November 22nd, 2011
Study Examines Role of Surgery for Infective Endocarditis and Heart Failure
Larry Husten, PHD
Although current guidelines recommend valve surgery for patients with infective endocarditis and heart failure (HF), a large prospective registry finds that many of these patients do not undergo surgery — and have much worse outcomes.
In a paper published in JAMA, Todd Kiefer and colleagues report on 4166 patients with infective endocarditis enrolled in the International Collaboration on Endocarditis – Prospective Cohort Study. One third of the patients had HF, yet only 61.7% of these had valve surgery. In-hospital mortality was 29.7% for all patients with HF, but it was significantly lower in the surgical group than in the medical therapy group: 20.6% versus 44.8% (p<0.001). At 1 year, the difference in mortality was larger: 29.1% versus 58.4% (p<0.001). The investigators report that the association between surgery and survival “was apparent across the spectrum of HF severity.”
The authors write that their results support the need for “multidisciplinary, guideline-based management of infective endocarditis.”
NEJM Journal Watch — Recent Cardiology Articles- Anticoagulation in Patients with Cancer-Associated Pulmonary Embolism: How Long is Long Enough?
- Spironolactone Use After Percutaneous Intervention for Acute Myocardial Infarction
- CRISPR/Cas9 Gene Editing for Transthyretin Cardiomyopathy
- Does Colchicine Reduce Cardiac Events After Myocardial Infarction?
- First-Line Therapy for Ventricular Tachycardia After MI: What's the Best Approach?