SURVIVAL AND RECURRENCE OF ENDOCARDITIS FOLLOWING MECHANICAL VS. BIOLOGICAL MITRAL VALVE REPLACEMENT FOR ENDOCARDITIS IN PATIENTS AGED 40 TO 70 YEARS: DATA FROM THE INFECT-REGISTRY

Background and Aim: Infective endocarditis (IE) is a serious disease, and in many cases, surgery is necessary. The aim of the present study is to quantify differences in long-term survival and recurrence of endocarditis after mitral valve replacement (MVR) for IE according to prosthesis type among patients aged 40 to 70 years. Methods: This was an analysis of the INFECT- REGISTRY. Trends in proportion to the use of mechanical prostheses versus biological ones over time were tested. Confounders were adjusted using a doubly robust method that combines regression model with inverse probability treatment weighting (IPTW) by propensity score. Survival was analyzed with Cox models, differences in recurrence of endocarditis were evaluated using the Gray test. Results: 5253 patients were operated on for IE from 2000 to 2021. Of these,741 aged between 40 and 70 years, underwent MVR. A total of 403(54.4%) received mechanical prostheses, and 338(45.6%) received bioprostheses. A significant trend in the reduction of implantation of mechanical vs. biological prostheses was observed during the study period in patients aged 40 to 50 and 60 to 70 years. Patients with mechanical valves and bioprostheses had comparable early mortality. The improved overall survival rate in the patients who received a mechanical prosthesis than those receiving a biological prosthesis showed a trend toward significance at Cox analysis adjusted for propensity score weighting (HR 0.746, 95% CI:0.53–1.03, p =0.07). Mechanical prostheses were associated with significantly less recurrent endocarditis after AVR than biological prostheses (Gray’s test p<0.001). Conclusions: The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after a mechanical MV implantation in middle- aged patients.

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Journal
Journal of Cardiovascular Medicine
Published
2024-12-01
DOI
https://doi.org/10.2459/01.jcm.0001096128.27258.02
Primary Topic
Infective Endocarditis Diagnosis and Management
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article
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article

SURVIVAL AND RECURRENCE OF ENDOCARDITIS FOLLOWING MECHANICAL VS. BIOLOGICAL MITRAL VALVE REPLACEMENT FOR ENDOCARDITIS IN PATIENTS AGED 40 TO 70 YEARS: DATA FROM THE INFECT-REGISTRY

Michele Di Mauro, Fabio Barili, Riccardina Lorusso, I. Vendramin et al.
Journal of Cardiovascular Medicine
Infective Endocarditis Diagnosis and Management
article

SURVIVAL AND RECURRENCE OF ENDOCARDITIS FOLLOWING MECHANICAL VS. BIOLOGICAL MITRAL VALVE REPLACEMENT FOR ENDOCARDITIS IN PATIENTS AGED 40 TO 70 YEARS: DATA FROM THE INFECT-REGISTRY

Michele Di Mauro, Fabio Barili, Riccardina Lorusso, I. Vendramin, Diego Cugola, Andrea Colli, Alessandro Parolari, Francesco Onorati, Antonio Pantaleo, Lorena Labate, Davide Pacini, Elisa Mikus, Alberto Pilozzi Casado, Francesco Pollari, Guglielmo Mario Actis Dato, Carlo De Vincentiis, Salvatore Nicolardi, Alessandro Della Corte, Roberto Scrofani, F. Musumeci, Antonio Salsano, Emmanuel Villa, F. Santini, Mauro Rinaldi, Enrico Vizzardi, Francesco Nicolini, Giangiuseppe Cappabianca, M. De Bonis
article en

Abstract

Background and Aim: Infective endocarditis (IE) is a serious disease, and in many cases, surgery is necessary. The aim of the present study is to quantify differences in long-term survival and recurrence of endocarditis after mitral valve replacement (MVR) for IE according to prosthesis type among patients aged 40 to 70 years. Methods: This was an analysis of the INFECT- REGISTRY. Trends in proportion to the use of mechanical prostheses versus biological ones over time were tested. Confounders were adjusted using a doubly robust method that combines regression model with inverse probability treatment weighting (IPTW) by propensity score. Survival was analyzed with Cox models, differences in recurrence of endocarditis were evaluated using the Gray test. Results: 5253 patients were operated on for IE from 2000 to 2021. Of these,741 aged between 40 and 70 years, underwent MVR. A total of 403(54.4%) received mechanical prostheses, and 338(45.6%) received bioprostheses. A significant trend in the reduction of implantation of mechanical vs. biological prostheses was observed during the study period in patients aged 40 to 50 and 60 to 70 years. Patients with mechanical valves and bioprostheses had comparable early mortality. The improved overall survival rate in the patients who received a mechanical prosthesis than those receiving a biological prosthesis showed a trend toward significance at Cox analysis adjusted for propensity score weighting (HR 0.746, 95% CI:0.53–1.03, p =0.07). Mechanical prostheses were associated with significantly less recurrent endocarditis after AVR than biological prostheses (Gray’s test p<0.001). Conclusions: The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after a mechanical MV implantation in middle- aged patients.

Journal of Cardiovascular MedicineVol. 25(Supplement 1Supplement 1)
University of Pisa (IT), University of Verona (IT), University of Parma (IT), University of Udine (IT), Vita-Salute San Raffaele University (IT), University of Milan (IT), University of Campania "Luigi Vanvitelli" (IT), Maastricht University Medical Centre (NL), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Maastricht University (NL), Fondazione Ricerca Molinette (IT), IRCCS Policlinico San Donato (IT), Nuremberg Hospital (DE), Maria Cecilia Hospital (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Ospedale Papa Giovanni XXIII (IT), A. O. Ordine Mauriziano di Torino (IT), IRCCS Ospedale San Raffaele (IT), Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT), Ca' Foncello Hospital (IT), Ospedale Policlinico San Martino (IT), Fondazione Poliambulanza Istituto Ospedaliero (IT), Fondazione Audiologica Varese (IT), Ospedale Vito Fazzi (IT), Carlo Forlanini Hospital (IT), University of Turin (IT), University of Genoa (IT), University of Bologna (IT)
Good health and well-being
Openalex Percentile: Top 66%
Infective Endocarditis Diagnosis and Management
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