Efficacy of Early Surgery for Infective Endocarditis: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LIANGFu-xiang ^1,2 ,  SONGBing ^1,2 , LIURui-sheng ¹ , LIYuan-min ¹ , TANGHan-bo ¹

1. Department of Cardiovascular Surgery, the First Hospital of Lanzhou University, Lanzhou 730000, China;
2. The First Clinical College of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

SONGBing, Email: ysllfx@gmail.com

Keywords：

Infective endocarditis; Early surgery; Systematic review; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.20150157

Video：

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Objective To systematically review the short term and long term efficacy of early surgery for infective endocarditis (IE) patients. Methods We searched PubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases for cohort studies concerning the efficacy of early surgery for IE patients from inception to October 2014. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results Sixteen cohort studies including 8 141 patients were included. The results of meta-analysis showed that early surgery could reduce the short term mortality (OR=0.57, 95%CI 0.42 to 0.77, P=0.000 4) and long term mortality (OR=0.57, 95%CI 0.43 to 0.77, P=0.000 7) in IE patients. Subgroup analysis showed that early surgery could significantly reduce the short term mortality and long term mortality in patients with native valve endocarditis (NVE). Conclusion Early surgery can reduce IE patients' short term mortality and long term mortality. Due to the limited quality and quantity of the included studies, more large-scale high-quality studies are needed to verify the above conclusion.

Citation： LIANGFu-xiang, SONGBing, LIURui-sheng, LIYuan-min, TANGHan-bo. Efficacy of Early Surgery for Infective Endocarditis: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(8): 938-944. doi: 10.7507/1672-2531.20150157 Copy

