Relapses, recurrences, valve replacements, and mortality during the long-term follow-up after infective endocarditis

Background late prognosis after infective endocarditis has not been systema tically studied in large series of patients with different underlying heart conditions in recent years. Methods We studied an inception cohort study of 420 patients discharged aft er treatment of endocarditis from a university tertiary core hospital. The patients were aged 34.2 +/- 17.2 years (mean +/- SD), ranging from 2 months to 83 years; 270 (64.3%) were men and 150 (35.7%) were women. Mean follow- up was 6.1 +/- 4.3 years for survivors and 3.7 +/- 3.7 years for the patien ts who died during the follow-up. We studied the frequency and risk factors for relapses and recurrences of endocarditis, cardiac valve replacements, and deaths during the follow-up. Statistical analysis was performed through comparison of groups, of event-free survival, and risk ratios. Results Relapses were observed in 14 (3.3%) patients. There was one recurre nce of endocarditis in 48 (11.4%) patients, two (0.5%) in 2 patients, three in 1 patient (0.2%), and five (0.2%) in 1 patient. Valve replacement was p erformed in 83 (19.7%) patients. Ninety-eight (12.3%) patients died. Risk f actors for recurrent endocarditis were increasing age (risk ratio 1.02) and male sex (risk ratio 1.61). Risk factors for valve replacement were recurr ent endocarditis (risk ratio 1.62) and prosthetic valve endo carditis (risk ratio 1.61). Risk factors for death were increasing age (risk ratio 1.03) and recurrent endocarditis (risk ratio 2.06). Conclusions The long-term event-free survival for patients who survived the ir first episode of endocarditis was low. Recurrent endocarditis, prostheti c valve endocarditis, and increasing age contributed to the high rate of ev ents during the follow-up.