Pacemaker Increases Infective Endocarditis Risk in Aortic Valve Replacement

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Risk of infective endocarditis twice as high in patients with a pacemaker undergoing aortic valve replacement.
Risk of infective endocarditis twice as high in patients with a pacemaker undergoing aortic valve replacement.

The presence of a pacemaker increases the risk of infective endocarditis in patients undergoing aortic valve replacement, according to research presented at the 66th Annual Scientific Session & Expo of the American College of Cardiology in Washington, DC.

Lauge Østergaard, from the Heart Centre of Copenhagen University Hospital  in Denmark, and colleagues analyzed data from the Danish registries of all patients who had undergone an aortic valve replacement in Denmark from January 1996 to December 31, 2012. Patients were followed until they were admitted to the hospital due to infective endocarditis, until death, or the end of the study period, whichever came first. Patients who had previous or current infective endocarditis following aortic valve replacement were excluded from the study.

Of the 13,454 patients who had undergone aortic valve replacement, 3% (n=401) had a pacemaker vs 97% (n=13,053) with no pacemaker. Men accounted for the majority of patients in both groups: 70.6% (median age, 75.2; interquartile range [IQR]: 68.8-79.4 years) in the group with pacemaker vs 63.6% (median age, 71.3; IQR: 63.3-77.1 years) in the group with no pacemaker.

There was an increased incidence of infective endocarditis in patients with a pacemaker compared with the group with no pacemaker. In a multivariable adjusted analysis, this observation was held true (hazard ratio: 1.92; 95% CI 1.26-2.94).

“In patients undergoing aortic valve replacement, a concomitant pacemaker was associated with twice the incidence of infective endocarditis,” the researchers concluded.

Reference

Østergaard L, Køber NV, Køber L, et al. Risk of infective endocarditis associated with concomitant pacemaker among patients undergoing aortic valve replacement: a nationwide study. Abstract 1103-025. Presented at: the 66th Scientific Session & Expo of the American College of Cardiology. March 17-19, 2017; Washington, DC.

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