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Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017
BACKGROUND: To evaluate the prognostic impact of diabetes mellitus (DM) in patients with Infective Endocarditis (IE). METHODS AND RESULTS: 375 patients with diagnosis of IE referred to our Hospital between 1994–2017 were retrospectively included; diabetes was reported in 129 (34.4%). Diabetic patien...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860434/ https://www.ncbi.nlm.nih.gov/pubmed/31738753 http://dx.doi.org/10.1371/journal.pone.0223710 |
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author | Benvenga, Rossella M. De Rosa, Roberta Silverio, Angelo Matturro, Rosanna Zambrano, Cristina Masullo, Alfonso Mastrogiovanni, Generoso Soriente, Lucia Ascoli, Roberto Citro, Rodolfo Piscione, Federico Galasso, Gennaro |
author_facet | Benvenga, Rossella M. De Rosa, Roberta Silverio, Angelo Matturro, Rosanna Zambrano, Cristina Masullo, Alfonso Mastrogiovanni, Generoso Soriente, Lucia Ascoli, Roberto Citro, Rodolfo Piscione, Federico Galasso, Gennaro |
author_sort | Benvenga, Rossella M. |
collection | PubMed |
description | BACKGROUND: To evaluate the prognostic impact of diabetes mellitus (DM) in patients with Infective Endocarditis (IE). METHODS AND RESULTS: 375 patients with diagnosis of IE referred to our Hospital between 1994–2017 were retrospectively included; diabetes was reported in 129 (34.4%). Diabetic patients were older than non-diabetic (66±1 vs. 57±2 years, p<0.001) and showed a higher prevalence of comorbidities such as hypertension (75 vs. 54%, p<0.001), coronary artery disease (30 vs. 12%, p<0.001) and history of heart failure (HF; 24 vs. 13%, p = 0.021). Echocardiography showed a higher incidence of paravalvular complications (82 vs. 64%, p<0.001) and a lower left ventricular ejection fraction (LVEF; 52±11 vs. 55±10%, p = 0.001) in diabetic than in non-diabetic patients. In-hospital mortality was higher in diabetic patients (83 vs. 74%; p = 0.030). At logistic regression, history of HF (OR = 3.1, 95%CI: 1.87–5.29, p<0.001) resulted an independent predictor of in-hospital death. At long-term follow-up [median 24(7–84) months], the Kaplan-Meier analysis showed a significantly lower survival free from all-cause death in the group with diabetes (Log-rank<0.001). At the propensity score adjusted Cox multivariable analysis, DM (HR = 1.76, 95%CI: 1.18–2.6, p = 0.005), age (HR = 1.03, 95%CI: 1.02–1.05, p<0.001), intravenous drug users (HR = 5.42, 95%CI: 2.55–11.51, p<0.001) and low LVEF (HR = 0.98, 95%CI: 0.96–0.99, p = 0.013) were independently associated to a higher mortality. CONCLUSION: In patients with IE, DM is associated to a higher prevalence of anatomic complications and a more impaired LVEF. Diabetic patients show a significantly lower survival both in hospital and during follow-up compared to the non-diabetic ones. |
format | Online Article Text |
id | pubmed-6860434 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-68604342019-12-07 Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017 Benvenga, Rossella M. De Rosa, Roberta Silverio, Angelo Matturro, Rosanna Zambrano, Cristina Masullo, Alfonso Mastrogiovanni, Generoso Soriente, Lucia Ascoli, Roberto Citro, Rodolfo Piscione, Federico Galasso, Gennaro PLoS One Research Article BACKGROUND: To evaluate the prognostic impact of diabetes mellitus (DM) in patients with Infective Endocarditis (IE). METHODS AND RESULTS: 375 patients with diagnosis of IE referred to our Hospital between 1994–2017 were retrospectively included; diabetes was reported in 129 (34.4%). Diabetic patients were older than non-diabetic (66±1 vs. 57±2 years, p<0.001) and showed a higher prevalence of comorbidities such as hypertension (75 vs. 54%, p<0.001), coronary artery disease (30 vs. 12%, p<0.001) and history of heart failure (HF; 24 vs. 13%, p = 0.021). Echocardiography showed a higher incidence of paravalvular complications (82 vs. 64%, p<0.001) and a lower left ventricular ejection fraction (LVEF; 52±11 vs. 55±10%, p = 0.001) in diabetic than in non-diabetic patients. In-hospital mortality was higher in diabetic patients (83 vs. 74%; p = 0.030). At logistic regression, history of HF (OR = 3.1, 95%CI: 1.87–5.29, p<0.001) resulted an independent predictor of in-hospital death. At long-term follow-up [median 24(7–84) months], the Kaplan-Meier analysis showed a significantly lower survival free from all-cause death in the group with diabetes (Log-rank<0.001). At the propensity score adjusted Cox multivariable analysis, DM (HR = 1.76, 95%CI: 1.18–2.6, p = 0.005), age (HR = 1.03, 95%CI: 1.02–1.05, p<0.001), intravenous drug users (HR = 5.42, 95%CI: 2.55–11.51, p<0.001) and low LVEF (HR = 0.98, 95%CI: 0.96–0.99, p = 0.013) were independently associated to a higher mortality. CONCLUSION: In patients with IE, DM is associated to a higher prevalence of anatomic complications and a more impaired LVEF. Diabetic patients show a significantly lower survival both in hospital and during follow-up compared to the non-diabetic ones. Public Library of Science 2019-11-18 /pmc/articles/PMC6860434/ /pubmed/31738753 http://dx.doi.org/10.1371/journal.pone.0223710 Text en © 2019 Benvenga et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Benvenga, Rossella M. De Rosa, Roberta Silverio, Angelo Matturro, Rosanna Zambrano, Cristina Masullo, Alfonso Mastrogiovanni, Generoso Soriente, Lucia Ascoli, Roberto Citro, Rodolfo Piscione, Federico Galasso, Gennaro Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017 |
title | Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017 |
title_full | Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017 |
title_fullStr | Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017 |
title_full_unstemmed | Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017 |
title_short | Infective endocarditis and diabetes mellitus: Results from a single-center study from 1994 to 2017 |
title_sort | infective endocarditis and diabetes mellitus: results from a single-center study from 1994 to 2017 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860434/ https://www.ncbi.nlm.nih.gov/pubmed/31738753 http://dx.doi.org/10.1371/journal.pone.0223710 |
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