Coronary events complicating infective endocarditis

Virginie Roux (1) , Erwan Salaun (2) , Christophe Tribouilloy (3, 4) , Sandrine Hubert (2) , Yohann Bohbot (3) , Jean-Paul Casalta (5) , Pierre-Antoine Barral , Dan Rusinaru (4, 3) , Frederique Gouriet (5) , Cecile Lavoute (6) , Julie Haentjens , Mathieu Di Biscegli , Aurelie Dehaene , Sebastien Renard , Anne-Claire Casalta , Julie Pradier , Jean-Francois Avierinos (6) , Alberto Riberi (7, 6) , Marc Lambert , Frederic Collart (8) , Alexis Jacquier (9) , Franck Thuny (10) , Laurence Camoin-Jau (11) , Hubert Lepidi (5) , Didier Raoult (12) , Gilbert Habib (5)

1 CHU Pointe-à-Pitre/Abymes [Guadeloupe]
2 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
3 Service de Cardiologie [Amiens]
4 Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux
5 URMITE - Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes
6 Service de cardiologie
7 AMU - Aix Marseille Université
8 APHM - Assistance Publique - Hôpitaux de Marseille
9 CRMBM - Centre de résonance magnétique biologique et médicale
10 URMITE - Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes
11 Physiopathologie de l'Endothelium
12 URPE - Unité des Rickettsies et pathogènes émergents

OBJECTIVE: Acute coronary syndromes (ACS) are a rare complication of infective endocarditis (IE). Only case reports and small studies have been published to date. We report the largest series of ACS in IE. The aim of our study was to describe the incidence and mechanisms of ACS associated with IE, to assess their prognostic impact and to describe their management. METHODS: In a bicentre prospective observational cohort study, all patients with a definite diagnosis of IE were prospectively included. The incidence, mechanism and prognosis of patients with ACS were studied. RESULTS: Among 1210 consecutive patients with definite IE, 26 patients (2.2%) developed an ACS. Twenty-three patients (88%) had a coronary embolism. Two patients had coronary compression by an abscess or a pseudoaneurysm and one patient had an obstruction of his bioprosthesis and left coronary ostium by a large vegetation. Nineteen (73%) patients with ACS developed heart failure and this complication was 2.5 times more frequent than in patients without ACS (p\textless0.0001). In the ACS population, mortality rate was twice than the population without ACS. CONCLUSIONS: ACS is a rare complication of IE but is associated with an increased risk of heart failure and high mortality rate.

Mots clés: acute coronary syndromes; endocarditis; cvs

Domaines: Imagerie médicale; Imagerie

Virginie Roux, Erwan Salaun, Christophe Tribouilloy, Sandrine Hubert, Yohann Bohbot, et al.. Coronary events complicating infective endocarditis. Heart (British Cardiac Society), 2017, ⟨10.1136/heartjnl-2017-311624⟩. ⟨hal-01657974⟩