Clinical InvestigationPredisposing cardiac conditions, interventional procedures, and antibiotic prophylaxis among patients with infective endocarditis
Section snippets
Study design and population
Data from the Registro Italiano della Endocardite Infettiva (RIEI) were used for this study. The RIEI database was created in 2006 and enrollment began in 2007. The background and inclusion criteria of this prospective, multicenter registry of IE have previously been reported.22 From July 2007 to December 2010, patients with IE from 17 Italian centers were enrolled. Patients were prospectively identified using site-specific procedures to ensure consecutive enrollment and were enrolled into RIEI
Results
Figure 1 shows the case selection process. A total of 680 consecutive patients with definite IE were enrolled; 3 patients were excluded because echocardiographic data were not available. The study population was subsequently formed by 677 patients with definite IE (median age 65.34 years; male n = 492 [73%]).
Discussion
In the present study, information on PCCs, interventional procedure, and AP was systematically collected in a large series of consecutive patients with definite IE. The highlights of this observational study are that data are prospectively collected, the cohort is relatively recent, and the multicenter nature of the study increases the generalizability of the results, although most sites are tertiary care centers from a single country. A predisposing cardiac abnormality was identified in 50% of
Conclusions
The epidemiology of IE has dramatically changed in the last years. The predisposing factors for the development of IE have changed, mainly with the decreasing incidence of rheumatic heart disease and the increasing impact of prosthetic heart valves, nosocomial infection, and intravenous drug misuse. The role of AP in preventing IE has been the focus of much debate in recent years. The usefulness of this practice has been questioned, and several national societies have reassessed the current
Acknowledgments
The authors would like to thank Laura McMahon for carefully reading the manuscript and providing help with the editing of the text in English language.
The authors express their gratitude to Anna Castiglione e Gianni Ciccone for the statistical analysis of the results.
RIEI Investigators
Enrico Cecchi, MD; Massimo Imazio, MD; Silvia Ferro, MD; Cristina Cecchi, Rita Trinchero, MD (Cardiology Department, Maria Vittoria Hospital, Torino, Italy). Francesco Giuseppe De Rosa, MD; Filippo Lipani, MD
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