Long-term outcome in patients with prosthetic valve endocarditis: results from a single center in Turkey

OBJECTIVE
Prosthetic valve endocarditis (PVE) is associated with increased mortality and morbidity. Information regarding the long-term outcome of PVE is scarce in Turkey. The aim of this study was to evaluate long-term mortality rates of PVE and identify predictors of mortality in these patients.

METHODS
From January 2008 through August 2013, 44 patients (25 male, 19 female; mean age 49.3±12.1 years) who received a definitive diagnosis of PVE enrolled in the study. Median follow-up period was 23 months. Survival status was assessed for each patient by reviewing charts and making contact by phone. Cox regression analysis was used to evaluate outcome predictors.

RESULTS
The mitral valve was the most commonly affected valve and Staphylococcus aureus the most prevalent microorganism. Fourteen patients (32%) underwent surgery, 7 of whom underwent early surgery. Overall mortality and in-hospital mortality rates were 39% (n=17) and 25% (n=11), respectively. In multivariate analysis, NYHA classification >2 (hazard ratio [HR] 3.7; 95% confidence interval [CI], 1.16–11.8; p=0.03), early-onset PVE (HR 4.23; 95% CI, 1.1–16.42; p=0.04), vegetation size ≥10 mm (HR 3.94; 95% CI, 1.1–14.75; p=0.04), and heart failure (HR 4.18; 95% CI, 1.36–12.8; p=0.01) were found to be independent predictors of mortality.

CONCLUSION
Our findings suggest that PVE is associated with increased long-term mortality rates. Poor functional status, early-onset PVE, heart failure, and vegetation size are independent predictors of survival in patients with PVE.