Mylotte D, et al. - Researchers conducted this study using the population-based Quebec congenital heart disease (CHD) database in order to describe the predictors of infective endocarditis (IE) and, to assess whether IE was related to mortality among adult CHD (ACHD) patients without prior valve replacement surgery. Findings demonstrated that the the risk of IE in ACHD patients was lesion-specific and was greatest in the context of recent medical interventions. Furthermore, it was noted that regardless of broad CHD lesion grouping, IE was related to increased 1-year mortality.

Methods

• Researchers extracted data on ACHD patients with IE and evaluated the lesion-specific incidence of IE, risk factors for IE acquisition, and all-cause 1-year mortality.

Results

• During follow-up period of 378,901 patient-years, from 1988-2010, 285 patients (0.95%) developed IE out of a total of 29,866 ACHD patients.
• Data demonstrated that the highest and lowest lesion-specific incidences of IE were observed with left-sided lesions (1.61/1000 patient-years) and patent ductus arteriosus (0.24/1000 patient-years), respectively.
• Cardiac surgery in the previous 6 months (9.07, 3.98-20.67), endocardial cushion defects (6.65, 3.84-11.53), left-sided lesions (5.11, 3.60-7.25), cyanosis at birth (4.82, 3.12-7.46), ventricular septal defect (2.81, 1.87-4.21), diabetes mellitus (1.65, 1.10-2.48), and recent medical interventions (12.52, 5.23-29.97) were identified as the predictors of risk of IE acquisition (odds ratio (OR), 95% confidence interval [CI]).
• Researchers observed that within 1-year of IE diagnosis, 25 (8.77%) patients died, a substantially elevated rate compared to patients without IE (OR 31.07, 95%CI 16.23-59.49).
• In addition, they noted that mortality risk following IE diagnosis was similarly elevated among patients with left-sided, cyanotic and other CHD lesions.