Heart Failure in Patients with Infective Endocarditis: Surgery or No Surgery?

Much remains unknown about the optimal management of patients with infective endocarditis. To find out more, an international collaborative of investigators examined the risk factors for heart failure (HF) and adverse outcomes among consecutive patients with definite endocarditis from 61 centers in 28 countries.

Of 4075 participants, 33% had HF. Compared with patients without HF, those with HF were older and more likely to have a healthcare-associated infection, new or worsening murmur, left-sided native-valve infection with new regurgitation, or paravalvular complications. The risk for in-hospital mortality was significantly higher in patients with HF than in those without HF (30% vs. 13%; odds ratio, 2.8). Surgery was performed in 62% of p…