1.	Hoen B, Alla F, Selton-Suty C, et al. Changing profile of infective endocarditis:Results of a 1-year survey in france. JAMA, 2002, 288(1):75-81.
2.	Lalani T, Cabell CH, Benjamin DK, et al. Analysis of the impact of early surgery on in-hospital mortality of native valve endocarditis:Use of propensity score and instrumental variable methods to adjust for treatment-selection bias. Circulation, 2010, 121(8):1005-1013.
3.	Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med, 2001, 345(18):1318-1330.
4.	Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis:Diagnosis, antimicrobial therapy, and management of complications:A statement for healthcare professionals from the committee on rheumatic fever, endocarditis, and kawasaki disease, council on cardiovascular disease in the young, and the councils on clinical cardiology, stroke, and cardiovascular surgery and anesthesia, american heart association:Endorsed by the infectious diseases society of america. Circulation, 2005, 111(23):e394-434.
5.	Habib G, Hoen B, Tornos P, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009):The task force on the prevention, diagnosis, and treatment of infective endocarditis of the european society of cardiology (esc). Endorsed by the european society of clinical microbiology and infectious diseases (escmid) and the international society of chemotherapy (isc) for infection and cancer. Eur Heart J, 2009, 30(19):2369-2413.
6.	Kang DH, Kim YJ, Kim SH, et al. Early surgery versus conventional treatment for infective endocarditis. N Engl J Med, 2012, 366(26):2466-2473.
7.	Aksoy O, Sexton DJ, Wang A, et al. Early surgery in patients with infective endocarditis:A propensity score analysis. Clin Infect Dis, 2007, 44(3):364-372.
8.	Bannay A, Hoen B, Duval X, et al. The impact of valve surgery on short- and long-term mortality in left-sided infective endocarditis:Do differences in methodological approaches explain previous conflicting results? Eur Heart J, 2011, 32(16):2003-2015.
9.	Cabell CH, Abrutyn E, Fowler VG, Jr., et al. Use of surgery in patients with native valve infective endocarditis:Results from the international collaboration on endocarditis merged database. Am Heart J, 2005, 150(5):1092-1098.
10.	Funakoshi S, Kaji S, Yamamuro A, et al. Impact of early surgery in the active phase on long-term outcomes in left-sided native valve infective endocarditis. J Thorac Cardiovasc Surg, 2011, 142(4):836-842.
11.	Hill EE, Herregods MC, Vanderschueren S, et al. Outcome of patients requiring valve surgery during active infective endocarditis. Ann Thorac Surg, 2008, 85(5):1564-1569.
12.	Lalani T, Chu VH, Park LP, et al. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis. JAMA Inter Med, 2013, 173(16):1495-1504.
13.	Mourvillier B, Trouillet JL, Timsit JF, et al. Infective endocarditis in the intensive care unit:Clinical spectrum and prognostic factors in 228 consecutive patients. Intensive Care Med, 2004, 30(11):2046-2052.
14.	Ohara T, Nakatani S, Kokubo Y, et al. Clinical predictors of in-hospital death and early surgery for infective endocarditis:Results of cardiac disease registration (cadre), a nation-wide survey in japan. Int J Cardiol, 2013, 167(6):2688-2694.
15.	Sy RW, Bannon PG, Bayfield MS, et al. Survivor treatment selection bias and outcomes research:A case study of surgery in infective endocarditis. Circ Cardiovasc Qual Outcomes, 2009, 2(5):469-474.
16.	Thuny F, Beurtheret S, Mancini J, et al. The timing of surgery influences mortality and morbidity in adults with severe complicated infective endocarditis:A propensity analysis. Eur Heart J, 2011, 32(16):2027-2033.
17.	Tleyjeh IM, Ghomrawi HM, Steckelberg JM, et al. The impact of valve surgery on 6-month mortality in left-sided infective endocarditis. Circulation, 2007, 115(13):1721-1728.
18.	Vikram HR, Buenconsejo J, Hasbun R, et al. Impact of valve surgery on 6-month mortality in adults with complicated, left-sided native valve endocarditis:A propensity analysis. JAMA, 2003, 290(24):3207-3214.
19.	Wang A, Pappas P, Anstrom KJ, et al. The use and effect of surgical therapy for prosthetic valve infective endocarditis:A propensity analysis of a multicenter, international cohort. Am Heart J, 2005, 150(5):1086-1091.
20.	王辉, 张抒扬, 田庄, 等. 早期手术对左心感染性心内膜炎长期预后的影响. 中华内科杂志, 2014, 53(6):450-454.
21.	贾立群, 付强, 杨帅, 等. 早期手术治疗感染性心内膜炎的可行性探讨. 中华胸心血管外科杂志, 2012, 28(8):464-466.
22.	Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis, 2000, 30(4):633-638.
23.	中华医学会心血管病学分会. 成人感染性心内膜炎预防、诊断和治疗专家共识. 中华心血管病杂志, 2014, 42(10):806-816.
24.	Chatterjee S, Sardar P. Early surgery reduces mortality in patients with infective endocarditis:Insight from a meta-analysis. Int J Cardiol, 2013, 168(3):3094-3097.
25.	San Roman JA, Lopez J, Revilla A, et al. Rationale, design, and methods for the early surgery in infective endocarditis study (endoval 1):A multicenter, prospective, randomized trial comparing the state-of-the-art therapeutic strategy versus early surgery strategy in infective endocarditis. Am Heart J, 2008, 156(3):431-436.

