Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature.
<h4>Background</h4>Septic embolization is a common and potentially life-threatening complication of infective endocarditis (IE), with a prevalence of 22-50%. While acute coronary syndrome secondary to septic embolism is rare, it poses significant risks.<h4>Aims</h4>This study...
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2024-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0314718 |
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| author | Ruggero Mazzotta Matteo Orlandi Valentina Scheggi Niccolò Marchionni Pierluigi Stefàno |
| author_facet | Ruggero Mazzotta Matteo Orlandi Valentina Scheggi Niccolò Marchionni Pierluigi Stefàno |
| author_sort | Ruggero Mazzotta |
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| description | <h4>Background</h4>Septic embolization is a common and potentially life-threatening complication of infective endocarditis (IE), with a prevalence of 22-50%. While acute coronary syndrome secondary to septic embolism is rare, it poses significant risks.<h4>Aims</h4>This study examines coronary embolism (CE) in left-sided IE, describing clinical characteristics and outcomes.<h4>Methods</h4>We retrospectively analysed 649 patients with non-device-related left-sided IE treated between January 2013 and December 2023 in a high-volume surgical centre. CE was diagnosed via ECG, clinical and laboratory signs of acute coronary syndrome, and confirmed by coronary angiography or magnetic resonance imaging. All patients were treated according to current European Society of Cardiology guidelines. A structured follow-up was performed.<h4>Results</h4>Among patients included in the study, surgery was performed in 514 (79%) patients. Median follow-up duration was 4.7 years. CE occurred in 8 (1.2%) patients, and 6 (80%) of them were treated surgically. We found no significant differences in overall mortality rate between patients with or without CE (p = 0.65). Finally, cerebral embolism was significantly more frequent in patients with than without CE (75% vs 25%, p = 0.006, post-hoc power 87.8%).<h4>Conclusion</h4>CE is a rare but severe complication of IE, significantly associated with cerebral embolism. Early recognition and treatment are crucial to improve patient outcomes. Multicentre studies with larger patient populations are needed to further elucidate risk factors and enhance prognosis for CE in IE patients. |
| format | Article |
| id | doaj-art-620d244bd8034236a4cd517eb6d5c7a3 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-620d244bd8034236a4cd517eb6d5c7a32024-12-10T05:32:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031471810.1371/journal.pone.0314718Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature.Ruggero MazzottaMatteo OrlandiValentina ScheggiNiccolò MarchionniPierluigi Stefàno<h4>Background</h4>Septic embolization is a common and potentially life-threatening complication of infective endocarditis (IE), with a prevalence of 22-50%. While acute coronary syndrome secondary to septic embolism is rare, it poses significant risks.<h4>Aims</h4>This study examines coronary embolism (CE) in left-sided IE, describing clinical characteristics and outcomes.<h4>Methods</h4>We retrospectively analysed 649 patients with non-device-related left-sided IE treated between January 2013 and December 2023 in a high-volume surgical centre. CE was diagnosed via ECG, clinical and laboratory signs of acute coronary syndrome, and confirmed by coronary angiography or magnetic resonance imaging. All patients were treated according to current European Society of Cardiology guidelines. A structured follow-up was performed.<h4>Results</h4>Among patients included in the study, surgery was performed in 514 (79%) patients. Median follow-up duration was 4.7 years. CE occurred in 8 (1.2%) patients, and 6 (80%) of them were treated surgically. We found no significant differences in overall mortality rate between patients with or without CE (p = 0.65). Finally, cerebral embolism was significantly more frequent in patients with than without CE (75% vs 25%, p = 0.006, post-hoc power 87.8%).<h4>Conclusion</h4>CE is a rare but severe complication of IE, significantly associated with cerebral embolism. Early recognition and treatment are crucial to improve patient outcomes. Multicentre studies with larger patient populations are needed to further elucidate risk factors and enhance prognosis for CE in IE patients.https://doi.org/10.1371/journal.pone.0314718 |
| spellingShingle | Ruggero Mazzotta Matteo Orlandi Valentina Scheggi Niccolò Marchionni Pierluigi Stefàno Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature. PLoS ONE |
| title | Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature. |
| title_full | Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature. |
| title_fullStr | Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature. |
| title_full_unstemmed | Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature. |
| title_short | Coronary embolism in left-sided infective endocarditis. A retrospective analysis from a high-volume surgical centre and review of the literature. |
| title_sort | coronary embolism in left sided infective endocarditis a retrospective analysis from a high volume surgical centre and review of the literature |
| url | https://doi.org/10.1371/journal.pone.0314718 |
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