BAV with IE n=41 | BAV without IE n=1081 | TAV with IE n=371 | TAV without IE n=18 356 | p value BAV IE versus TAV IE | p value BAV IE versus BAV no IE | p value TAV IE versus TAV no IE | |
Demographics | |||||||
Age, years | |||||||
<40 | 16 (39%) | 297 (27%) | 63 (17%) | 3067 (17%) | <0.001 | 0.71 | 0.98 |
40–49 | 10 (24%) | 246 (23%) | 50 (13%) | 2272 (12%) | |||
50–59 | 5 (12%) | 199 (18%) | 63 (17%) | 3117 (17%) | |||
60–69 | 7 (17%) | 224 (21%) | 84 (23%) | 4313 (23%) | |||
70–79 | 2 (5%) | 76 (7%) | 76 (20%) | 3690 (20.%) | |||
>=80 | 1 (2%) | 39 (4%) | 35 (9%) | 1897 (10.%) | |||
Gender (female) | 31 (76%) | 870 (80%) | 232 (63%) | 11 424 (62%) | 0.12 | 0.43 | 0.96 |
Race (Caucasian) | 36 (88%) | 1026 (95%) | 305 (82%) | 15 073 (82%) | 0.51 | 0.063 | 1.0 |
Income decile | |||||||
0–4 | 1 (2%) | 55 (5%) | 36 (10%) | 1099 (6%) | 0.058 | 0.045 | 0.004 |
5–7 | 12 (29%) | 158 (15%) | 66 (19%) | 2827 (16%) | |||
8–10 | 27 (66%) | 845 (80%) | 251 (71%) | 13 583 (78%) | |||
Elixhauser Score† | |||||||
<=0 | 11 (27%) | 187 (17%) | 31 (8%) | 3742 (20%) | 0.047 | 0.45 | <0.0001 |
1–10 | 13 (32%) | 389 (36%) | 95 (26%) | 5430 (30%) | |||
11–20 | 9 (22%) | 296 (27%) | 120 (32%) | 3823 (21%) | |||
>20 | 7 (17%) | 209 (19%) | 122 (33%) | 5361 (29%) | |||
Diabetes | 2 (5%) | 125 (12%) | 45 (12%) | 2684 (15%) | 0.20 | 0.22 | 0.15 |
COPD | 7 (17%) | 219 (20%) | 97 (26%) | 6688 (36%) | 0.19 | 0.70 | 0.0001 |
Cancer | 4 (10%) | 135 (12%) | 45 (12%) | 4664 (25%) | 0.80 | 0.81 | <0.0001 |
Lymphoma | 2 (5%) | 35 (3%) | 13 (4%) | 960 (5%) | 1.00 | 0.40 | 0.91 |
Renal disease | 6 (15%) | 96 (9%) | 115 (31%) | 2850 (16%) | 0.03 | 0.27 | <0.0001 |
Liver disease | 5 (12%) | 123 (11%) | 76 (21%) | 3871 (21%) | 0.22 | 0.81 | 0.90 |
Obesity | 5 (12%) | 142 (13%) | 25 (7%) | 4199 (23%) | 0.19 | 0.08 | 0.02 |
Alcohol abuse | 3 (7%) | 58 (5%) | 31 (8%) | 1789 (10%) | 1.00 | 0.48 | 0.0008 |
Drug abuse | 10 (24%) | 61 (6%) | 75 (20%) | 1544 (8%) | 0.42 | 0.0001 | <0.0001 |
Prior cardiac status | |||||||
Hypertension | 15 (37%) | 541 (50%) | 178 (48%) | 10 697 (58%) | 0.24 | 0.15 | 0.0002 |
Congestive heart failure | 18 (44%) | 404 (37%) | 204 (55%) | 3923 (21%) | 0.24 | 0.32 | <0.0001 |
Previous stroke | 10 (25%) | 549 (51%) | 61 (17%) | 3329 (18%) | 0.19 | 0.002 | 0.49 |
Rheumatic heart disease | 3 (7%) | 41 (4%) | 30 (8%) | 1866 (10%) | 1.0 | 0.20 | 0.22 |
Arrhythmia | 20 (49%) | 603 (56%) | 218 (59%) | 8183 (45%) | 0.31 | 0.52 | <0.0001 |
Valve disease | |||||||
Aortic valve endocarditis | 38 (93%) | - | 127 (34%) | - | <0.0001 | - | - |
Mitral valve endocarditis | 8 (20%) | - | 200 (54%) | - | <0.0001 | - | - |
