Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture
Background Subclinical infection of cardiac implantable electronic devices (CIEDs) is a common condition and increases the risk of clinical infection. However, there are limited studies focused on risk stratifying and prognostic analysis of subclinical CIED infection. Methods and Results Data from 4...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-11-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.022260 |
| _version_ | 1811310970644987904 |
|---|---|
| author | Gaofeng Lin Tong Zou Min Dong Junpeng Liu Wen Cui Jiabin Tong Haifeng Shi Hao Chen Jia Chong You Lyu Sujuan Wu Zhilei Wang Xin Jin Xu Gao Lin Sun Yimei Qu Jiefu Yang |
| author_facet | Gaofeng Lin Tong Zou Min Dong Junpeng Liu Wen Cui Jiabin Tong Haifeng Shi Hao Chen Jia Chong You Lyu Sujuan Wu Zhilei Wang Xin Jin Xu Gao Lin Sun Yimei Qu Jiefu Yang |
| author_sort | Gaofeng Lin |
| collection | DOAJ |
| description | Background Subclinical infection of cardiac implantable electronic devices (CIEDs) is a common condition and increases the risk of clinical infection. However, there are limited studies focused on risk stratifying and prognostic analysis of subclinical CIED infection. Methods and Results Data from 418 consecutive patients undergoing CIED replacement or upgrade between January 2011 and December 2019 were used in the analysis. Among the patients included, 50 (12.0%) were detected as positive by bacterial culture of pocket tissues. The most frequently isolated bacteria were coagulase‐negative staphylococci (76.9%). Compared with the noninfection group, more patients in the subclinical infection group were taking immunosuppressive agents, received electrode replacement, or received CIED upgrade and temporary pacing. Patients in the subclinical infection group had a higher PADIT (Prevention of Arrhythmia Device Infection Trial) score. Univariable and multivariable logistic regression analysis found that use of immunosuppressive agents (odds ratio [OR], 6.95 [95% CI, 1.44–33.51]; P=0.02) and electrode replacement or CIED upgrade (OR, 6.73 [95% CI, 2.23–20.38]; P=0.001) were significantly associated with subclinical CIED infection. Meanwhile, compared with the low‐risk group, patients in the intermediate/high‐risk group had a higher risk of subclinical CIED infection (OR, 3.43 [95% CI, 1.58–7.41]; P=0.002). After a median follow‐up time of 36.5 months, the end points between the subclinical infection group and noninfection group were as follows: composite events (58.0% versus 41.8%, P=0.03), rehospitalization (54.0% versus 32.1%, P=0.002), cardiovascular rehospitalization (32.0% versus 13.9%, P=0.001), CIED infection (2.0% versus 0.5%, P=0.32), all‐cause mortality (28.0% versus 21.5%, P=0.30), and cardiovascular mortality (10.0% versus 7.6%, P=0.57). Conclusions Subclinical CIED infection was a common phenomenon. The PADIT score had significant value for stratifying patients at high risk of subclinical CIED infection. Subclinical CIED infection was associated with increased risks of composite events, rehospitalization, and cardiovascular rehospitalization. |
| first_indexed | 2024-04-13T10:09:46Z |
| format | Article |
| id | doaj.art-61d11fe4de4d434ca65e8deb1cde1a52 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T10:09:46Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-61d11fe4de4d434ca65e8deb1cde1a522022-12-22T02:50:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-11-01102210.1161/JAHA.121.022260Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial CultureGaofeng Lin0Tong Zou1Min Dong2Junpeng Liu3Wen Cui4Jiabin Tong5Haifeng Shi6Hao Chen7Jia Chong8You Lyu9Sujuan Wu10Zhilei Wang11Xin Jin12Xu Gao13Lin Sun14Yimei Qu15Jiefu Yang16Department of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing ChinaBackground Subclinical infection of cardiac implantable electronic devices (CIEDs) is a common condition and increases the risk of clinical infection. However, there are limited studies focused on risk stratifying and prognostic analysis of subclinical CIED infection. Methods and Results Data from 418 consecutive patients undergoing CIED replacement or upgrade between January 2011 and December 2019 were used in the analysis. Among the patients included, 50 (12.0%) were detected as positive by bacterial culture of pocket tissues. The most frequently isolated bacteria were coagulase‐negative staphylococci (76.9%). Compared with the noninfection group, more patients in the subclinical infection group were taking immunosuppressive agents, received electrode replacement, or received CIED upgrade and temporary pacing. Patients in the subclinical infection group had a higher PADIT (Prevention of Arrhythmia Device Infection Trial) score. Univariable and multivariable logistic regression analysis found that use of immunosuppressive agents (odds ratio [OR], 6.95 [95% CI, 1.44–33.51]; P=0.02) and electrode replacement or CIED upgrade (OR, 6.73 [95% CI, 2.23–20.38]; P=0.001) were significantly associated with subclinical CIED infection. Meanwhile, compared with the low‐risk group, patients in the intermediate/high‐risk group had a higher risk of subclinical CIED infection (OR, 3.43 [95% CI, 1.58–7.41]; P=0.002). After a median follow‐up time of 36.5 months, the end points between the subclinical infection group and noninfection group were as follows: composite events (58.0% versus 41.8%, P=0.03), rehospitalization (54.0% versus 32.1%, P=0.002), cardiovascular rehospitalization (32.0% versus 13.9%, P=0.001), CIED infection (2.0% versus 0.5%, P=0.32), all‐cause mortality (28.0% versus 21.5%, P=0.30), and cardiovascular mortality (10.0% versus 7.6%, P=0.57). Conclusions Subclinical CIED infection was a common phenomenon. The PADIT score had significant value for stratifying patients at high risk of subclinical CIED infection. Subclinical CIED infection was associated with increased risks of composite events, rehospitalization, and cardiovascular rehospitalization.https://www.ahajournals.org/doi/10.1161/JAHA.121.022260bacterial culturecardiac implantable electronic devicesprognosisrisk stratifyingsubclinical infection |
| spellingShingle | Gaofeng Lin Tong Zou Min Dong Junpeng Liu Wen Cui Jiabin Tong Haifeng Shi Hao Chen Jia Chong You Lyu Sujuan Wu Zhilei Wang Xin Jin Xu Gao Lin Sun Yimei Qu Jiefu Yang Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease bacterial culture cardiac implantable electronic devices prognosis risk stratifying subclinical infection |
| title | Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture |
| title_full | Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture |
| title_fullStr | Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture |
| title_full_unstemmed | Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture |
| title_short | Risk Stratifying and Prognostic Analysis of Subclinical Cardiac Implantable Electronic Devices Infection: Insight From Traditional Bacterial Culture |
| title_sort | risk stratifying and prognostic analysis of subclinical cardiac implantable electronic devices infection insight from traditional bacterial culture |
| topic | bacterial culture cardiac implantable electronic devices prognosis risk stratifying subclinical infection |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.022260 |
| work_keys_str_mv | AT gaofenglin riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT tongzou riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT mindong riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT junpengliu riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT wencui riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT jiabintong riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT haifengshi riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT haochen riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT jiachong riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT youlyu riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT sujuanwu riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT zhileiwang riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT xinjin riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT xugao riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT linsun riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT yimeiqu riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture AT jiefuyang riskstratifyingandprognosticanalysisofsubclinicalcardiacimplantableelectronicdevicesinfectioninsightfromtraditionalbacterialculture |