A Contemporary Picture of Enterococcal Endocarditis

dc.contributor.authorPericàs, Juan M.
dc.contributor.authorLlopis Pérez, Jaime
dc.contributor.authorMuñoz, Patricia
dc.contributor.authorGálvez Acebal, Juan
dc.contributor.authorKestler, Martha
dc.contributor.authorValerio, Maricela
dc.contributor.authorHernández Meneses, Marta
dc.contributor.authorGoneaga, Miguel A.
dc.contributor.authorCobo Belaustegui, Manuel
dc.contributor.authorMontejo, Miguel
dc.contributor.authorOjeda Burgos, Guillermo
dc.contributor.authorSousa Regueiro, M. Dolores
dc.contributor.authorAlarcón, Aristides de
dc.contributor.authorRamos Martínez, Antonio
dc.contributor.authorMiró Meda, José M.
dc.contributor.authorGAMES Investigators
dc.date.accessioned2022-05-25T13:35:11Z
dc.date.available2022-05-25T13:35:11Z
dc.date.issued2020-02
dc.description.abstractBackground 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.ca_ES
dc.identifier.doihttps://doi.org/10.1016/j.jacc.2019.11.047
dc.identifier.issn0735-1097
dc.identifier.urihttp://hdl.handle.net/10459.1/83385
dc.language.isoengca_ES
dc.publisherElsevierca_ES
dc.relation.isformatofVersió postprint del document publicat a: https://doi.org/10.1016/j.jacc.2019.11.047ca_ES
dc.relation.ispartofJournal of the American College of Cardiology, 2020, vol. 75, núm. 5, p. 482-494ca_ES
dc.rightscc-by-nc-nd (c) Elsevier, 2020ca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectEnterococcica_ES
dc.subjectEpidemiologyca_ES
dc.subjectHeart failureca_ES
dc.subjectInfective endocarditisca_ES
dc.subjectProsthetic valvesca_ES
dc.subjectRelapsesca_ES
dc.titleA Contemporary Picture of Enterococcal Endocarditisca_ES
dc.typeinfo:eu-repo/semantics/articleca_ES
dc.type.versioninfo:eu-repo/semantics/acceptedVersionca_ES
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