TY - JOUR 
A1 - Zegri-Reiriz, Isabel
AU - Alarcón González, Arístides de
AU - Muñoz, Patricia
AU - Martínez Sellés Oliveria Soares, Manuel
AU - González Ramallo, Victor
AU - Miró, J. M.
AU - Falces, Carles
AU - Gonzalez Rico, Claudia
AU - Kortajarena Urkola, Xabier
AU - García Pavía, Pablo
AU - Et al.
T1 - Infective endocarditis in patients with bicuspid aortic valve or mitral valve prolapse
Y1 - 2018
SN - 0735-1097

UR - http://hdl.handle.net/11268/7540
AB - Background:
There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions.

Objectives:
This study sought to describe the clinical and microbiological features of IE in patients with BAV and MVP and compare them with those of IE patients with and without IEAP indication, to determine the potential benefit of IEAP in these conditions.

Methods:
This analysis involved 3,208 consecutive IE patients prospectively included in the GAMES (Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España) registry at 31 Spanish hospitals. Patients were classified as high-risk IE with IEAP indication (high-risk group; n = 1,226), low- and moderate-risk IE without IEAP indication (low/moderate-risk group; n = 1,839), and IE with BAV (n = 54) or MVP (n = 89).

Results:
BAV and MVP patients had a higher incidence of viridans group streptococci IE than did high-risk group and low/moderate-risk group patients (35.2% and 39.3% vs. 12.1% and 15.0%, respectively; all p < 0.01). A similar pattern was seen for IE from suspected odontologic origin (14.8% and 18.0% vs. 5.8% and 6.0%; all p < 0.01). BAV and MVP patients had more intracardiac complications than did low/moderate-risk group (50% and 47.2% vs. 30.6%, both p < 0.01) patients and were similar to high-risk group patients.

Conclusions:
IE in patients with BAV and MVP have higher rates of viridans group streptococci IE and IE from suspected odontologic origin than in other IE patients, with a clinical profile similar to that of high-risk IE patients. Our findings suggest that BAV and MVP should be classified as high-risk IE conditions and the case for IEAP should be reconsidered.
KW - Antibióticos
KW - Válvulas cardíacas
KW - Endocarditis infecciosa
KW - Enfermedad cardiovascular
KW - Tratamiento médico
LA - eng
ER -