Table 1. Characteristics of patients with native valve endocarditis compared patients with prosthetic valve endocarditis.
| Native (n = 2769) | Prosthetic (n = 1354) | Overall (N = 4123) | p-value | |
|---|---|---|---|---|
| Age. years (IQR) | 66 (53–76) | 71 (62–77) | 68 (57–76) | <0.001 |
| Male gender | 1897 (68.5) | 903 (66.9) | 2800 (67.9) | 0.240 |
| Hospital-acquired | 590 (21.3) | 515 (38.0) | 1105 (26.8) | <0.001 |
| Site of infection | ||||
| Aortic | 1386 (50.1) | 969 (71.6) | 2355 (57.1) | <0.001 |
| Mitral | 1469 (53.1) | 515 (38.0) | 1984 (48.1) | <0.001 |
| Comorbidity | ||||
| Coronary disease | 556 (20.1) | 471 (34.7) | 1027 (24.9) | <0.001 |
| Chronic heart failure | 661 (23.9) | 609 (44.9) | 1270 (30.8) | <0.001 |
| Intravenous drug user | 109 (3.9) | 10 (0.7) | 119 (2.8) | <0.001 |
| Cerebrovascular disease | 282 (10.2) | 235 (17.3) | 517 (12.5) | <0.001 |
| Chronic renal failure | 664 (24.0) | 357 (26.4) | 1021 (24.7) | 0.095 |
| Chronic liver disease | 339 (12.2) | 95 (7.1) | 434 (10.5) | <0.001 |
| Age-adjusted Charlson index (IQR) | 4 (3–6) | 5 (3–7) | 5 (3–7) | <0.001 |
| Microbiology | ||||
| Gram-positive bacteria | ||||
| Staphylococcus aureus | 766 (27.7) | 208 (15.4) | 974 (23.6) | <0.001 |
| MRSA | 116 (4.1) | 42 (3.1) | 158 (3.8) | 0.088 |
| Coagulase-negative staphylococci | 285 (10.3) | 437 (32.3) | 722 (17.5) | <0.001 |
| Enterococcus spp | 441 (15.9) | 217 (16.0) | 658 (15.9) | 0.934 |
| Streptococcus spp | 932 (33.7) | 262 (19.4) | 1194 (28.9) | <0.001 |
| Gram-negative bacilli | 91 (3.3) | 63 (4.7) | 154 (3.7) | 0.030 |
| Anaerobic bacteria | 16 (0.6) | 30 (2.2) | 46 (1.1) | <0.001 |
| Fungi | ||||
| Candida spp | 31 (1.1) | 33 (2.4) | 64 (1.5) | 0.001 |
| Other fungi | 10 (0.4) | 2 (0.1) | 12 (0.3) | 0.358 |
| Polymicrobial | 34 (1.2) | 18 (1.3) | 52 (1.2) | 0.784 |
| Other microorganisms | 65 (2.3) | 36 (2.7) | 101 (2.4) | 0.544 |
| Negative cultures (no growth) | 78 (2.8) | 37 (2.7) | 115 (2.7) | 0.877 |
| Echocardiographic findings | ||||
| Vegetation | 2359 (85.2) | 928 (68.5) | 3287 (79.7) | <0.001 |
| Intracardiac complications | 971 (35.1) | 569 (42.0) | 1540 (37.3) | <0.001 |
| Valve perforation or rupture | 633 (22.9) | 50 (3.6) | 683 (16.5) | <0.001 |
| Pseudoaneurysm | 144 (5.2) | 148 (10.9) | 292 (7.0) | <0.001 |
| Perivalvular abscess | 366 (13.2) | 460 (34.0) | 826 (20.0) | <0.001 |
| Intracardiac fistula | 59 (2.1) | 63 (4.6) | 122 (2.9) | <0.001 |
| Clinical course | ||||
| Acute heart failure | 1271 (45.9) | 542 (40.0) | 1813 (43.9) | <0.001 |
| Persistent bacteremia | 326 (11.8) | 153 (11.3) | 479 (11.6) | 0.656 |
| Stroke | 602 (21.7) | 320 (23.6) | 922 (22.3) | 0.171 |
| Embolism a | 721 (26.0) | 285 (21.0) | 1006 (24.3) | <0.001 |
| Mycotic aneurism | 75 (2.7) | 30 (2.2) | 105 (2.5) | 0.345 |
| Acute renal failure | 948 (34.2) | 571 (42.1) | 1519 (36.8) | <0.001 |
| Septic shock | 376 (13.6) | 183 (13.5) | 559 (13.5) | 0.955 |
| Surgical indication | 1887 (68.1) | 1009 (74.5) | 2896 (70.2) | <0.001 |
| Surgery performed b | 1306 (69.2) | 650 (64.4) | 1956 (67.5) | 0.009 |
| Surgery indicated. not performed | 581 (30.8) | 359 (35.6) | 940 (32.4) | <0.001 |
| In-hospital mortality | 709 (25.6) | 442 (32.6) | 1151 (27.9) | <0.001 |
| First year mortality | 876 (31.6) | 507 (37.4) | 1383 (33.5) | <0.001 |
| Recurrence c | 28 (1.3) | 21 (2.3) | 49 (1.6) | 0.063 |
IQR: Interquartile range. MRSA: methicillin-resistant S. aureus.
a Excluding cases with stroke.
b Percentages calculated considering only patients with surgical indications.
c during the first year after diagnosis calculated on patients discharged from the hospital (n = 2972).
Seventy cases (5.1%) showed concomitant involvement of native and prosthetic valves.