Tricuspid valve endocarditis | 1 (2%) | - | 87 (23%) | - | 0.0005 | - | - |
Pulmonary valve endocarditis | 0 (0%) | - | 4 (1%) | - | 1.0 | - | - |
Vegetation present | 40 (98%) | - | 367 (99%) | - | 0.40 | - | - |
Abscess present | 11 (27%) | - | 15 (4%) | - | <0.0001 | - | - |
Organism | |||||||
Staphylococcus aureus | 8 (20%) | - | 169 (46%) | - | 0.016 ** | - | - |
Staphylococcus (coagulase-negative) | 2 (5%) | - | 14 (4%) | - | - | - | |
Streptoccus viridans | 4 (10%) | - | 7 (2%) | - | - | - | |
Streptoccus mitis | 4 (10%) | - | 16 (4.%) | - | - | - | |
Streptoccus mutans | 3 (7%) | - | 3 (1%) | - | - | - | |
Streptoccus sanguinus | 3 (7%) | - | 9 (2%) | - | - | - | |
Streptoccus species other or unclassified | 3 (7%) | - | 42 (11%) | - | - | - | |
Gemella species | 1 (2%) | - | 3 (1%) | - | - | - | |
Haemophilus parainfluenzae | 1 (2%) | - | 4 (1%) | - | - | - | |
Enterococcus sp. | 3 (7%) | - | 46 (12%) | - | - | - | |
HACEK organism | - | - | 2 (1%) | - | - | - | |
Mixed flora or other species | - | - | 18 (5%) | - | - | - | |
Culture negative | 7 (17%) | - | 35 (10%) | - | - | - | |
Modified Duke criteria for IE | |||||||
Major: imaging | 41 (100%) | - | 371 (100%) | - | 1.0 | - | - |
Major: microbiology | 38 (91%) | - | 365 (98%) | - | 0.051 | - | - |
Minor: intravenous drug use | 11 (26%) | - | 79 (20.1%) | - | 0.42 | - | - |
Minor: heart disease | 41 (100%) | - | 9 (2%) | - | <0.0001 | - | - |
Minor: fever | 21 (50%) | - | 260 (70%) | - | 0.021 | - | - |
Minor: implanted device | 0 | - | 29 (8%) | - | 0.10 | - | - |
Minor: end-stage renal disease | 2 (5%) | - | 25 (7%) | - | 1.0 | - | - |
Minor: immunological | 3 (7%) | - | 66 (17%) | - | 0.12 | - | - |
Outcomes* | |||||||
Valve replacement | |||||||
1 year | 30/41 (73%) | 40/802 (5%) | 164/371 (44%) | 21/16,464 (0.02%) | 0.0005 | <0.0001 | <0.0001 |
5 years | 32/39 (85%) | 89/522 (17%) | 155/332 (47%) | 141/12,895 (1%) | 0.0009 | <0.0001 | <0.0001 |
Survival | |||||||
1 year | 36/41 (88%) | 805/812 (99%) | 270/367 (74%) | 12,874/13,056 (99%) | 0.06 | 0.0001 | <0.0001 |
5 years | 20/26 (77%) | 518/557 (93%) | 141/281 (50%) | 8,160/9,275 (88%) | 0.013 | 0.011 | <0.0001 |
10 years | 4/13 (31%) | 172/242 (71%) | 49/206 (24%) | 3,3332/5,371 (62%) | 0.52 | 0.013 | <0.0001 |
*After diagnosis of IE in the IE case, and the age-equivalent date in the non-IE control.
†Comparing patients with Staphylococcus aureus infection versus all other infections.
BAV, bicuspid aortic valve; COPD,Chronic Obstructive Pulmonary Disease; IE, infective endocarditis; TAV, tricuspid aortic valve; HACEK, Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella.