Prospective Cohort Study of Infective Endocarditis in People
Who Inject Drugs

PERICAS, J. M., J. LLOPIS, E. ATHAN, M. HERNANDEZ-MENESES, M. M. HANNAN, D. R. MURDOCH, Z. KANAFANI, Tomáš FREIBERGER, J. STRAHILEVITZ, N. FERNANDEZ-HIDALGO, C. LAMAS, E. DURANTE-MANGONI, P. TATTEVIN, F. NACINOVICH, V. H. CHU and J. M. MIRO. Prospective Cohort Study of Infective Endocarditis in People Who Inject Drugs. Journal of the American College of Cardiology. New York: Elsevier Science INC, 2021, vol. 77, No 5, p. 544-555. ISSN 0735-1097. Available from: https://dx.doi.org/10.1016/j.jacc.2020.11.062.

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TY  - JOUR
ID  - 1776200
AU  - Pericas, J. M. - Llopis, J. - Athan, E. - Hernandez-Meneses, M. - Hannan, M. M. - Murdoch, D. R. - Kanafani, Z. - Freiberger, Tomáš - Strahilevitz, J. - Fernandez-Hidalgo, N. - Lamas, C. - Durante-Mangoni, E. - Tattevin, P. - Nacinovich, F. - Chu, V. H. - Miro, J. M.
PY  - 2021
TI  - Prospective Cohort Study of Infective Endocarditis in People Who Inject Drugs
JF  - Journal of the American College of Cardiology
VL  - 77
IS  - 5
SP  - 544-555
EP  - 544-555
PB  - Elsevier Science INC
SN  - 07351097
KW  - cardiac surgery
KW  - HIV
KW  - infective endocarditis
KW  - opioid crisis
KW  - people who inject drugs
KW  - Staphylococcus aureus
UR  - https://www.sciencedirect.com/science/article/pii/S0735109720380050?via%3Dihub
N2  - BACKGROUND Infective endocarditis (IE) in people who inject drugs (PWID) is an emergent public health problem. OBJECTIVES The purpose of this study was to investigate IE in PWID and compare it with IE in non-PWID patients. METHODS Two prospective cohort studies (ICE-PCS and ICE-Plus databases, encompassing 8,112 IE episodes from 2000 to 2006 and 2008 to 2012, with 64 and 34 sites and 28 and 18 countries, respectively). Outcomes were compared between PWID and non-PWID patients with IE. Logistic regression analyses were performed to investigate risk factors for 6-month mortality and relapses amongst PWID. RESULTS A total of 7,616 patients (591 PWID and 7,025 non-PWID) were included. PWID patients were significantly younger (median 37.0 years [interquartile range: 29.5 to 44.2 years] vs. 63.3 years [interquartile range: 49.3 to 74.0 years]; p < 0.001), male (72.5% vs. 67.4%; p = 0.007), and presented lower rates of comorbidities except for human immunodeficiency virus, liver disease, and higher rates of prior IE. Amongst IE cases in PWID, 313 (53%) episodes involved left-side valves and 204 (34.5%) were purely left-sided IE. PWID presented a larger proportion of native IE (90.2% vs. 64.4%; p < 0.001), whereas prosthetic-IE and cardiovascular implantable electronic device-IE were more frequent in non-PWID (9.3% vs. 27.0% and 0.5% vs. 8.6%; both p < 0.001). Staphylococcus aureus caused 65.9% and 26.8% of cases in PWID and non-PWID, respectively (p < 0.001). PWID presented higher rates of systemic emboli (51.1% vs. 22.5%; p < 0.001) and persistent bacteremia (14.7% vs. 9.3%; p < 0.001). Cardiac surgery was less frequently performed (39.5% vs. 47.8%; p < 0.001), and in-hospital and 6-month mortality were lower in PWID (10.8% vs. 18.2% and 14.4% vs. 22.2%; both p < 0.001), whereas relapses were more frequent in PWID (9.5% vs. 2.8%; p < 0.001). Prior IE, left-sided IE, polymicrobial etiology, intracardiac complications, and stroke were risk factors for 6-month mortality, whereas cardiac surgery was associated with lower mortality in the PWID population. CONCLUSIONS A notable proportion of cases in PWID involve left-sided valves, prosthetic valves, or are caused by microorganisms other than S. aureus. (C) 2021 by the American College of Cardiology Foundation.
ER  -

