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. 2022 May 9;11(9):2651.
doi: 10.3390/jcm11092651.

Infective Endocarditis in Diabetic Patients: A Different Profile with Prognostic Consequences

María Isabel Biezma  1 , Patricia Muñoz  2   3 , Sofía De la Villa  2 , Mª Carmen Fariñas-Álvarez  4 , Francisco Arnáiz de Las Revillas  4 , Encarnación Gutierrez-Carretero  5 , Arístides De Alarcón  5 , Raquel Rodríguez-García  6 , Jaume Llopis  7 , Miguel Ángel Goenaga  8 , Andrea Gutierrez-Villanueva  9 , Antonio Plata  10 , Laura Vidal  11 , Manuel Martínez-Sellés  1   12 , On Behalf Of Games
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Infective Endocarditis in Diabetic Patients: A Different Profile with Prognostic Consequences

María Isabel Biezma et al. J Clin Med. .

Abstract

Background. Infective Endocarditis (IE) is a severe condition. Diabetes mellitus (DM) has been associated with a poor prognosis in other settings. Our aim was to describe the profile and prognosis of IE with and without DM and to analyze the prognostic relevance of DM-related organ damage. Methods. Retrospective analysis of the Spanish IE Registry (2008−2020). Results. The cohort comprises 5590 IE patients with a mean age of 65.0 ± 15.5 years; 3764 (67.3%) were male. DM was found in 1625 patients (29.1%) and 515 presented DM-related organ damage. DM prevalence during the first half of the study period was 27.6% vs. 30.6% in the last half, p = 0.015. Patients with DM presented higher in-hospital mortality than those without DM (521 [32.1%] vs. 924 [23.3%], p < 0.001) and higher one-year mortality (640 [39.4%] vs. 1131 [28.5%], p < 0.001). Among DM patients, organ damage was associated with higher in-hospital (200 [38.8%] vs. 321 [28.9%], p < 0.001) and one-year mortality (247 [48.0%] vs. 393 [35.4%], p < 0.001). Multivariate analyses showed an independent association of DM with in-hospital (odds ratio [OR] = 1.34, 95% confidence interval [CI]: 1.16−1.55, p < 0.001) and one-year mortality (OR = 1.38, 95% CI: 1.21−1.59, p < 0.001). Among DM patients, organ damage was independently associated with higher in-hospital (OR = 1.37, 95% CI: 1.06−1.76, p = 0.015) and one-year mortality (OR = 1.59, 95% CI = 1.26−2.01, p < 0.001) Conclusions. The prevalence of DM among patients with IE is increasing and is already above 30%. DM is independently associated with a poor prognosis, particularly in the case of DM with organ damage.

Keywords: diabetes mellitus; in-hospital mortality; infective endocarditis; one-year mortality; organ damage; prognosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study overview. IE: infective endocarditis. DM: diabetes mellitus.
Figure 2
Figure 2
Yearly prevalence of diabetes during the study period.
Figure 3
Figure 3
Kaplan–Meier survival according to the presence of diabetes mellitus (DM) and DM-related organ damage.
See this image and copyright information in PMC

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