AUTHOR=Cosyns Bernard , Roosens Bram , Lancellotti Patrizio , Laroche Cécile , Dulgheru Raluca , Scheggi Valentina , Vilacosta Isidre , Pasquet Agnès , Piper Cornelia , Reyes Graciela , Mahfouz Essam , Kobalava Zhanna , Piroth Lionel , Kasprzak Jarosław D. , Moreo Antonella , Faucher Jean-François , Ternacle Julien , Meshaal Marwa , Maggioni Aldo P. , Iung Bernard , Habib Gilbert 

TITLE=Cancer and Infective Endocarditis: Characteristics and Prognostic Impact

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.766996

DOI=10.3389/fcvm.2021.766996

ISSN=2297-055X

ABSTRACT=<p><bold>Background:</bold> The interplay between cancer and IE has become of increasing interest. This study sought to assess the prevalence, baseline characteristics, management, and outcomes of IE cancer patients in the ESC EORP EURO-ENDO registry.</p><p><bold>Methods:</bold> Three thousand and eighty-five patients with IE were identified based on the ESC 2015 criteria. Three hundred and fifty-nine (11.6%) IE cancer patients were compared to 2,726 (88.4%) cancer-free IE patients.</p><p><bold>Results:</bold> In cancer patients, IE was mostly community-acquired (74.8%). The most frequently identified microorganisms were <italic>S. aureus</italic> (25.4%) and Enterococci (23.8%). The most frequent complications were acute renal failure (25.9%), embolic events (21.7%) and congestive heart failure (18.1%). Theoretical indication for cardiac surgery was not significantly different between groups (65.5 vs. 69.8%, <italic>P</italic> = 0.091), but was effectively less performed when indicated in IE patients with cancer (65.5 vs. 75.0%, <italic>P</italic> = 0.002). Compared to cancer-free IE patients, in-hospital and 1-year mortality occurred in 23.4 vs. 16.1%, <italic>P</italic> = 0.006, and 18.0 vs. 10.2%; <italic>P</italic> &lt; 0.001, respectively. In IE cancer patients, predictors of mortality by multivariate analysis were creatinine &gt; 2 mg/dL, congestive heart failure and unperformed cardiac surgery (when indicated).</p><p><bold>Conclusions:</bold> Cancer in IE patients is common and associated with a worse outcome. This large, observational cohort provides new insights concerning the contemporary profile, management, and clinical outcomes of IE cancer patients across a wide range of countries.</p>