; 95% confidence interval, 1.21–3.68; P=0.006) and intracardiac abscess (hazard ratio, 2.25; 95% confidence interval, 1.26–3.78; P=0.004) were the only independent predictors of 1-year mortality.


S aureus is an independent predictor of 1-year mortality in subjects with LNVIE. In S aureus LNVIE, intracardiac abscess and left ventricular ejection fraction <40% independently predicted in-hospital mortality and intracardiac abscess and valve perforation independently predicted 1-year mortality.
Keywords echocardiography
odds ratio
risk factors
survival analysis
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