PT - JOURNAL ARTICLE AU - Laura Varela Barca AU - Laura Vidal-Bonnet AU - MC Fariñas AU - Patricia Muñoz AU - Maricela Valerio Minero AU - Arístides de Alarcón AU - Encarnacion Gutiérrez Carretero AU - Manuel Gutiérrez Cuadra AU - Asuncion Moreno Camacho AU - Xabier Kortajarena Urkola AU - Josune Goikoetxea Agirre AU - Guillermo Ojeda Burgos AU - Luis Eduardo López-Cortés AU - JC Porres Azpiroz AU - Jose Lopez-Menendez ED - , TI - Analysis of sex differences in the clinical presentation, management and prognosis of infective endocarditis in Spain AID - 10.1136/heartjnl-2021-319254 DP - 2021 Nov 01 TA - Heart PG - 1717--1724 VI - 107 IP - 21 4099 - http://heart.bmj.com/content/107/21/1717.short 4100 - http://heart.bmj.com/content/107/21/1717.full SO - Heart2021 Nov 01; 107 AB - Introduction Sex-dependent differences of infective endocarditis (IE) have been reported. Women suffer from IE less frequently than men and tend to present more severe manifestations. Our objective was to analyse the sex-based differences of IE in the clinical presentation, treatment, and prognosis.Material and methods We analysed the sex differences in the clinical presentation, modality of treatment and prognosis of IE in a national-level multicentric cohort between 2008 and 2018. All data were prospectively recorded by the GAMES cohort (Spanish Collaboration on Endocarditis).Results A total of 3451 patients were included, of whom 1105 were women (32.0%). Women were older than men (mean age, 68.4 vs 64.5). The most frequently affected valves were the aortic valve in men (50.6%) and mitral valve in women (48.7%). Staphylococcus aureus aetiology was more frequent in women (30.1% vs 23.1%; p<0.001).Surgery was performed in 38.3% of women and 50% of men. After propensity score (PS) matching for age and estimated surgical risk (European System for Cardiac Operative Risk Evaluation II (EuroSCORE II)), the analysis of the matched cohorts revealed that women were less likely to undergo surgery (OR 0.74; 95% CI 0.59 to 0.91; p=0.05).The observed overall in-hospital mortality was 32.8% in women and 25.7% in men (OR for the mortality of female sex 1.41; 95% CI 1.21 to 1.65; p<0.001). This statistical difference was not modified after adjusting for all possible confounders.Conclusions Female sex was an independent factor related to mortality after adjusting for confounders. In addition, women were less frequently referred for surgical treatment.All data relevant to the study are included in the article or uploaded as supplementary information. The study included all consecutive patients included in the GAMES registry, maintained by 27 Spanish tertiary hospitals.