RT Journal Article
SR Electronic
T1 Analysis of sex differences in the clinical presentation, management and prognosis of infective endocarditis in Spain
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1717
OP 1724
DO 10.1136/heartjnl-2021-319254
VO 107
IS 21
A1 Varela Barca, Laura
A1 Vidal-Bonnet, Laura
A1 Fariñas, MC
A1 Muñoz, Patricia
A1 Valerio Minero, Maricela
A1 de Alarcón, Arístides
A1 Gutiérrez Carretero, Encarnacion
A1 Gutiérrez Cuadra, Manuel
A1 Moreno Camacho, Asuncion
A1 Kortajarena Urkola, Xabier
A1 Goikoetxea Agirre, Josune
A1 Ojeda Burgos, Guillermo
A1 López-Cortés, Luis Eduardo
A1 Porres Azpiroz, JC
A1 Lopez-Menendez, Jose
A1 
YR 2021
UL http://heart.bmj.com/content/107/21/1717.abstract
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.