TY - JOUR
T1 - Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse
AU - Zegri-Reiriz, Isabel
AU - de Alarcón, Arístides
AU - Muñoz, Patricia
AU - Martínez Sellés, Manuel
AU - González-Ramallo, Victor
AU - Miro, Jose M.
AU - Falces, Carles
AU - Gonzalez Rico, Claudia
AU - Kortajarena Urkola, Xabier
AU - Lepe, José Antonio
AU - Rodriguez Alvarez, Regino
AU - Reguera Iglesias, Jose Maria
AU - Navas, Enrique
AU - Dominguez, Fernando
AU - Garcia-Pavia, Pablo
AU - Fernández Sánchez, Fernando
AU - Noureddine, Mariam
AU - Rosas, Gabriel
AU - de la Torre Lima, Javier
AU - Aramendi, José
AU - Bereciartua, Elena
AU - Blanco, María José
AU - Blanco, Roberto
AU - Boado, María Victoria
AU - Campaña Lázaro, Marta
AU - Crespo, Alejandro
AU - Goikoetxea, Josune
AU - Iruretagoyena, José Ramón
AU - Irurzun Zuazabal, Josu
AU - López-Soria, Leire
AU - Montejo, Miguel
AU - Nieto, Javier
AU - Rodrigo, David
AU - Rodríguez, David
AU - Rodríguez, Regino
AU - Vitoria, Yolanda
AU - Voces, Roberto
AU - García López, María Victoria
AU - Ivanova Georgieva, Radka
AU - Ojeda, Guillermo
AU - Rodríguez Bailón, Isabel
AU - Ruiz Morales, Josefa
AU - Cuende, Ana María
AU - Echeverría, Tomás
AU - Fuerte, Ana
AU - Gaminde, Eduardo
AU - Goenaga, Miguel Ángel
AU - Idígoras, Pedro
AU - Iribarren, José Antonio
AU - de Benito, Natividad
N1 - Publisher Copyright:
© 2018 American College of Cardiology Foundation
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/6/19
Y1 - 2018/6/19
N2 - Background: There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions. Objectives: This study sought to describe the clinical and microbiological features of IE in patients with BAV and MVP and compare them with those of IE patients with and without IEAP indication, to determine the potential benefit of IEAP in these conditions. Methods: This analysis involved 3,208 consecutive IE patients prospectively included in the GAMES (Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España) registry at 31 Spanish hospitals. Patients were classified as high-risk IE with IEAP indication (high-risk group; n = 1,226), low- and moderate-risk IE without IEAP indication (low/moderate-risk group; n = 1,839), and IE with BAV (n = 54) or MVP (n = 89). Results: BAV and MVP patients had a higher incidence of viridans group streptococci IE than did high-risk group and low/moderate-risk group patients (35.2% and 39.3% vs. 12.1% and 15.0%, respectively; all p < 0.01). A similar pattern was seen for IE from suspected odontologic origin (14.8% and 18.0% vs. 5.8% and 6.0%; all p < 0.01). BAV and MVP patients had more intracardiac complications than did low/moderate-risk group (50% and 47.2% vs. 30.6%, both p < 0.01) patients and were similar to high-risk group patients. Conclusions: IE in patients with BAV and MVP have higher rates of viridans group streptococci IE and IE from suspected odontologic origin than in other IE patients, with a clinical profile similar to that of high-risk IE patients. Our findings suggest that BAV and MVP should be classified as high-risk IE conditions and the case for IEAP should be reconsidered.
AB - Background: There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions. Objectives: This study sought to describe the clinical and microbiological features of IE in patients with BAV and MVP and compare them with those of IE patients with and without IEAP indication, to determine the potential benefit of IEAP in these conditions. Methods: This analysis involved 3,208 consecutive IE patients prospectively included in the GAMES (Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España) registry at 31 Spanish hospitals. Patients were classified as high-risk IE with IEAP indication (high-risk group; n = 1,226), low- and moderate-risk IE without IEAP indication (low/moderate-risk group; n = 1,839), and IE with BAV (n = 54) or MVP (n = 89). Results: BAV and MVP patients had a higher incidence of viridans group streptococci IE than did high-risk group and low/moderate-risk group patients (35.2% and 39.3% vs. 12.1% and 15.0%, respectively; all p < 0.01). A similar pattern was seen for IE from suspected odontologic origin (14.8% and 18.0% vs. 5.8% and 6.0%; all p < 0.01). BAV and MVP patients had more intracardiac complications than did low/moderate-risk group (50% and 47.2% vs. 30.6%, both p < 0.01) patients and were similar to high-risk group patients. Conclusions: IE in patients with BAV and MVP have higher rates of viridans group streptococci IE and IE from suspected odontologic origin than in other IE patients, with a clinical profile similar to that of high-risk IE patients. Our findings suggest that BAV and MVP should be classified as high-risk IE conditions and the case for IEAP should be reconsidered.
KW - antibiotic prophylaxis
KW - bicuspid aortic valve
KW - endocarditis
KW - mitral valve prolapse
UR - http://www.scopus.com/inward/record.url?scp=85047935983&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2018.03.534
DO - 10.1016/j.jacc.2018.03.534
M3 - Article
C2 - 29903346
AN - SCOPUS:85047935983
VL - 71
SP - 2731
EP - 2740
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 24
ER -