1. Hoen B, Alla F, Selton-Suty C, et al. Changing profile of infective endocarditis:Results of a 1-year survey in france. JAMA, 2002, 288(1):75-81.
2. Lalani T, Cabell CH, Benjamin DK, et al. Analysis of the impact of early surgery on in-hospital mortality of native valve endocarditis:Use of propensity score and instrumental variable methods to adjust for treatment-selection bias. Circulation, 2010, 121(8):1005-1013.
3. Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med, 2001, 345(18):1318-1330.
4. Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis:Diagnosis, antimicrobial therapy, and management of complications:A statement for healthcare professionals from the committee on rheumatic fever, endocarditis, and kawasaki disease, council on cardiovascular disease in the young, and the councils on clinical cardiology, stroke, and cardiovascular surgery and anesthesia, american heart association:Endorsed by the infectious diseases society of america. Circulation, 2005, 111(23):e394-434.
5. Habib G, Hoen B, Tornos P, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009):The task force on the prevention, diagnosis, and treatment of infective endocarditis of the european society of cardiology (esc). Endorsed by the european society of clinical microbiology and infectious diseases (escmid) and the international society of chemotherapy (isc) for infection and cancer. Eur Heart J, 2009, 30(19):2369-2413.
6. Kang DH, Kim YJ, Kim SH, et al. Early surgery versus conventional treatment for infective endocarditis. N Engl J Med, 2012, 366(26):2466-2473.
7. Aksoy O, Sexton DJ, Wang A, et al. Early surgery in patients with infective endocarditis:A propensity score analysis. Clin Infect Dis, 2007, 44(3):364-372.
8. Bannay A, Hoen B, Duval X, et al. The impact of valve surgery on short- and long-term mortality in left-sided infective endocarditis:Do differences in methodological approaches explain previous conflicting results? Eur Heart J, 2011, 32(16):2003-2015.
9. Cabell CH, Abrutyn E, Fowler VG, Jr., et al. Use of surgery in patients with native valve infective endocarditis:Results from the international collaboration on endocarditis merged database. Am Heart J, 2005, 150(5):1092-1098.
10. Funakoshi S, Kaji S, Yamamuro A, et al. Impact of early surgery in the active phase on long-term outcomes in left-sided native valve infective endocarditis. J Thorac Cardiovasc Surg, 2011, 142(4):836-842.
11. Hill EE, Herregods MC, Vanderschueren S, et al. Outcome of patients requiring valve surgery during active infective endocarditis. Ann Thorac Surg, 2008, 85(5):1564-1569.
12. Lalani T, Chu VH, Park LP, et al. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis. JAMA Inter Med, 2013, 173(16):1495-1504.
13. Mourvillier B, Trouillet JL, Timsit JF, et al. Infective endocarditis in the intensive care unit:Clinical spectrum and prognostic factors in 228 consecutive patients. Intensive Care Med, 2004, 30(11):2046-2052.
14. Ohara T, Nakatani S, Kokubo Y, et al. Clinical predictors of in-hospital death and early surgery for infective endocarditis:Results of cardiac disease registration (cadre), a nation-wide survey in japan. Int J Cardiol, 2013, 167(6):2688-2694.
15. Sy RW, Bannon PG, Bayfield MS, et al. Survivor treatment selection bias and outcomes research:A case study of surgery in infective endocarditis. Circ Cardiovasc Qual Outcomes, 2009, 2(5):469-474.
16. Thuny F, Beurtheret S, Mancini J, et al. The timing of surgery influences mortality and morbidity in adults with severe complicated infective endocarditis:A propensity analysis. Eur Heart J, 2011, 32(16):2027-2033.
17. Tleyjeh IM, Ghomrawi HM, Steckelberg JM, et al. The impact of valve surgery on 6-month mortality in left-sided infective endocarditis. Circulation, 2007, 115(13):1721-1728.
18. Vikram HR, Buenconsejo J, Hasbun R, et al. Impact of valve surgery on 6-month mortality in adults with complicated, left-sided native valve endocarditis:A propensity analysis. JAMA, 2003, 290(24):3207-3214.
19. Wang A, Pappas P, Anstrom KJ, et al. The use and effect of surgical therapy for prosthetic valve infective endocarditis:A propensity analysis of a multicenter, international cohort. Am Heart J, 2005, 150(5):1086-1091.
20. 王辉, 张抒扬, 田庄, 等. 早期手术对左心感染性心内膜炎长期预后的影响. 中华内科杂志, 2014, 53(6):450-454.
21. 贾立群, 付强, 杨帅, 等. 早期手术治疗感染性心内膜炎的可行性探讨. 中华胸心血管外科杂志, 2012, 28(8):464-466.
22. Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis, 2000, 30(4):633-638.
23. 中华医学会心血管病学分会. 成人感染性心内膜炎预防、诊断和治疗专家共识. 中华心血管病杂志, 2014, 42(10):806-816.
24. Chatterjee S, Sardar P. Early surgery reduces mortality in patients with infective endocarditis:Insight from a meta-analysis. Int J Cardiol, 2013, 168(3):3094-3097.
25. San Roman JA, Lopez J, Revilla A, et al. Rationale, design, and methods for the early surgery in infective endocarditis study (endoval 1):A multicenter, prospective, randomized trial comparing the state-of-the-art therapeutic strategy versus early surgery strategy in infective endocarditis. Am Heart J, 2008, 156(3):431-436.

Chinese Journal of Evidence-Based Medicine

Efficacy of Early Surgery for Infective Endocarditis: A Meta-analysis

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