323. Impact of Statin Use on Clinical Manifestations and Echocardiographic Features of Cardiovascular Implantable Electronic Device Infections
Session: Poster Abstract Session: Assessing and Reducing Infection Risk
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • 323_AmmarHabib.pdf (26.1 MB)
  • Background: Cardiovascular implantable electronic device (CIED)-related infective endocarditis (CIED-IE) is a major complication of device infection and is associated with increased mortality. Statin use is common in CIED recipients due to underlying hyperlipidemia and coronary artery disease. Because statins have anti-inflammatory and antimicrobial properties, we hypothesized that ongoing statin therapy effects clinical manifestation of CIED infection.

    Methods: We performed a retrospective review of all cases of CIED infection admitted to our institution from 1991 to 2008. Clinical manifestations of CIED infection and prevalence of CIED-IE between patients with and without statin therapy were compared using Wilcoxon rank sum, chi-square and Fisher’s exact tests.

    Results: We identified 415 patients with CIED infection during the study period. Of these, data regarding statin use were available in 395 subjects. Approximately one-third (122, 31%) of these 395 patients were on statin therapy at the time of CIED infection. There were no statistically significant differences in pathogen distribution of device infection between the two groups. Nevertheless, patients who had received statin therapy were less likely to have positive generator pocket (59% vs. 70%, p=0.02) and lead tip (43% vs. 46%, p=0.03) cultures. Patients who had received statins were less likely to experience local symptoms of pocket swelling (37% vs. 49%, p=0.02), purulent drainage (16% vs 27%, p=0.01), and skin ulceration (8% vs. 20%, p<0.01) or manifest peripheral leukocytosis (32% vs. 43%, p=0.03).  There were no significant differences in CIED-IE and overall frequency of intracardiac masses (attached to CIED leads) between the treatment groups.  There was also no significant difference in overall survival between the two groups (p=0.41).

    Conclusion: Although there was no significant differences in CIED-IE or mortality, statin therapy at time of CIED infection appeared to impact local manifestations of infection.


    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Ammar Habib, MD, Katherine Y. Le, MD, MPH, Christine Lohse, Paul A. Friedman, MD, David Hayes, MD, Walter R. Wilson, MD, James Steckelberg, MD, FIDSA, Larry M. Baddour, MD and Muhammad R. Sohail, MD, Mayo School of Graduate Medical Education, Rochester, MN

    Disclosures:

    A. Habib, None

    K. Y. Le, None

    C. Lohse, None

    P. A. Friedman, Medtronic, St. Jude, Guidant, Astra Zeneca: Consultant and Research Contractor, Consulting fee, Research grant and Speaker honorarium

    D. Hayes, Medtronic: Scientific Advisor, Speaker honorarium
    Boston Scientific: Scientific Advisor, Speaker honorarium
    St. Jude Medical: Scientific Advisor, Speaker honorarium
    Sorin Medical: Speaker's Bureau, Speaker honorarium
    Biotronik: Speaker's Bureau, Speaker honorarium

    W. R. Wilson, None

    J. Steckelberg, None

    L. M. Baddour, Up ToDate Inc: , Licensing agreement or royalty and Royality payments (<$10000)
    Massachusetts Medical Society (Journal Watch Infectious Diseases): Consultant and Editorship ,

    M. R. Sohail, None

    << Previous Abstract | Next Abstract

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.