Takeaway
- In patients with infective endocarditis (IE), diabetes mellitus (DM) was associated with a higher prevalence of vegetations, anatomic complications and impaired left ventricular ejection fraction (LVEF).
- Patients with DM had significantly higher mortality both in hospital and at long-term.
Why this matters
- There is no clarity regarding the prognostic impact of DM in terms of morbidity and mortality in patients with IE.
Study design
- Retrospective analysis of 375 patients with a diagnosis of IE.
- Primary outcome: risk for all-cause death at long-term follow-up.
- Secondary outcome: risk for in-hospital mortality.
- Funding: None
Key results
- Of 375 patients with IE, 129 (34.4%) were diagnosed with diabetes.
- Patients with diabetes vs those without had a higher incidence of paravalvular complications (82% vs 64%; P<.001) and a lower incidence of LVEF (52±11% vs 55±10%; P=.001).
- Risk for in-hospital mortality was higher in patients with diabetes vs those without diabetes (84% vs 74%; P=.030).
- In logistic regression analysis, history of heart failure (OR, 3.12; 95% CI, 1.64-5.95) and low value of LVEF (OR, 0.96; 95% CI, 0.93-0.98; P=.001 for both) were independent predictors of in-hospital mortality.
- At long-term follow-up [median 24(7–84) months], the Kaplan-Meier analysis showed that patients with diabetes had a lower survival free from all-cause death (Log-rank P<.001).
- In the propensity score-adjusted Cox multivariable analysis, DM (HR, 1.75; 95% CI, 1.18-2.60; P=.005), age (HR, 1.03; 95% CI, 1.02-1.05; P<.001), intravenous drug users (HR, 5.42; 95% CI, 2.55-11.52; P<.001) and low LVEF (HR, 0.98; 95% CI, 0.96-0.99; P=.013) were independent predictors of higher mortality.
Limitations
- Retrospective design.
- Single-centre study.
References
References
