Cardiac device-related infective endocarditis need for lead extraction whatever the device according to the ESC EORP EURO-ENDO registry-Reference-Cited by-同舟云学术

Cardiac device-related infective endocarditis need for lead extraction whatever the device according to the ESC EORP EURO-ENDO registry

Published:2023-07 Issue:4 Volume:3 Page:
ISSN:2752-4191
Container-title:European Heart Journal Open
language:en
Short-container-title:

Author:

Donal Erwan¹^ORCID,Tribouilloy Christophe²^ORCID,Sadeghpour Anita³^ORCID,Laroche Cécile⁴,Tude Rodrigues Ana Clara⁵,Pereira Nunes Maria do Carmo⁶,Kang Duk-Hyun⁷^ORCID,Hernadez-Meneses Marta⁸^ORCID,Kobalava Zhanna⁹^ORCID,De Bonis Michele¹⁰^ORCID,Dworakowski Rafal¹¹^ORCID,Ivanovic Branislava¹²^ORCID,Holicka Maria¹³^ORCID,Kitai Takeshi¹⁴^ORCID,Cruz Ines¹⁵^ORCID,Huttin Olivier¹⁶^ORCID,Colonna Paolo¹⁷^ORCID,Lancellotti Patrizio¹⁸¹⁹^ORCID,Habib Gilbert²⁰²¹^ORCID

Affiliation:

1. Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes-1 , hopital pontchaillou, 35000 Rennes , France

2. Department of Cardiology, Amiens University Hospital Amiens , Amiens 80000 , France

3. Echocardiography Research Centre, Rajaie Cardiovascular Medical and Research Centre, Iran University of Medical Sciences , Tehran , Iran

4. European Society of Cardiology, EORP , Sophia-Antipolis , France

5. servico de Echocardiografia—InRad-HC—Faculdade de Medicina, Universidade de Sao Paulo , SP , Brazil

6. Serviço de Cardiologia e Cirurgia Cardiovascular e Centro de Telessaúde, Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte, MG , Brazil

7. Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 388-1, Poongnap-dong, Songpa-gu, Seoul 138-736 , Korea

8. Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona , Barcelona , Spain

9. Department of Cardiology, RUDN Univerisity , Moscow , Russia

10. Cardiac Surgery, Innovation and Research, ‘Vita-Salute’ San Raffaele University Hospital , Milan 20132 , Italy

11. Department of Cardiology, Kings College Hospital and King's College London , Denmark Hill, London SE5 9RS , UK

12. Clinical Center of Serbia, Clinic of Cardiology , Belgrade , Serbia

13. Department of Cardiology, University Hospital Brno , Jihlavska 20, Brno 62500 , Czech Republic

14. Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital , Kobe , Japan

15. Departamento de Cardiologia, Hospital Garcia de Orta , Almada , Portugal

16. F-CRIN INI-CRCT Cardiovascular and Renal Clinical Trialists Network, INSERM 1116, CHRU de Nancy , Nancy , France

17. Department of Cardiology, Polyclinic of Bari—Hospital , Bari 70124 , Italy

18. Department of Cardiology, Heart Valve Clinic, GIGA Cardiovascular Sciences, CHU Sart Tilman, University of Liege Hospital , Liege , Belgium

19. Department of Cardiology, Gruppo Villa Maria Care and Research, Anthea Hospital , Bari , Italy

20. APHM, Cardiology Department, La Timone Hospital , Marseille , France

21. IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix Marseille University , Marseille , France

Abstract

Abstract Aims Cardiac device–related infective endocarditis (CDRIE) is a severe complication of cardiac device (CD) implantation and is usually treated by antibiotic therapy and percutaneous device extraction. Few studies report the management and prognosis of CDRIE in real life. In particular, the rate of device extraction in clinical practice and the management of patients with left heart infective endocarditis (LHIE) and an apparently non-infected CD (LHIE+CDRIE−) are not well described. Methods and results We sought to study in EURO-ENDO, the characteristics, prognosis, and management of 483 patients with a CD included in the European Society of Cardiology EurObservational Research Programme EURO-ENDO registry. Three populations were compared: 280 isolated CDRIE (66.7 ± 14.3 years), 157 patients with LHIE and an apparently non-infected CD (LHIE+CDRIE−) (71.1 ± 13.6), and 46 patients with both LHIE and CDRIE (LHIE+CDRIE+) (70.2 ± 10.1). Echocardiography was not always transoesophageal echography (TOE); it was transthoracic echography (TTE) for isolated CDRIE in 88.4% (TOE = 67.6%), for LHIE+CDRIE− TTE = 93.0% (TOE = 58.6%), and for CDRIE+LHIE+ TTE = 87.0% (TOE = 63.0%). Nuclear imaging was performed in 135 patients (positive for 75.6%). In-hospital mortality was lower in isolated CDRIE 13.2% vs. 22.3% and 30.4% for LHIE+CDRIE− and LHIE+CDRIE+ (P = 0004). Device extraction was performed in 62.1% patients with isolated CDRIE, 10.2% of LHIE+CDRIE− patients, and 45.7% of CDRIE+LHIE+ patients. Device extraction was associated with a better prognosis [hazard ratio 0.59 (0.40–0.87), P = 0.0068] even in the LHIE+CDRIE− group (P = 0.047). Conclusion Prognosis of endocarditis in patients with a CD remains poor, particularly in the presence of an associated LHIE. Although recommended by guidelines, device extraction is not always performed. Device removal was associated with better prognosis, even in the LHIE+CDRIE− group.

Funder

Abbott Vascular Int

Amgen Cardiovascular

AstraZeneca

Bayer AG

Boehringer Ingelheim

Boston Scientific

Bristol Myers Squibb

Pfizer Alliance

Daiichi Sankyo Europe GmbH

Alliance Daiichi Sankyo Europe GmbH

Eli Lilly and Company