Infective Endocarditis Following FRANCE-TAVI Insights
Author(s)
Johann Cattan, MD1, Hugues Delamare, MD2, Manon Leclère, MSc2, Xavier Ansolabehere, MSc2, Cheick Tamberou, MSc2, Elise Arnée, PharmD2, Florence Du Chayla, MS2.
1Bordeaux University Hospital, BORDEAUX, France, 2Clinityx by Gers, Boulogne-Billancourt, France.
1Bordeaux University Hospital, BORDEAUX, France, 2Clinityx by Gers, Boulogne-Billancourt, France.
OBJECTIVES: This study aimed to identify the incidence, risk factors, and prognostic outcomes of IE in TAVI patients, with a focus on the timing of onset and temporal trends over the past decade.
METHODS: This retrospective multicentric study analyzed data from 77,662 patients who underwent TAVI in France between 2010 and 2021 using the FRANCE TAVI registry and the French National Health Data System. All endocarditis cases diagnosed after the TAVI procedure were targeted. The only exclusion criterion was confirmation of IE beyond the 45th day after TAVI surgical replacement in order not to confuse it with an infection affecting the new prosthetic valve rather than the initial TAVI.
RESULTS: IE incidence was 0.72 cases per 100 patient-years, with 52.6% of cases occurring within the first year (early IE). Factors associated with IE included male sex (HR 1.47, p<0.001), obesity (HR 1.17, p<0.001), and postprocedural complications such as pacemaker implantation (HR 1.22, p<0.001). Early IE was predominantly linked to procedural and clinical factors, while late IE was more influenced by patient comorbidities. One-year mortality post-IE diagnosis was 39.7%, with poor outcomes linked to late IE (HR 1.22, p<0.05) and severe comorbidities. The annual incidence of early IE decreased significantly from 2010 to 2016, stabilizing thereafter, reflecting improved patient selection and procedural advancements.
CONCLUSIONS: This study highlights the epidemiological and clinical burden of IE post-TAVI, emphasizing the need for targeted prevention strategies and tailored follow-up care. The findings provide insights into patient risk stratification and procedural optimization to mitigate IE risk and improve outcomes.
METHODS: This retrospective multicentric study analyzed data from 77,662 patients who underwent TAVI in France between 2010 and 2021 using the FRANCE TAVI registry and the French National Health Data System. All endocarditis cases diagnosed after the TAVI procedure were targeted. The only exclusion criterion was confirmation of IE beyond the 45th day after TAVI surgical replacement in order not to confuse it with an infection affecting the new prosthetic valve rather than the initial TAVI.
RESULTS: IE incidence was 0.72 cases per 100 patient-years, with 52.6% of cases occurring within the first year (early IE). Factors associated with IE included male sex (HR 1.47, p<0.001), obesity (HR 1.17, p<0.001), and postprocedural complications such as pacemaker implantation (HR 1.22, p<0.001). Early IE was predominantly linked to procedural and clinical factors, while late IE was more influenced by patient comorbidities. One-year mortality post-IE diagnosis was 39.7%, with poor outcomes linked to late IE (HR 1.22, p<0.05) and severe comorbidities. The annual incidence of early IE decreased significantly from 2010 to 2016, stabilizing thereafter, reflecting improved patient selection and procedural advancements.
CONCLUSIONS: This study highlights the epidemiological and clinical burden of IE post-TAVI, emphasizing the need for targeted prevention strategies and tailored follow-up care. The findings provide insights into patient risk stratification and procedural optimization to mitigate IE risk and improve outcomes.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO154
Topic
Clinical Outcomes, Epidemiology & Public Health, Health Service Delivery & Process of Care
Topic Subcategory
Clinical Outcomes Assessment, Relating Intermediate to Long-term Outcomes
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Surgery