Sex Differences in Infective Endocarditis

Polishchuk, Ilya; Stavi, Vered; Awesat, Jenan; Golan, Yael Ben-Baruch; Bartal, Carmi; Sagy, Iftach; Jotkowitz, Alan; Barski, Leonid

doi:10.1016/j.amjms.2020.08.021

Cited by 12 publications

(32 citation statements)

References 24 publications

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“…In contrast to previous findings [ 8 , 9 , 12 , 14 ], female patients in our study were not distinctly older and did not present with more comorbid conditions when compared to men. As shown in previous studies [ 9 , 13 , 17 ], IE affected the aortic valve in men most frequently, while in female patients, a predominant affection of the mitral valve was found.…”

Section: Discussioncontrasting

confidence: 99%

“…Despite major medical advances in diagnostics and therapy, IE is still associated with severe morbidity and a high early mortality of around 20% [ 3 , 10 , 11 ]. In cases of IE, female gender shows no protective effect, since several studies demonstrate a similar or higher early mortality when compared to men [ 8 , 12 , 13 , 14 , 15 ]. The persistently poor overall prognosis regarding hospital mortality is, besides the female gender, attributed to several possible causative factors such as the increase of elderly and more severely ill patients, previous cardiac surgery, an increasing rate of IE in prosthetic heart valves and devices, cerebral complications, renal failure, preoperative ventilation, New York Heart Association heart failure (NYHA) stage, paravalvular abscess, S. aureus infection, and withholding of indicated surgery [ 3 , 10 , 12 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Sex-Specific Risk Factors for Short- and Long-Term Outcomes after Surgery in Patients with Infective Endocarditis

Friedrich

Salem

Puehler

et al. 2022

JCM

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(1) Background: Surgery for infective endocarditis (IE) is associated with considerable mortality and it is controversial whether the female gender is predictive for a worse outcome. This large single-center study investigated the impact of sex on outcomes after surgery for IE. (2) Methods: 413 patients (25.4% female) were included into this retrospective observational study. Univariate and multivariable analyses identified sex-specific risk factors for 30 day and late mortality. Survival was estimated by the Kaplan-Meier-method. (3) Results: Women presented more often with mitral valve infection (p = 0.039). Men presented more frequently with previous endocarditis (p = 0.045), coronary heart disease (p = 0.033), and aortic valve infection (p = 0.005). Blood transfusion occurred more frequently intraoperatively in women (p < 0.001), but postoperatively in men (p = 0.015) and men had a longer postoperative stay (p = 0.046). Women showed a higher 30 day mortality than men (p = 0.007) and female gender was predictive for 30 day mortality (OR 2.090). Late survival showed no sex-specific difference (p = 0.853), and the female gender was not an independent predictor for late mortality (p = 0.718). Risk factors for early and late mortality showed distinct sex-specific differences such as increased preoperative CRP level in women and culture-negative IE in men.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sex-Specific Risk Factors for Short- and Long-Term Outcomes after Surgery in Patients with Infective Endocarditis

Friedrich

Salem

Puehler

et al. 2022

JCM

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“…Clinically acquired etiologies include need for vascular access especially for long-term therapies, valvular prosthesis, implantable intracardiac devices, and non-cardiac prosthesis [ 5 ]. IE has been described mostly in the elderly population with males being affected more than females [ 6 , 7 ]. In a study by Jensen et al, looking at 8,905 patients over a 20-year interval, median age was 70.2.…”

Section: Epidemiologymentioning

confidence: 99%

Native and Prosthetic Valve Staphylococcus capitis Endocarditis: A Review of the Literature

et al. 2021

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Infective endocarditis (IE) is a rare but serious disease. Coagulasenegative staphylococci (CoNS) are among the least prevalent causes of IE. Staphylococcus capitis, a species of CoNS, although described in the literature before has only been seen in a few cases. Even with such few cases, complications and mortality have still been demonstrated. In our review, we look at the epidemiology, diagnosis, management, and literature prevalence of CoNS in native and prosthetic valve IE.

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“…Sex differences were also not evident in treatment strategies, in-hospital outcomes, or mortality in patients with IE [ 15 , 16 ]. In contrast, a recent retrospective study reported significant differences between sexes in infective organisms found in IE [ 14 ]. Female sex was found to be independently associated with higher mortality among patients with IE [ 10 , 14 ].…”

Section: Introductionmentioning

confidence: 95%

“…The few existing studies on sex differences in IE yielded contradictory findings [ 10 , 13 , 14 , 15 , 16 ]. In two prospective studies of patients with IE, results showed sex differences in univariate analysis; however, multivariable analyses demonstrated that underlying comorbidities or preoperative risk factors, and not sex differences, were the reasons for the observed differences in the clinical outcomes between male and female patients with IE [ 13 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study

Bhandari

Tiwari

Alexander

et al. 2022

JCM

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Infectious diseases like infective endocarditis (IE) may manifest or progress differently between sexes. This study sought to identify the differences in demographic and clinical characteristics among male and female patients with IE. Data were obtained from a newly developed registry comprising all adult patients with first IE admission at the four major tertiary cardiovascular centers in West Virginia, USA during 2014–2018. Patient characteristics were compared between males and females using Chi-square test, Fisher’s exact test, and Wilcoxon rank-sum test. A secondary analysis was restricted to IE patients with drug use only. Among 780 unique patients (390 males, 390 females), significantly more women (a) were younger than males (median age 34.9 vs. 41.4, p < 0.001); (b) reported drug use (77.7% vs. 64.1%, p < 0.001); (c) had tricuspid valve endocarditis (46.4% vs. 30.8%, p < 0.001); and (d) were discharged against medical advice (20% vs. 9.5%, p < 0.001). These differences persisted even within the subgroup of patients with drug use-associated IE. In a state with one of the highest incidences of drug use and overdose deaths, the significantly higher incident IE cases in younger women and higher proportion of women leaving treatment against medical advice are striking. Differential characteristics between male and female patients are important to inform strategies for specialized treatment and care.

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Sex Differences in Infective Endocarditis

Cited by 12 publications

References 24 publications

Sex-Specific Risk Factors for Short- and Long-Term Outcomes after Surgery in Patients with Infective Endocarditis

Sex-Specific Risk Factors for Short- and Long-Term Outcomes after Surgery in Patients with Infective Endocarditis

Native and Prosthetic Valve Staphylococcus capitis Endocarditis: A Review of the Literature

Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study

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