title: Changing pattern of infective endocarditis in Iran: A 16 years survey.
abstract: OBJECTIVE
  To investigate the changes in characteristics of patients with infective endocarditis in Iran and comparing the results with the changing profiles of Infection Endocarditis (IE) in other countries.
  
  
  METHODS
  We studied all patients with definite or possible IE seen at four referral teaching hospitals in Iran from Jan. 1995 to Dec. 2010. The data was analyzed both collectively and separately in two consecutive eight-year periods, i.e. 1995-2003 and 2004-2010.
  
  
  RESULTS
  A total of 286 episodes of IE, 172 males and 114 females, were reviewed from which 162 ones were in the first eight-year time period and 124 episodes in the second one. Mean age of the patients was significantly increased in the second eight-year period (24.2±11 vs 39.4±15 years old, p value = 0.01). Increase in the episodes caused by Staphylococcus aureus was significant (40.7% vs 22.8%, p value = 0.01). The mean size of the vegetation was noticeably higher among IDUs than non-IDUs (1.53±0.1cm vs 0.76±0.2cm, p value < 0.001). As well as extra cardiac complications, mortality rate was noticeably higher among the patients with vegetation size ≥ 1cm (34.4% vs 16.3%, p value = 0.003). There was not a significant difference regarding the mortality rate between the conservatively and surgically treated patients (20.7% vs 22.9%, p value = 0.07).
  
  
  CONCLUSIONS
  The most important changing characteristic of IE which influences the outcome of the disease seems to be vegetation size which can account for as the outcome predictor.
authors.affiliation: Behnam Hajihossainlou, MD, Graduate Student in Clinical Research Program, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Behnam
authors.initials: B
authors.lastname: Hajihossainlou
authors.affiliation: Mohammad-Ali Heidarnia, MD, Assistant Professor, Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad-Ali
authors.initials: MA
authors.lastname: Heidarnia
authors.affiliation: Dr. Babak Sharif Kashani, MD, Assistant Professor, Department of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Sharif Kashani
keywords: IDUs; Infective Endocarditis; Vegetation size