The retrospective study reviewed the medical chart at Juntendo University Hospital (1020-bedded university hospital) between February 2012 to March 2016. An episode of IE was defined according to modified Duke criteria (possible or definitive). Patients with IE had no infectious disease (ID) consultation were excluded. Data included age, gender, habitus, underlying diseases, quick SOFA (qSOFA) score at admission, C-reactive protein (CRP), procalcitonin (PCT), brain natriuretic peptide (BNP) at admission, cardiovascular surgery during admission, and crude in-hospital mortality. Multivariate analysis was performed to determine the independent risk factors associated with death. All variables with P<0.1 in the univariate analysis were evaluated using the multivariate model with the level of significance set at P<0.05. Statistical analyses were performed using R version 3.1.1.
Results:A total 60 patients with IE were included. The mean age was 66 years (range, 26 to 92) and 43 (43/60, 71.6%) were men. The median qSOFA score at admission was 0 (range, 0 to 2). Patients had the history of smoking (23/60, 38.3%) and alcohol intake (27/60, 45%). Underlying diseases were cardiovascular disease (38/60, 63.3%), diabetes mellitus (8/60, 13.3%), and dialysis (4/60, 6.7%). Cardiovascular surgery including valve replacement was performed in 38 patients (63.3%). Laboratory data showed CRP (median 4.55, range, 0.1 to 21.9) mg/dl, PCT (0.245, range, 0.04-19.05) ng/ml, BNP (313.4, range, 5.1 to 8637) pg/ml. Multivariate analysis revealed Age >65 years old (Odds Ratio (OR), 15.7; 95% Confidence Interval, 1.68–146.0; P=0.0157) and alcohol intake (OR, 12.1; 95%CI, 1.31–112.0; P=0.02) was an independent risk factor associated with developing heart failure.
Conclusion:For patients with IE, potential of myocardial damage caused by alcohol intake is suspected. However, measurement of alcohol intake such as counting CAGE score was not performed. Further investigation with objective quantitation is needed.
K. Suzuki, None
Y. Uehara, None
K. Mitsuhashi, None
T. Naito, None
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