Infectious Endocarditis Risk ID'd in Congenital Heart Disease
Risk of IE 6.1 per 1,000 children; predictors include cyanotic CHD, endocardial cushion defects
MONDAY, Sept. 23 (HealthDay News) -- For children with congenital heart disease (CHD), the risk of infectious endocarditis (IE) is 6.1 per 1,000 children, and predictors include cyanotic CHD, endocardial cushion defects, and left-sided lesions, according to a study published in the Sept. 24 issue of Circulation.
Dinela Rushani, of the University of Montreal, and colleagues conducted a population-based analysis involving 47,518 children with CHD who were followed for 458,109 patient-years. The incidence of IE was assessed in a subcohort of 34,279 children with CHD who had been followed since birth.
The researchers found that there were 185 cases of IE in the full cohort. Within the subgroup followed since birth, the risk of IE was 6.1 per 1,000 children. Compared to those with atrial septal defects, in a nested case-control analysis, cyanotic CHD, endocardial cushion defects, and left-sided lesions correlated with highest risk of IE (adjusted rate ratio, 6.44, 5.47, and 1.88, respectively). An elevated risk of IE was also seen for cardiac surgery within six months and an age younger than 3 years (adjusted rate ratio, 5.34 and 3.53, respectively).
"In a large population-based cohort of children with CHD, we documented the cumulative incidence of IE and associated factors," the authors write. "These findings help identify groups of patients who are at the highest risk of developing IE."
Abstract (http://circ.ahajournals.org/content/128/13/1412.abstract )Full Text (http://circ.ahajournals.org/content/128/13/1412.full )Editorial (http://circ.ahajournals.org/content/128/13/1396.full )