Cardiology in the young · 2026
Infective endocarditis in patients with and without CHD: a meta-analysis of age-specific outcomes.
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Pinilla Juan, Baral Brijesh, Rosseto Guilherme, Shelar Vrushali, Coy Zaraith, Neves Henrique, Dandamudi Mrunalini, do Carmo Jorge Sergio, Giorgi Juliana
Аннотация
BACKGROUND: Infective endocarditis remains a serious condition. Patients with CHD are particularly susceptible due to structural abnormalities and repeated interventions. However, comparative data on infective endocarditis outcomes in patients with and without CHD stratified by age group remain limited.
METHODS: We searched PubMed, Embase, and Cochrane for cohort studies comparing infective endocarditis outcomes in CHD versus non-CHD. Risk ratios with 95% confidence intervals were pooled using random-effects models.
RESULTS: We included six observational cohort studies encompassing 180,194 patients, of whom 176,882 were adults and 3312 were children. Overall, 65% of the population were male. Patients with CHD tended to be younger and carried a lower comorbidity burden. CHD was associated with lower in-hospital mortality risk in adults (RR 0.42; 95% CI 0.34-0.53; p < 0.01), whereas children with CHD demonstrated higher risk (RR 1.59; 95% CI 1.08 to 2.32; p = 0.02). Streptococcus infective endocarditis was more common in adults with CHD (RR 1.28; 95% CI 1.09 to 1.50; p < 0.01), while Staphylococcus aureus infective endocarditis was less common in both adults (RR 0.71; 95% CI 0.58 to 0.88; p < 0.01) and paediatric (RR 0.73; 95% CI 0.64 to 0.84; p < 0.01) CHD patients.
CONCLUSION: In this meta-analysis, mortality patterns in CHD varied by age, with lower mortality in adults and higher mortality in children. Streptococcus infective endocarditis was more common in adults with CHD, whereas Staphylococcus aureus was less frequent across CHD age groups. These results highlight the need for age-specific and individualised endocarditis management in CHD.
METHODS: We searched PubMed, Embase, and Cochrane for cohort studies comparing infective endocarditis outcomes in CHD versus non-CHD. Risk ratios with 95% confidence intervals were pooled using random-effects models.
RESULTS: We included six observational cohort studies encompassing 180,194 patients, of whom 176,882 were adults and 3312 were children. Overall, 65% of the population were male. Patients with CHD tended to be younger and carried a lower comorbidity burden. CHD was associated with lower in-hospital mortality risk in adults (RR 0.42; 95% CI 0.34-0.53; p < 0.01), whereas children with CHD demonstrated higher risk (RR 1.59; 95% CI 1.08 to 2.32; p = 0.02). Streptococcus infective endocarditis was more common in adults with CHD (RR 1.28; 95% CI 1.09 to 1.50; p < 0.01), while Staphylococcus aureus infective endocarditis was less common in both adults (RR 0.71; 95% CI 0.58 to 0.88; p < 0.01) and paediatric (RR 0.73; 95% CI 0.64 to 0.84; p < 0.01) CHD patients.
CONCLUSION: In this meta-analysis, mortality patterns in CHD varied by age, with lower mortality in adults and higher mortality in children. Streptococcus infective endocarditis was more common in adults with CHD, whereas Staphylococcus aureus was less frequent across CHD age groups. These results highlight the need for age-specific and individualised endocarditis management in CHD.