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Infective endocarditis (IE) can adversely affect the structures and functions of the heart. IE can cause sepsis, embolisation and valvular regurgitation. The mortality rate from IE appears to have been static over the last five decades: 18% in a 1979 study1 and 17.1% in the largest European study (EURO-ENDO) registry by Habib et al in 2019.2 The main EURO-ENDO registry prospectively recruited 3116 adults with IE between January 2016 and March 2018, based on the 2015 European Society of Cardiology (ESC) diagnostic criteria.2 The registry included 20.7% of the patients from non-ESC countries increasing its international relevance, in addition to it being the largest published series of IE cases.
Some of those surviving the first IE episode experience recurrent IE. The latter is the main aspect of the EURO-ENDO registry being reported by Citro and Kwan-Leung et al.3 This large observational study provides insights into the epidemiology and the determinants of the early and 1-year prognosis of patients with recurrent IE. The authors divided the cohort into IE relapse (recurrent IE within 6 months, caused by the same micro-organism) and IE reinfection (recurrent IE after more than 6 months or caused by a different micro-organism).3 The authors completed a matching exercise that enabled comparisons between patients with first IE episode and those with recurrent IE. This allowed ascertainment of the determinants of prognosis.3
The patients with recurrent IE were more likely to have had a valvular intervention, a history of heart failure (HF) and a shorter period from symptom onset to diagnosis, when compared with those with first IE episode. Intravenous drug users (IVDUs) were more represented in the recurrent IE group.
The three most common organisms in both groups were Staphylococcus aureus, enterococci and viridans group streptococci. Enterococci occurred significantly more …
Contributors AA-M is the sole contributor to this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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