Basic information
Original name	Prospective Cohort Study of Infective Endocarditis in People Who Inject Drugs
Authors	PERICAS, J. M., J. LLOPIS, E. ATHAN, M. HERNANDEZ-MENESES, M. M. HANNAN, D. R. MURDOCH, Z. KANAFANI, Tomáš FREIBERGER (203 Czech Republic, belonging to the institution), J. STRAHILEVITZ, N. FERNANDEZ-HIDALGO, C. LAMAS, E. DURANTE-MANGONI, P. TATTEVIN, F. NACINOVICH, V. H. CHU and J. M. MIRO (guarantor).
Edition	Journal of the American College of Cardiology, New York, Elsevier Science INC, 2021, 0735-1097.

Other information
Original language	English
Type of outcome	Article in a journal
Field of Study	30201 Cardiac and Cardiovascular systems
Country of publisher	United States of America
Confidentiality degree	is not subject to a state or trade secret
WWW	URL
Impact factor	Impact factor: 27.203
RIV identification code	RIV/00216224:14110/21:00121771
Organization unit	Faculty of Medicine
Doi	http://dx.doi.org/10.1016/j.jacc.2020.11.062
UT WoS	000631946500004
Keywords in English	cardiac surgery; HIV; infective endocarditis; opioid crisis; people who inject drugs; Staphylococcus aureus
Tags	14110114, rivok
Tags	International impact, Reviewed
Changed by	Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 12/12/2022 09:24.

Abstract

BACKGROUND Infective endocarditis (IE) in people who inject drugs (PWID) is an emergent public health problem. OBJECTIVES The purpose of this study was to investigate IE in PWID and compare it with IE in non-PWID patients. METHODS Two prospective cohort studies (ICE-PCS and ICE-Plus databases, encompassing 8,112 IE episodes from 2000 to 2006 and 2008 to 2012, with 64 and 34 sites and 28 and 18 countries, respectively). Outcomes were compared between PWID and non-PWID patients with IE. Logistic regression analyses were performed to investigate risk factors for 6-month mortality and relapses amongst PWID. RESULTS A total of 7,616 patients (591 PWID and 7,025 non-PWID) were included. PWID patients were significantly younger (median 37.0 years [interquartile range: 29.5 to 44.2 years] vs. 63.3 years [interquartile range: 49.3 to 74.0 years]; p < 0.001), male (72.5% vs. 67.4%; p = 0.007), and presented lower rates of comorbidities except for human immunodeficiency virus, liver disease, and higher rates of prior IE. Amongst IE cases in PWID, 313 (53%) episodes involved left-side valves and 204 (34.5%) were purely left-sided IE. PWID presented a larger proportion of native IE (90.2% vs. 64.4%; p < 0.001), whereas prosthetic-IE and cardiovascular implantable electronic device-IE were more frequent in non-PWID (9.3% vs. 27.0% and 0.5% vs. 8.6%; both p < 0.001). Staphylococcus aureus caused 65.9% and 26.8% of cases in PWID and non-PWID, respectively (p < 0.001). PWID presented higher rates of systemic emboli (51.1% vs. 22.5%; p < 0.001) and persistent bacteremia (14.7% vs. 9.3%; p < 0.001). Cardiac surgery was less frequently performed (39.5% vs. 47.8%; p < 0.001), and in-hospital and 6-month mortality were lower in PWID (10.8% vs. 18.2% and 14.4% vs. 22.2%; both p < 0.001), whereas relapses were more frequent in PWID (9.5% vs. 2.8%; p < 0.001). Prior IE, left-sided IE, polymicrobial etiology, intracardiac complications, and stroke were risk factors for 6-month mortality, whereas cardiac surgery was associated with lower mortality in the PWID population. CONCLUSIONS A notable proportion of cases in PWID involve left-sided valves, prosthetic valves, or are caused by microorganisms other than S. aureus. (C) 2021 by the American College of Cardiology Foundation.

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Prospective Cohort Study of Infective Endocarditis in People Who Inject Drugs

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