Infective endocarditis and cancer in the elderly

Abstract

Background Little is known about the magnitude of the association between infective endocarditis and cancer, and about the natural history of cancer patients with concomitant diagnosis of infective endocarditis. Methods We used the SEER-Medicare linked database to identify individuals aged 65 years or more diagnosed with colorectal, lung, breast, or prostate cancer, and without any cancer diagnosis (5% random Medicare sample from SEER areas) between 1992–2009. We identified infective endocarditis from the ICD-9 diagnosis of each admission recorded in the Medpar file and its incidence rate 90 days around cancer diagnosis. We also estimated the overall survival and CRC-specific survival after a concomitant diagnosis of infective endocarditis. Results The peri-diagnostic incidence of infective endocarditis was 19.8 cases per 100,000 person-months for CRC, 5.7 cases per 100,000 person-months for lung cancer, 1.9 cases per 100,000 person-months for breast cancer, 4.1 cases per 100,000 person-months for prostate cancer and 2.4 cases per 100,000 person-months for individuals without cancer. Two-year overall survival was 46.4% (95% CI 39.5, 54.5%) for stage I–III CRC patients with concomitant endocarditis and 73.1% (95% CI 72.9, 73.3%) for those without it. Conclusion In this elderly population, the incidence of infective endocarditis around CRC diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers. A concomitant diagnosis of infective endocarditis in patients with CRC diagnosis is associated with shorter survival.

Infective endocarditis in patients with cancer

“…The association between colon cancer and IE is well known [ 3 , 6 , 17 , 18 ] ; however, in our series, a high risk of IE was also present for lymphoma, prostate cancer, and genitourinary cancer. In many cases, IE occurs concurrently with, and even leads to, a diagnosis of cancer (42; 26% cases).…”

“…Studies describing IE in patients with cancer or vice versa are subject to limitations: they analyze single-center cohorts, [ 2 ] do not draw comparisons with a population without cancer, [ 4 ] focus only on nonbacterial thrombotic endocarditis [ 5 ] or endocarditis associated with specific kinds of cancer, [ 3 ] and report the association in specific population subsets. [ 6 ]…”

Incidence and associated risk factors of cancer in patients after infective endocarditis hospitalization: A propensity score matched analysis

“…Cancer patients without clinical manifestation with compromised immunity could be vulnerable to IE (6,11). Increased the incidence of peri-diagnosis of IE in elderly cancer patients has been demonstrated (25). Despite the causal relationship is not clear, our results provide further evidence in the association between IE and cancer risk, and the risk remains high in 10-year follow-up.…”

Infective Endocarditis and Malignant Neoplasms: Facts and Hypotheses

“…В 1980-2000 годах в ряде исследований, в том числе нескольких небольших исследованиях «случай-контроль» и их метаанализе, было показано, что ИЭ, вызванный Streptococcus gallolyticus (ранее bovis), ассоциируется с карциномой толстой кишки [10][11][12][13][14][15][16], а также были опубликованы описания отдельных случаев и малых серий наблюдений ИЭ у больных с другими онкологическими заболеваниями [17]. Однако наиболее значимые доказательства, подтверждающие ассоциацию ИЭ с онкологическими заболеваниями, были опубликованы за последние 5 лет: 5 крупных популяционных контролируемых исследований и 1 метаанализ, включившие суммарно более 4500 больных ИЭ, у которых при наблюдении разной длительности были диагностированы онкологические заболевания [18][19][20][21][22][23]. В рекомендациях Европейского общества кардиологов 2015 г. ИЭ у онкологических больных выделен как особая форма заболевания [24].…”

“…Факт 2: у больных с ЗН повышена заболеваемость ИЭ. Два года назад было опубликовано первое крупное популяционное проспективное исследование X. Garcıa-Albeniz и соавт., которое доказывает, что заболеваемость О б з о р ы ИЭ у пожилых больных с наиболее частыми видами рака (кишечника, легких, предстательной железы и молочной железы) значимо выше, чем у пожилых людей без онкопатологии [21]. В исследовании оценивали частоту ИЭ, диагностированного за 90 дней до выявления рака и в течение 90 дней последующего наблюдения.…”