Long-term outcome in patients with prosthetic valve endocarditis: results from a single center in Turkey.
Prosthetic valve endocarditis (PVE) is associated with increased mortality and morbidity. Information regarding the long-term outcome of PVE is scarce in Turkey. The aim of this study was to evaluate long-term mortality rates of PVE and identify predictors of mortality in these patients.



From January 2008 through August 2013, 44 patients (25 male, 19 female; mean age 49.3±12.1 years) who received a definitive diagnosis of PVE enrolled in the study.Median follow-up period was 23 months. Survival status was assessed for each patient by reviewing charts and making contact by phone. Cox regression analysis was used to evaluate outcome predictors.



The mitral valve was the most commonly affected valve and Staphylococcus aureus the most prevalent microorganism. Fourteen patients (32%) underwent surgery, 7 of whom underwent early surgery. Overall mortality and in-hospital mortality rates were 39% (n=17) and 25% (n=11), respectively. In multivariate analysis, NYHA classification >2 (hazard ratio [HR] 3.7; 95% confidence interval [CI], 1.16-11.8; p=0.03), early-onset PVE (HR 4.23; 95% CI, 1.1-16.42; p=0.04), vegetation size ≥10 mm (HR 3.94; 95% CI, 1.1-14.75; p=0.04), and heart failure (HR 4.18; 95% CI, 1.36-12.8; p=0.01) were found to be independent predictors of mortality.



Our findings suggest that PVE is associated with increased long-term mortality rates. Poor functional status, early-onset PVE, heart failure, and vegetation size are independent predictors of survival in patients with PVE.
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey. yesimguray@gmail.com.
Yeşim
Y
Güray
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Esra
E
Gücük İpek
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Burak
B
Acar
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Mevlüt Serdar
MS
Kuyumcu
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Fatih
F
Uçar
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Habibe
H
Kafes
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Lale
L
Asarcıklı
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Gizem
G
Çabuk
Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Burcu
B
Demirkan
Department of Cardiology, Numune Training and Research Hospital, Ankara, Turkey.
Ümit
Ü
Güray
D000328:Adult; D004697:Endocarditis, Bacterial / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology