Infective endocarditis in cancer patients

Causative organisms, predisposing procedures, and prognosis differ from infective endocarditis in non-cancer patients

Kyu Kim, Darae Kim, Sang Eun Lee, In Jeong Cho, ChiYoung Shim, Geu Ru Hong, Jong Won Ha

Research output: Contribution to journalArticle

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Abstract

Background: Infective endocarditis (IE) in cancer patients is increasing, but because little is known about it in these patients, we analyzed patient characteristics and outcomes and compared these factors in IE patients with and without cancer. Methods and Results: This retrospective cohort study included 170 patients with IE newly diagnosed between January 2011 and December 2015. Among 170 patients, 30 (17.6%) had active cancer. The median age of IE patients with cancer was higher than that of non-cancer patients. Nosocomial IE was more common in cancer patients. Non-dental procedures, such as intravenous catheter insertion and invasive endoscopic or genitourinary procedures, were more frequently performed before IE developed in cancer patients. Staphylococcus was the most common pathogen in cancer patients, whereas Streptococcus was the most common in non-cancer patients. In-hospital mortality was significantly higher in cancer patients with IE (34.4% vs. 12.4%, P<0.001). IE was an important reason for discontinuing antitumor therapy and withholding additional aggressive treatment in nearly all deceased cancer patients. Conclusions: IE is common in cancer patients and is associated with poorer outcomes. Patients with IE and cancer have different clinical characteristics. Additional studies regarding antibiotic prophylaxis before non-dental invasive procedures in cancer patients are needed, as cancer patients are not considered to be at higher risk of IE.

Original languageEnglish
Pages (from-to)452-460
Number of pages9
JournalCirculation Journal
Volume83
Issue number2
DOIs
Publication statusPublished - 2019 Jan 1

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Non-Infective Endocarditis
Endocarditis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Infective endocarditis in cancer patients: Causative organisms, predisposing procedures, and prognosis differ from infective endocarditis in non-cancer patients",
abstract = "Background: Infective endocarditis (IE) in cancer patients is increasing, but because little is known about it in these patients, we analyzed patient characteristics and outcomes and compared these factors in IE patients with and without cancer. Methods and Results: This retrospective cohort study included 170 patients with IE newly diagnosed between January 2011 and December 2015. Among 170 patients, 30 (17.6{\%}) had active cancer. The median age of IE patients with cancer was higher than that of non-cancer patients. Nosocomial IE was more common in cancer patients. Non-dental procedures, such as intravenous catheter insertion and invasive endoscopic or genitourinary procedures, were more frequently performed before IE developed in cancer patients. Staphylococcus was the most common pathogen in cancer patients, whereas Streptococcus was the most common in non-cancer patients. In-hospital mortality was significantly higher in cancer patients with IE (34.4{\%} vs. 12.4{\%}, P<0.001). IE was an important reason for discontinuing antitumor therapy and withholding additional aggressive treatment in nearly all deceased cancer patients. Conclusions: IE is common in cancer patients and is associated with poorer outcomes. Patients with IE and cancer have different clinical characteristics. Additional studies regarding antibiotic prophylaxis before non-dental invasive procedures in cancer patients are needed, as cancer patients are not considered to be at higher risk of IE.",
author = "Kyu Kim and Darae Kim and Lee, {Sang Eun} and Cho, {In Jeong} and ChiYoung Shim and Hong, {Geu Ru} and Ha, {Jong Won}",
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Infective endocarditis in cancer patients : Causative organisms, predisposing procedures, and prognosis differ from infective endocarditis in non-cancer patients. / Kim, Kyu; Kim, Darae; Lee, Sang Eun; Cho, In Jeong; Shim, ChiYoung; Hong, Geu Ru; Ha, Jong Won.

In: Circulation Journal, Vol. 83, No. 2, 01.01.2019, p. 452-460.

Research output: Contribution to journalArticle

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AU - Kim, Darae

AU - Lee, Sang Eun

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AU - Shim, ChiYoung

AU - Hong, Geu Ru

AU - Ha, Jong Won

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