Epidemiological Profile of Patients with Infective Endocarditis at three Tertiary Centers in Brazil from 2003 to 2017

Bezerra, Renato Lott; Salgado, Lucas Sousa; Silva, Yago Machado da; Figueiredo, Gustavo Guimarães Rocha; Bezerra, Raimundo Matos; Machado, Eduardo Luís Guimarães; Gómes, Isabel Cristina; Cunha, Ângelo Geraldo José

doi:10.36660/ijcs.20210181

Cited by 3 publications

(20 citation statements)

References 38 publications

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“…The incidence rate of IE in males was, on average, 11.39/100,000 person-years; in females, it was 5.24/100,000 person-years [ 12 , 24 ]. On average, males comprised 65.8% of patients who developed IE, while females comprised only 34.2% of patients [ 12 , 14 - 19 , 21 - 23 , 26 , 27 , 29 - 31 ]. However, one study done in 2022 found that the incidence of developing IE between males and females was equal [ 32 ].…”

Section: Reviewmentioning

confidence: 99%

“…Along with comparing the incidence of IE between the sexes, it’s also been shown that there is a variation in the age at which each sex develops IE. Most patients with IE were between 60 and 79 years old, with an average of 62.2 years old [ 17 - 19 , 22 , 35 , 36 ]. Erichsen et al observed that the mean age of IE diagnosis in both sexes has increased steadily, but no study reports variations towards one sex [ 22 ].…”

Section: Reviewmentioning

confidence: 99%

“…This can also be differentiated between native, bioprosthetic, and mechanical valves. Native valve infections occurred on average 71.7% of the time, while bioprosthetic prosthesis valve infections were 17.2%, and mechanical valve infections were 10.7% [ 17 , 19 ]. The most affected native valve was found to be the mitral valve at 41.7% regardless of the patient's sex, while the least affected valve in general was the pulmonic valve [ 19 ].…”

Section: Reviewmentioning

confidence: 99%

“…Native valve infections occurred on average 71.7% of the time, while bioprosthetic prosthesis valve infections were 17.2%, and mechanical valve infections were 10.7% [ 17 , 19 ]. The most affected native valve was found to be the mitral valve at 41.7% regardless of the patient's sex, while the least affected valve in general was the pulmonic valve [ 19 ]. In assessing which side was affected the most between sexes in general, there was a complete split, with half observing that males were more likely to develop right-sided IE at 40.5%, and the other 75% of males developed left-sided IE [ 27 , 37 , 41 ].…”

Section: Reviewmentioning

confidence: 99%

“…When looking closely at the specific valves, females were more likely to develop IE of the mitral and tricuspid valve whether or not the valve was native or prosthetic [ 23 , 26 , 32 , 37 , 39 ]. Compared to females, males were more likely to develop IE in their aortic valves, especially native valves, with one study observing up to 73.9% [ 13 , 19 , 23 , 26 , 32 , 38 , 39 , 42 ]. Notably, the proportion of patients diagnosed with IE involving the native and mechanical valves has decreased.…”

Section: Reviewmentioning

confidence: 99%

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Sex Differences in Infective Endocarditis: A Systematic Review

Slouha,

Al-Geizi,

Albalat

et al. 2023

Cureus

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Despite the advancement in medicine, there is still a lack of understanding of the sex disparities in disease onset, progression, treatment, and outcome. In some life-threatening acute conditions, despite most patients with these illnesses being males, females have a significantly higher chance of mortality. This can be due to the differences in disease progression or healthcare disparities in managing the illness between the sexes. Treatment of illnesses tends to be more conservative for women without an explanation, but this disparity is due to the healthcare provider. Infective endocarditis (IE) is an acute life-threatening condition where bacteria latch onto and seed damaged endocardium, with some preliminary information reporting differences between the sexes. This paper aims to evaluate the sex disparities in the incidence, age, comorbidities, etiology, risk factors, manifestations, treatment, and outcomes of IE. From 2003-2023, 21584 articles were found that focused on the sex differences in IE and, through PRISMA guidelines, were narrowed down to 34 publications. There are significant differences between the sexes in IE, such as a significantly higher incidence of IE in males, who also tend to be older and have their native aortic valves involved, compared to younger females who have their mitral valve involved. Comorbidities also vary between the sexes; females tend to have atrial fibrillation, chronic kidney disease, psychiatric disorders, and taking immunosuppressants compared to males who suffer from chronic liver disease, underlying valve disease, and peripheral artery disease, contributing to the ease of developing IE. While the most common microorganism leading to IE is Staphylococcus aureus, females were more likely to have culture-negative IE, and men were more likely to be infected with Streptococcus viridans. Major manifestations in IE are fever and vegetation along the closure of the valves in the heart, where females were more likely to have vegetation on the mitral and aortic valves. At the same time, males were more likely to have it on the tricuspid valve. On par with sex disparities in health, females usually took longer to seek medical help than males despite the advancement of symptoms and deterioration. Females were also treated conservatively through antibiotic management, whereas males were more likely to advance to surgical treatment, leading to a longer hospital stay. While there was no true difference in the in-hospital mortality rate, the 30-day and 1-year mortality were significantly increased in females. These differences provide a range of starting points for various research to further educate physicians on sex disparities, such as why males have a higher incidence of infective endocarditis and determining whether it’s hormones and basic metabolites, possibly limiting those who develop the infection. Another important point is treating females with IE; the antibiotic doses are standard, but whether they...

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