When infective endocarditis after TAVR is most likely to be fatal

Infective endocarditis (IE) is one of the most substantial side effects of transcatheter aortic valve replacement (TAVR), leading to a much higher risk of stroke or even death. Hoping to learn more about the timing of IE after TAVR, a team of researchers from the Cleveland Clinic have tracked data more than 900 patients, sharing their findings in the American Journal of Cardiology.[1]

The group used the Nationwide Readmission Database to track data from 906 patients hospitalized for post-TAVR IE from 2014 to 2017. They evaluated how long after TAVR each patient was hospitalized for IE, looking for links between time-to-IE after TAVR and TAVR outcomes.

Reviewing their findings, the authors reported that the mean time-to-IE after TAVR was nearly 109 days. While 261 patients were hospitalized for IE within 50 days of TAVR, 235 patients were hospitalized from days 51 to 100, 179 patients were hospitalized from days 101 to 150, 110 patients were hospitalized from days 151 to 200, 61 were hospitalized from days 201 to 250 and 60 patients were hospitalized from days 251 to 365. The cut-off date for IE hospitalizations included in this analysis was 365 days after TAVR.

Also, the total in-hospital mortality rate was 12.36%. The rate was 15.61% for patients hospitalized within 50 days of TAVR, but dropped to 10.87% for patients hospitalized from days 51 to 100. In-hospital mortality was actually the highest (17.36%) for patients hospitalized from days 101 to 150 and lowest (2.93%) for patients hospitalized from days 201 to 250.

Overall, the team determined IE hospitalizations any later than 150 days after TAVR were associated with a significant decrease in in-hospital mortality. Rates of stroke and acute kidney injury, however, did not appear to be impacted by the time-to-IE after TAVR.