Factors Associated With Infective Endocarditis in TAVR

HealthDay News – The incidence of infective endocarditis was found to 1.1% among patients undergoing transcatheter aortic valve replacement (TAVR), with age, gender, diabetes, and aortic regurgitation found to be associated with increased risk.  These results were recently reported in the Journal of the American Medical Association.

Ander Regueiro, MD, from Laval University in Quebec City, and colleagues examined the associated factors, clinical characteristics, and outcomes of patients with infective endocarditis after TAVR. Patients were identified from 47 centers from Europe, North America, and South America between June 2005 and October 2015.

The researchers noted 250 cases of infective endocarditis in 20,006 patients after TAVR (incidence, 1.1% per person-year), occurring at a median of 5.3 months after TAVR. Higher risk of progressing to infective endocarditis after TAVR was seen with younger age (hazard ratio [HR], 0.97), male sex (HR, 1.69), diabetes mellitus (HR, 1.52), and moderate to severe aortic regurgitation (HR, 2.05). 

Overall, 52.8%  of patients had health care-associated infective endocarditis. The most frequently isolated microorganisms were Enterococci species and Staphylococcus aureus. The rate of in-hospital mortality was 36%, and 14.8% of patients underwent surgery during the infective endocarditis episode. Higher logistic EuroSCORE, heart failure, and acute kidney injury were associated with in-hospital mortality.

“Among patients undergoing TAVR, younger age, male sex, history of diabetes mellitus, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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Regueiro A, Linke A, Latib A, et al. Association between transcatheter aortic valve replacement and subsequent infective endocarditis and in-hospital death. JAMA. 2016;316(10):1083-1092.