Characteristics of infective endocarditis in a cancer population
Jose Banchs,
Juhee Song,
Saamir A Hassan,
Cullen Grable,
George M Viola,
Owais Ulhaq,
Corey T Jensen,
Harsh Goel,
Syed W Yusuf
Affiliations
Jose Banchs
1 Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA
Juhee Song
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Saamir A Hassan
Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Cullen Grable
Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
George M Viola
Department of Infectious Diseases, Infection Control and Employee Health, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, Houston, Texas, USA
Owais Ulhaq
Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Corey T Jensen
Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Harsh Goel
Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Syed W Yusuf
Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Background Infective endocarditis (IE) is more common in patients with cancer as compared with the general population. Due to an immunocompromised state, the need for invasive procedures, hypercoagulability and the presence of indwelling catheters, patients with cancer are particularly predisposed to the development of IE.Objectives Limited information exists about IE in patients with cancer. We aimed to evaluate the characteristics of patients with cancer and IE at our tertiary care centre, including a comparison of the microorganisms implicated and their association with mortality.Methods A retrospective chart review of patients with cancer who had echocardiography for suspicion of endocarditis was conducted. A total of 56 patients with a confirmed diagnosis of cancer and endocarditis, based on the modified Duke criteria, were included in the study. Baseline demographics, risk factors for developing IE, echocardiography findings, microbiology and mortality data were analysed.Results Following the findings of vegetations by echocardiography, the median survival time was 8.5 months. Staphylococcus aureus was the most common organism identified as causing endocarditis. The mitral and aortic valves were the most commonly involved sites of endocarditis. Patients with S. aureus endocarditis (SAE) had a significantly poorer survival when compared with patients without SAE (p=0.0217) over the 12-month period from diagnosis of endocarditis.Conclusions Overall survival of patients with cancer and endocarditis is poor, with a worse outcome in patients with SAE.
