Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
Clinical characteristics, treatment, and outcomes in CIED-related vs. left-sided infective endocarditis: a nationwide study from the NIDUS registry.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Alhakak Amna, Graversen Peter Laursen, Hadji-Turdeghal Katra, Møller Jacob Eifer, Bruun Niels Eske, Ruwald Anne-Christine, Jørgensen Peter Godsk, Jensen Andreas Dalsgaard, Petersen Jeppe K, Lafta Mohammed Bakir Ahmad, Bengtsen Kasper Høtoft, Le Melanie Vuong, Iversen Kasper Karmark, Povlsen Jonas Agerlund, Moser Claus Ernst, Smerup Morten Holdgaard, Helweg-Larsen Jannik, Bundgaard Henning, Østergaard Lauge, Køber Lars, Fosbøl Emil Loldrup
Аннотация
AIMS: Cardiac implantable electronic device (CIED)-related infective endocarditis (IE) presents distinct diagnostic and therapeutic challenges due to its unique characteristics and limited evidence supporting guidelines compared with left-sided valvular IE. We aimed to examine clinical characteristics, treatment, and mortality in patients with CIED-related IE vs. left-sided valvular IE.
METHODS AND RESULTS: We included patients with first-time IE using nationwide data from the NatIonal Danish endocarditis StUdieS (NIDUS) registry (2016-2021) and categorized them into isolated CIED-related IE without concomitant valvular IE and left-sided valvular IE. A total of 340 patients with isolated CIED-related IE and 2510 patients with left-sided IE were included. Patients with CIED-related IE vs. left-sided IE were older (76.1 vs. 73.2 years), and a higher proportion were males (78.5% vs. 65.9%), had diabetes (32.9% vs. 21.9%), heart failure (46.2% vs. 11.7%), Staphylococcus aureus (37.1% vs. 30.7%), coagulase-negative staphylococci (11.2% vs. 6.4%), and culture-negative IE (12.1% vs. 7.8%). However, fever at admission was lower in CIED-related IE (55.4% vs. 61.5%). Cardiac implantable electronic device removal was performed in 78.2% of patients with CIED-related IE. The 6-month cumulative incidence of mortality was 20.4% (95% CI: 16.2-24.9%) in CIED-related IE and 26.8% (95% CI: 25.1-28.6%) in left-sided IE (P = 0.009). In a multivariable Cox regression model, CIED-related IE was associated with lower 6-month mortality compared with left-sided IE (adjusted HR: 0.52 [95% CI: 0.40-0.68], P < 0.001).
CONCLUSION: In this nationwide study, patients with CIED-related IE were distinctly different from those with left-sided IE. Staphylococci were more prevalent, and despite higher age and differences in comorbidities, mortality was lower.
METHODS AND RESULTS: We included patients with first-time IE using nationwide data from the NatIonal Danish endocarditis StUdieS (NIDUS) registry (2016-2021) and categorized them into isolated CIED-related IE without concomitant valvular IE and left-sided valvular IE. A total of 340 patients with isolated CIED-related IE and 2510 patients with left-sided IE were included. Patients with CIED-related IE vs. left-sided IE were older (76.1 vs. 73.2 years), and a higher proportion were males (78.5% vs. 65.9%), had diabetes (32.9% vs. 21.9%), heart failure (46.2% vs. 11.7%), Staphylococcus aureus (37.1% vs. 30.7%), coagulase-negative staphylococci (11.2% vs. 6.4%), and culture-negative IE (12.1% vs. 7.8%). However, fever at admission was lower in CIED-related IE (55.4% vs. 61.5%). Cardiac implantable electronic device removal was performed in 78.2% of patients with CIED-related IE. The 6-month cumulative incidence of mortality was 20.4% (95% CI: 16.2-24.9%) in CIED-related IE and 26.8% (95% CI: 25.1-28.6%) in left-sided IE (P = 0.009). In a multivariable Cox regression model, CIED-related IE was associated with lower 6-month mortality compared with left-sided IE (adjusted HR: 0.52 [95% CI: 0.40-0.68], P < 0.001).
CONCLUSION: In this nationwide study, patients with CIED-related IE were distinctly different from those with left-sided IE. Staphylococci were more prevalent, and despite higher age and differences in comorbidities, mortality was lower.