Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis
Background: Infective endocarditis (IE) is a feared complication after surgical aortic valve replacement (SAVR)/transcatheter aortic valve implantation (TAVI). It is not certain which procedure carries a higher risk. Our aim was to assess the risk of IE after SAVR/TAVI. Methods: We conducted an obse...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/2/586 |
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| author | Jorge Calderón-Parra Juan E. de Villarreal-Soto Juan Francisco Oteo-Domínguez María Mateos-Seirul Elsa Ríos-Rosado Laura Dorado Beatriz Vera-Puente Carlos Arellano-Serrano Antonio Ramos-Martínez Alberto Forteza-Gil |
| author_facet | Jorge Calderón-Parra Juan E. de Villarreal-Soto Juan Francisco Oteo-Domínguez María Mateos-Seirul Elsa Ríos-Rosado Laura Dorado Beatriz Vera-Puente Carlos Arellano-Serrano Antonio Ramos-Martínez Alberto Forteza-Gil |
| author_sort | Jorge Calderón-Parra |
| collection | DOAJ |
| description | Background: Infective endocarditis (IE) is a feared complication after surgical aortic valve replacement (SAVR)/transcatheter aortic valve implantation (TAVI). It is not certain which procedure carries a higher risk. Our aim was to assess the risk of IE after SAVR/TAVI. Methods: We conducted an observational study of a prospective cohort, including patients with TAVI/SAVR, from March 2015 to December 2020. IE was defined according to the modified Duke’s criteria. IE occurring during the first 12 months of the procedure was considered early IE, and an episode occurring after 12 months was considered late IE. The propensity score was designed to include variables previously associated with TAVI/SAVR and IE. An inverse probability of treatment weight was generated. Results: In total, 355 SAVR and 278 TAVI were included. Median follow-up, 38 vs. 41 months, <i>p</i> = 0.550. IE occurred in 5 SAVR (1.41%, 95% CI 0.2–2.6) vs. 13 TAVI (4.65%, 95% CI 2.2–7.2), <i>p</i> = 0.016. TAVI patients had more frequent early IE (3.2% vs. 0.3%, <i>p</i> = 0.006). In the PS analyses, IE risk did not differ: OR 0.65, 95% CI 0.32–1.32. Factors associated with TAVI IE included younger age (74y vs. 83y, <i>p</i> = 0.030), complicated diabetes mellitus (38.5% vs. 6.8%, <i>p</i> = 0.002), COPD (46.2% vs. 16.3%, <i>p</i> = 0.015), advanced heart failure (100% vs. 52.9%, <i>p</i> < 0.001), and peripheral arteriopathy (61.5% vs. 26.7%, <i>p</i> = 0.011). Conclusions: Early IE was higher with TAVI, but in the PS analyses, the risk attributable to each procedure was similar. Studies are needed to identify and optimize the risk factors of IE prior to TAVI. |
| first_indexed | 2024-03-09T12:10:18Z |
| format | Article |
| id | doaj.art-13f3eb44d0bf4c6d94e82b003bce554c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T12:10:18Z |
| publishDate | 2023-01-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-13f3eb44d0bf4c6d94e82b003bce554c2023-11-30T22:51:59ZengMDPI AGJournal of Clinical Medicine2077-03832023-01-0112258610.3390/jcm12020586Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based AnalysisJorge Calderón-Parra0Juan E. de Villarreal-Soto1Juan Francisco Oteo-Domínguez2María Mateos-Seirul3Elsa Ríos-Rosado4Laura Dorado5Beatriz Vera-Puente6Carlos Arellano-Serrano7Antonio Ramos-Martínez8Alberto Forteza-Gil9Infectious Diseases Unit, Service of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainCardiovascular Surgery Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainInterventional Cardiology Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainInfectious Diseases Unit, Service of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainCardiovascular Surgery Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainInfectious Diseases Unit, Service of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainCardiovascular Surgery Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainInterventional Cardiology Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainInfectious Diseases Unit, Service of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainCardiovascular Surgery Department, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, SpainBackground: Infective endocarditis (IE) is a feared complication after surgical aortic valve replacement (SAVR)/transcatheter aortic valve implantation (TAVI). It is not certain which procedure carries a higher risk. Our aim was to assess the risk of IE after SAVR/TAVI. Methods: We conducted an observational study of a prospective cohort, including patients with TAVI/SAVR, from March 2015 to December 2020. IE was defined according to the modified Duke’s criteria. IE occurring during the first 12 months of the procedure was considered early IE, and an episode occurring after 12 months was considered late IE. The propensity score was designed to include variables previously associated with TAVI/SAVR and IE. An inverse probability of treatment weight was generated. Results: In total, 355 SAVR and 278 TAVI were included. Median follow-up, 38 vs. 41 months, <i>p</i> = 0.550. IE occurred in 5 SAVR (1.41%, 95% CI 0.2–2.6) vs. 13 TAVI (4.65%, 95% CI 2.2–7.2), <i>p</i> = 0.016. TAVI patients had more frequent early IE (3.2% vs. 0.3%, <i>p</i> = 0.006). In the PS analyses, IE risk did not differ: OR 0.65, 95% CI 0.32–1.32. Factors associated with TAVI IE included younger age (74y vs. 83y, <i>p</i> = 0.030), complicated diabetes mellitus (38.5% vs. 6.8%, <i>p</i> = 0.002), COPD (46.2% vs. 16.3%, <i>p</i> = 0.015), advanced heart failure (100% vs. 52.9%, <i>p</i> < 0.001), and peripheral arteriopathy (61.5% vs. 26.7%, <i>p</i> = 0.011). Conclusions: Early IE was higher with TAVI, but in the PS analyses, the risk attributable to each procedure was similar. Studies are needed to identify and optimize the risk factors of IE prior to TAVI.https://www.mdpi.com/2077-0383/12/2/586infective endocarditisTAVIrisk factors |
| spellingShingle | Jorge Calderón-Parra Juan E. de Villarreal-Soto Juan Francisco Oteo-Domínguez María Mateos-Seirul Elsa Ríos-Rosado Laura Dorado Beatriz Vera-Puente Carlos Arellano-Serrano Antonio Ramos-Martínez Alberto Forteza-Gil Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis Journal of Clinical Medicine infective endocarditis TAVI risk factors |
| title | Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis |
| title_full | Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis |
| title_fullStr | Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis |
| title_full_unstemmed | Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis |
| title_short | Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis |
| title_sort | risk of infective endocarditis associated with transcatheter aortic valve implantation versus surgical aortic valve replacement a propensity score based analysis |
| topic | infective endocarditis TAVI risk factors |
| url | https://www.mdpi.com/2077-0383/12/2/586 |
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