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
, Yeşim Uygun Kızmaz2
, Sabahattin Gündüz3
, Çağdaş Arslan1
, Serpil Özkan Öztürk4
, Elnur Alizade5
, Macit Kalçık6
, Serkan Kahraman1
, Cemalettin Akman1
, Ali Kemal Kalkan1
, Mehmet Özkan51
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey2
Department of Infectious Diseases and Clinical Microbiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey3
Department of Cardiology, Bahçeşehir University School of Medicine, İstanbul, Turkey4
Department of Infectious Diseases and Clinical Microbiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey5
Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, İstanbul, Turkey6
Department 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