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Current guidelines recommend antibiotic prophylaxis for patients who have high-risk heart conditions and who are undergoing procedures associated with bacteremia (e.g., NEJM JW Infect Dis Dec 2015 and Circulation 2015; 132:1435); however, bicuspid aortic valve (BAV) or mitral valve prolapse (MVP) is considered to be an intermediate-risk condition by most guidelines. Spanish investigators analyzed a large registry of patients with infective endocarditis to investigate the clinical features that are associated with BAV and MVP. Of 3208 consecutive patients, 1226 were at high risk and 1982 were at low or intermediate risk, including 54 with BAV and 89 with MVP.
Patients with BAV or MVP were significantly younger and had a significantly higher i…