Archives of the Turkish Society of Cardiology
Revascularization strategies in patients with infective endocarditis-related ST-elevation myocardial infarction: The STEMI-ENDO Registry [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(8): 654-665 | DOI: 10.5543/tkda.2021.21173

Revascularization strategies in patients with infective endocarditis-related ST-elevation myocardial infarction: The STEMI-ENDO Registry

Ahmet Güner1, Yeşim Uygun Kızmaz2, Sabahattin Gündüz3, Çağdaş Arslan1, Serpil Özkan Öztürk4, Elnur Alizade5, Macit Kalçık6, Serkan Kahraman1, Cemalettin Akman1, Ali Kemal Kalkan1, Mehmet Özkan5
1Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Infectious Diseases and Clinical Microbiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey
3Department of Cardiology, Bahçeşehir University School of Medicine, İstanbul, Turkey
4Department of Infectious Diseases and Clinical Microbiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
5Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey
6Department of Cardiology, Hitit University School of Medicine, Çorum, Turkey


OBJECTIVE
Infective endocarditis (IE)-related ST elevation myocardial infarction (STEMI) is extremely rare. A clear clinical consensus is lacking regarding the management of this emergency. In this study, we aimed to describe the clinical outcomes of treatment strategies in this patient population.

METHODS
The study population comprised 19 retrospectively evaluated patients (nine women; mean age 52±11.8 years) with a diagnosis of IE-related STEMI. Transesophageal echocardiography detected vegetation in all the patients. The study population was divided into two groups on the basis of in-hospital mortality.

RESULTS
Major clinical manifestations included dyspnea (89.5%), fever (78.9%), and chest pain (63.2%). Catheter-based coronary angiography was performed in all the patients. The causative agent was isolated in all the cases, and Staphylococcus aureus was identified in seven (36.8%). The most common infarction was in the left anterior descending artery (n=12 [63.2%]). The treatment strategy consisted of mechanical thrombectomy (n=1), valve replacement following stent implantation (n=5), direct balloon angioplasty (n=4), valve replacement along with coronary artery bypass grafting (CABG; n=6), and medical follow-up (n=3). Moreover, thrombolysis in myocardial infarction III flow was significantly higher in the survival group (100% vs. 0%, p<0.001). All these patients preferred CABG or stent implantation for revascularization.

CONCLUSION
The current data suggest that a revascularization strategy with stent implantation or revascularization with CABG has a lower mortality rate in patients with IE-related STEMI.


How to cite this article
Ahmet Güner, Yeşim Uygun Kızmaz, Sabahattin Gündüz, Çağdaş Arslan, Serpil Özkan Öztürk, Elnur Alizade, Macit Kalçık, Serkan Kahraman, Cemalettin Akman, Ali Kemal Kalkan, Mehmet Özkan. Revascularization strategies in patients with infective endocarditis-related ST-elevation myocardial infarction: The STEMI-ENDO Registry. Turk Kardiyol Dern Ars. 2021; 49(8): 654-665

Corresponding Author: Ahmet Güner, Türkiye
Manuscript Language: English
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