[Left-sided native valve infective endocarditis: Influence of age and the presence of underlying heart disease].
OBJECTIVE
Left-sided native valve infective endocarditis (LNVIE) epidemiology has been modified as a result of the increase in average age. The aim of our study is to analyze the influence of age and the presence of predisposing heart disease in the prognosis of these patients.


METHODS
We analyzed a series of 257 cases of LNVIE depending on their age (greater than or equal to 70 years old), both in the overall series and in the subgroup of patients without predisposing heart disease.


RESULTS
Mean age was 54.6 (18.6) years. There was an increase in the percentage of cases of older patients between 1987-2000 and 2001-2014 (9.8 vs. 34.8%, P<.001). These patients present higher prevalence of degenerative valves (50 vs. 22.8%) or not predisposing heart disease (50 vs. 39.9%), P<.001, health-care associated episodes (41.8 vs. 23.6%, P=.016), lower rate of surgery (43.7 vs. 63.8%, P=.005) and higher in-hospital mortality (39.1 vs. 20.7%, P=.003), with no differences in comorbidities. Older patients who did not have predisposing heart disease also suffered higher in-hospital mortality (47 vs. 22%, P=.01). Age greater than or equal to 70 years old is an independent predictor of mortality in patients with LNVIE (OR 2.53, 95% CI 1.24-5.15, P=.011), as in those without previous heart disease (OR 3.98, 95% CI 1.49-10.62, P=.006).


CONCLUSIONS
Patients of age greater than or equal to 70 years old and who suffer an LNVIE are becoming more frequent and have a worse prognosis with a lower rate of surgery and higher rates of in-hospital mortality.
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España. Electronic address: fjcasber@hotmail.com.
Francisco José
FJ
Castillo Bernal
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Manuel Pablo
MP
Anguita Sánchez
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Juan Carlos
JC
Castillo Domínguez
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Francisco
F
Carrasco Ávalos
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Martín
M
Ruiz Ortiz
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Mónica
M
Delgado Ortega
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Elías
E
Romo Peñas
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
Dolores
D
Mesa Rubio
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España.
José
J
Suárez de Lezo Cruzconde
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D016983:Enterococcus / Q000302:isolation & purification*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D034363:Viridans Streptococci / Q000302:isolation & purification*
Age; Edad; Endocarditis infecciosa; Infective endocarditis; Native valve; Válvula nativa