Long-term outcome in patients with prosthetic valve endocarditis: results from a single center in Turkey

Abstract

Objective: Prosthetic valve endocarditis (PVE) is associated with increased mortality and morbidity. Information regarding the long-term outcome of PVE is scarce in Turkey. The aim of this study was to evaluate long-term mortality rates of PVE and identify predictors of mortality in these patients. Methods: From January 2008 through August 2013, 44 patients (25 male, 19 female; mean age 49.3+-12.1 years) who received a definitive diagnosis of PVE enrolled in the study. Median follow-up period was 23 months. Survival status was assessed for each patient by reviewing charts and making contact by phone. Cox regression analysis was used to evaluate outcome predictors. Results: The mitral valve was the most commonly affected valve and Staphylococcus aureus the most prevalent microorganism. Fourteen patients (32%) underwent surgery, 7 of whom underwent early surgery. Overall mortality and in-hospital mortality rates were 39% (n=17) and 25% (n=11), respectively. In multivariate analysis, NYHA classification >2 (hazard ratio [HR] 3.7; 95% confidence interval [CI], 1.16–11.8; p=0.03), early-onset PVE (HR 4.23; 95% CI, 1.1–16.42; p=0.04), vegetation size ≥10 mm (HR 3.94; 95% CI, 1.1–14.75; p=0.04), and heart failure (HR 4.18; 95% CI, 1.36–12.8; p=0.01) were found to be independent predictors of mortality. Conclusion: Our findings suggest that PVE is associated with increased long-term mortality rates. Poor functional status, early-onset PVE, heart failure, and vegetation size are independent predictors of survival in patients with PVE.

Keywords

• angioplasty
• balloon
• coronary
• mortality; outcome; prosthetic valve endocarditis.