Infective endocarditis (IE) has significant morbidity and mortality that varies with several factors. The aim of this study is to compare long-term mortality for native versus prosthetic valve IE in a population-based cohort.
We conducted a retrospective cohort study including adults (> 18 y/o) from Olmsted County, MN diagnosed with definite or possible IE defined by modified Duke`s criteria between January 1, 1970 to December 31, 2013. The medical records were used to collect demographic, microbiology, date of last follow up, and date of death. Kaplan Meier curves were generated to define 5 year mortality in this cohort.
Overall, 196 cases of IE between 1970 and 2013 were identified and 149 (76%) patients had native valve endocarditis (NVE) and 47 (24%) had prosthetic valve endocarditis (PVE). Mean (±SD) age of patients with NVE and PVE was 62.8 (±19.1), and 66.1 (±17.3), respectively. Aortic valve IE was more common in patients with PVE (57% vs 29% for NVE P<0.001), while the mitral valve was more commonly involved in patients with NVE (47% vs 17% for PVE P<0.001). The most common pathogen identified in both groups (NVE, 28%; PVE, 30%) was Staphylococcus aureus.
The 1-and 5-year mortality rates were 28% and 47%, respectively, for NVE, and 36%, and 53%, respectively, for PVE. Overall, there was no statistically significant difference in 5-year mortality between native and prosthetic groups (Figure 1), however when mortality data were stratified by organism, S. aureus PVE was significantly associated with higher 5-year mortality (89% vs 61%) NVE (Figure 2) . This difference was not seen with other organisms.
IE has a high 5-year mortality, regardless of whether it involves native or prosthetic valves. S. aureus was the most common pathogen identified in both groups and it was significantly associated with worse outcomes in patients with PVE reaching a 5 year mortality of almost 90%. Overall, PVE was associated with worse outcomes as compared to that of NVE; however, these results reached statistical significance for IE caused by S. aureus only.
A. El Rafei,
J. M. Steckelberg, None
M. R. Sohail, Medtronic, plc.: Consultant and Scientific Advisor , Consulting fee , Research grant and Speaker honorarium
Spectranetics: Consultant , Consulting fee and Speaker honorarium
W. R. Wilson, None
L. M. Baddour, None