Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse

There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions. This study sought to describe the clinical and microbiological features...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of the American College of Cardiology Vol. 71; no. 24; pp. 2731 - 2740
Main Authors:	Gonzalez Rico, Claudia, Rodriguez Alvarez, Regino, Garcia-Pavia, Pablo, Noureddine, Mariam, de la Torre Lima, Javier, Blanco, María José, Crespo, Alejandro, Goikoetxea, Josune, Iruretagoyena, José Ramón, López-Soria, Leire, Nieto, Javier, Rodríguez, Regino, Vitoria, Yolanda, Rodríguez Bailón, Isabel, Ruiz Morales, Josefa, Cuende, Ana María, Fuerte, Ana, Goenaga, Miguel Ángel, Carrasco, Rafael, Climent, Vicente, Llamas, Patricio, Bravo-Ferrer, José María, Cuenca, José, Miguez Rey, Enrique, Rodríguez Mayo, María, Martínez, Francisco Javier, Alonso, María del Mar, Lacalzada, Juan, Reguera Iglesias, José Mª, Asensi Álvarez, Víctor, Paya Martínez, Begoña, Ambrosioni, Juan, Brunet, Mercè, Cartañá, Ramón, Fita, Guillermina, Fuster, David, Marco, Francesc, Miró, José María, Nicolás, David, Paré, Carlos, Pereda, Daniel, Pomar, José Luis, Ramírez, José, Téllez, Adrián, Vila, Jordi, Adán, Iván, Bouza, Emilio, Delgado Montero, Antonia, González Ramallo, Víctor, Kestler Hernández, Martha, Marín, Mercedes, Martínez-Sellés, Manuel, Menárguez, María Cruz, Rincón, Cristina, Verde Moreno, Eduardo, Moreno, Mar, Rial Bastón, Verónica, Romero, María, Saldaña, Araceli, Agüero Balbín, Jesús, Arnaiz, Ana, García, Iván, Gutiérrez-Cuadra, Manuel, Teira, Ramón, Domínguez, Fernando, Mirelis, Jesús González, Ramos, Antonio, Hermida, José Manuel, Barquero, José Miguel, de Cueto, Marina, Gálvez Acebal, Juan, López, Francisco, Alonso, Luis Javier, Azcárate, Pedro, Azcona Gutiérrez, José Manuel, Oteo, José Antonio, Pons, Guillem, Fernández, Ángel Luis, Martínez, Amparo, Mollar, José Cordo, Martín López, Alejandro, García Domínguez, Gloria, Arribas Leal, José Mª, García Vázquez, Elisa, Blázquez, Ana, de la Morena Valenzuela, Gonzalo, Calvo, Felicitas Elena, Heredero Gálvez, Eva, Cascales Alcolea, Eva, Soriano, Víctor, Moreno Escobar, Eduardo, Arrizabalaga Asenjo, María, Núñez Morcillo, Juana, Porres, Juan Carlos, Alcaraz Vidal, Begoña, Cobos Trigueros, Nazaret, Giner Caro, José Antonio, Jimeno Almazán, Amaya, Viqueira González, Monserrat, Pericás Ramis, Pere
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 19-06-2018 Elsevier Limited
Subjects:	Adult Aged Antibiotic Prophylaxis Antibiotics Aortic valve Aortic Valve - abnormalities bicuspid aortic valve Bicuspid Aortic Valve Disease Cardiology Complications Embolisms Endocarditis Endocarditis - microbiology Endocarditis - prevention & control Female Heart failure Heart surgery Heart Valve Diseases - complications Heart valves Hospitals Humans Indication Male Microorganisms Middle Aged Mitral valve mitral valve prolapse Mitral Valve Prolapse - complications Mortality Patients Prophylaxis Prostheses Registries Risk Risk groups Statistical analysis VGS MVP IEAP IQR mitral valve prolapse ESC bicuspid aortic valve BAV antibiotic prophylaxis endocarditis AHA IE CHD HF
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions. This study sought to describe the clinical and microbiological features of IE in patients with BAV and MVP and compare them with those of IE patients with and without IEAP indication, to determine the potential benefit of IEAP in these conditions. This analysis involved 3,208 consecutive IE patients prospectively included in the GAMES (Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España) registry at 31 Spanish hospitals. Patients were classified as high-risk IE with IEAP indication (high-risk group; n = 1,226), low- and moderate-risk IE without IEAP indication (low/moderate-risk group; n = 1,839), and IE with BAV (n = 54) or MVP (n = 89). BAV and MVP patients had a higher incidence of viridans group streptococci IE than did high-risk group and low/moderate-risk group patients (35.2% and 39.3% vs. 12.1% and 15.0%, respectively; all p < 0.01). A similar pattern was seen for IE from suspected odontologic origin (14.8% and 18.0% vs. 5.8% and 6.0%; all p < 0.01). BAV and MVP patients had more intracardiac complications than did low/moderate-risk group (50% and 47.2% vs. 30.6%, both p < 0.01) patients and were similar to high-risk group patients. IE in patients with BAV and MVP have higher rates of viridans group streptococci IE and IE from suspected odontologic origin than in other IE patients, with a clinical profile similar to that of high-risk IE patients. Our findings suggest that BAV and MVP should be classified as high-risk IE conditions and the case for IEAP should be reconsidered. [Display omitted]
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0735-1097 1558-3597
DOI:	10.1016/j.jacc.2018.03.534