Clinical InvestigationsLong-term incidence of infective endocarditis among patients with congenital heart disease
Graphical Abstract
Section snippets
Data sources
All Danish residents are assigned a unique and permanent civil registration number allowing accurate linkage of nationwide administrative registries at an individual level. For this study, data from the following two Danish administrative registries were obtained: (1) The Danish National Patient Registry, which holds information on all hospital admissions and outpatient contacts according to the International Classification of Diseases (ICD) 8th and 10th revision and surgical procedures
Baseline characteristics
In the period from January 1, 1977, to December 31, 2018, 23,464 patients (50% men) were born and diagnosed with CHD in Denmark at one of the 4 university hospitals (Figure 1). These patients were matched with 93,856 controls from the background population. In total, 1,144 (4.9%) CHD-patients were born in the 70s, 4,159 (17.7%) in the 80s, 6,318 (26.9%) in the 90s, 7,063 (30.1%) in the 00s, and 4,780 (20.4%) in the 10s. The median age at time of CHD diagnosis was 1.0 years (25th-75th percentile
Discussion
In this nationwide study, we examined the long-term incidence of IE in a birth cohort of Danish residents diagnosed with CHD during a 42-year observation period from 1977 to 2018. The study yielded the following major four findings: First, the burden of IE among patients with CHD was substantial with an incidence rate of 5.2 per 10,000 PY corresponding to a more than 50 times higher rate of IE than that of age- and sex-matched controls from the background population. Second, the CHDs with the
Conclusion
The long-term incidence of IE among patients with CHD is substantial and significantly higher compared with the background population. Patients with CHD in high risk of IE is a heterogenous group including patients with cyanotic heart defects, but also atrioventricular septal defects, and heart valve defects, meanwhile factors associated with an increased risk of IE among patients with CHD include male sex, cardiac prosthesis, chronic kidney disease, and presence of cardiac implantable
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest
EHB: None declared, JHB: None declared, LØ: None declared, JKP: None declared, CTP: Grant for randomized study from Bayer and grant for epidemiological study from Novo Nordisk, LK: Serves as a consultant for Boehringer Ingelheim, and has received other support from AstraZeneca, Novartis, and Novo Nordisk, ELF: None declared
Acknowledgments
None
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