Long- Term clinical outcome of major adverse cardiac events in survivors of infective endocarditis a nationwide population-based study

Chia Jen Shih, Hsi Chu, Pei Wen Chao, Yi Jung Lee, Shu Chen Kuo, Szu Yuan Li, Der Cherng Tarng, Chih Yu Yang, Wu Chang Yang, Shuo Ming Ou, Yung Tai Chen

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Abstract

Background-Substantial infective endocarditis (IE)-related morbidity and mortality may occur even after successful treatment. However, no previous study has explored long- Term hard end points (ie, stroke, myocardial infarction, heart failure, cardiovascular death) in addition to all-cause mortality in IE survivors. Methods and Results-A nationwide population-based cohort study was conducted among IE survivors identified with the use of the Taiwan National Health Insurance Research Database during 2000 to 2009. IE survivors were defined as those who survived after discharge from first hospitalization with a diagnosis of IE. A total of 10 116 IE survivors were identified. IE survivors were matched to control subjects without IE at a 1:1 ratio through the use of propensity scores. The primary outcomes were stroke, myocardial infarction, readmission for heart failure, and sudden cardiac death or ventricular arrhythmia. The secondary outcomes were repeat IE and all-cause mortality. Compared with the matched cohort, IE survivors had higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.59; 95% confidence interval [CI], 1.40-1.80), hemorrhagic stroke (aHR, 2.37; 95% CI, 1.90-2.96), myocardial infarction (aHR, 1.44; 95% CI, 1.17-1.79), readmission for heart failure (aHR, 2.24; 95% CI, 2.05-2.43), sudden death or ventricular arrhythmia (aHR, 1.69; 95% CI, 1.44-1.98), and all-cause death (aHR, 2.27; 95% CI, 2.14-2.40). Risk factors for repeat IE were older age, male sex, drug abuse, and valvular replacement after an initial episode of IE. Conclusion-Despite treatment, the risk of long- Term major adverse cardiac events was substantially increased in IE survivors.

Original languageEnglish
Pages (from-to)1684-1691
Number of pages8
JournalCirculation
Volume130
Issue number19
DOIs
Publication statusPublished - 2014

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Keywords

  • Endocarditis
  • Epidemiology
  • Heart failure
  • Mortality
  • Myocardial infarction
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Shih, C. J., Chu, H., Chao, P. W., Lee, Y. J., Kuo, S. C., Li, S. Y., Tarng, D. C., Yang, C. Y., Yang, W. C., Ou, S. M., & Chen, Y. T. (2014). Long- Term clinical outcome of major adverse cardiac events in survivors of infective endocarditis a nationwide population-based study. Circulation, 130(19), 1684-1691. https://doi.org/10.1161/CIRCULATIONAHA.114.012717