Prevalence of Right- and Left-Sided Endocarditis Among Intravenous Drug Use Patients at a Large Academic Medical Center.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Kanjit Leungsuwan, Mahender Vyasabattu, Heena Arshad, Ahmed Abdelfattah, Kory R Heier, Samiullah Arshad
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引用次数: 0

Abstract

Background: Left-sided infective endocarditis (IE) is increasingly being recognized among intravenous drug use (IVDU) patients. We sought to assess the trends and risk factors that contribute to left-sided IE in this high-risk population at University of Kentucky.

Methods: A retrospective chart review of patients with the diagnosis of both IE and IVDU admitted at University of Kentucky was carried out from January 1, 2015 to December 31, 2019. Baseline characteristics, trends of endocarditis and clinical outcomes (mortality and in-hospital interventions) were recorded.

Results: A total of 197 patients were admitted for management of endocarditis. One hundred and fourteen (57.9%) had right-sided endocarditis, 25 (12.7%) had combined left-sided and right-sided endocarditis, and 58 (29.4%) had left-sided endocarditis. Staphylococcus aureus was the most common pathogen. Mortality and inpatient surgical interventions were higher among patients with left-sided endocarditis. Patent foramen ovale (PFO) was the most common shunt found (3.1%), followed by atrial septal defect (ASD, 2.4%) with PFO being significantly more common among patients with left-sided endocarditis.

Conclusion: Right-sided endocarditis continues to be predominant among IVDU patients and Staphylococcus aureus was the most common organism involved. Patients with evidence of left-sided disease were found to have significantly more PFO, needed more inpatient valvular surgeries, and had higher all-cause mortality. Further studies are needed to assess if PFO or ASD can increase the risk of acquiring left-sided endocarditis in IVDU.

某大型学术医疗中心静脉用药患者左、右心内膜炎的患病率。
背景:左侧感染性心内膜炎(IE)越来越多地在静脉吸毒(IVDU)患者中得到认可。我们试图在肯塔基大学的高风险人群中评估导致左侧IE的趋势和风险因素。方法:回顾性分析2015年1月1日至2019年12月31日在肯塔基大学住院的同时诊断为IE和IVDU的患者。记录基线特征、心内膜炎趋势和临床结果(死亡率和住院干预)。结果:共收治心内膜炎患者197例。右侧心内膜炎114例(57.9%),左右合并心内膜炎25例(12.7%),左侧心内膜炎58例(29.4%)。金黄色葡萄球菌是最常见的病原体。左侧心内膜炎患者的死亡率和住院手术干预较高。卵圆孔未闭(PFO)是最常见的分流(3.1%),其次是房间隔缺损(ASD, 2.4%),其中PFO在左侧心内膜炎患者中更为常见。结论:右侧心内膜炎在IVDU患者中仍占主导地位,其中最常见的是金黄色葡萄球菌。有左侧疾病证据的患者有明显更多的PFO,需要更多的住院瓣膜手术,并且有更高的全因死亡率。需要进一步的研究来评估PFO或ASD是否会增加IVDU中获得左侧心内膜炎的风险。
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来源期刊
Cardiology Research
Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.50
自引率
0.00%
发文量
42
期刊介绍: Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.
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