Abstract Aims There are scant comparative data quantifying the risk of infective endocarditis (IE) and associated mortality in individuals with predisposing cardiac conditions. Methods and results English hospital admissions for conditions associated with increased IE risk were followed for 5 years to quantify subsequent IE admissions. The 5-year risk of IE or dying during an IE admission was calculated for each condition and compared with the entire English population as a control. Infective endocarditis incidence in the English population was 36.2/million/year. In comparison, patients with a previous history of IE had the highest risk of recurrence or dying during an IE admission [odds ratio (OR) 266 and 215, respectively]. These risks were also high in patients with prosthetic valves (OR 70 and 62) and previous valve repair (OR 77 and 60). Patients with congenital valve anomalies (currently considered ‘moderate risk’) had similar levels of risk (OR 66 and 57) and risks in other ‘moderate-risk’ conditions were not much lower. Congenital heart conditions (CHCs) repaired with prosthetic material (currently considered ‘high risk’ for 6 months following surgery) had lower risk than all ‘moderate-risk’ conditions—even in the first 6 months. Infective endocarditis risk was also significant in patients with cardiovascular implantable electronic devices. Conclusion These data confirm the high IE risk of patients with a history of previous IE, valve replacement, or repair. However, IE risk in some ‘moderate-risk’ patients was similar to that of several ‘high-risk’ conditions and higher than repaired CHC. Guidelines for the risk stratification of conditions predisposing to IE may require re-evaluation.

中文翻译：

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量化易感心脏病患者的感染性心内膜炎风险

摘要 目的 量化感染性心内膜炎 (IE) 风险和易感心脏病患者相关死亡率的比较数据很少。方法和结果 英国因 IE 风险增加而入院的情况被跟踪了 5 年，以量化随后的 IE 入院。计算每种情况下 IE 或在 IE 入院期间死亡的 5 年风险，并与作为对照的整个英国人口进行比较。英国人群中感染性心内膜炎的发生率为 36.2/百万/年。相比之下，既往有 IE 病史的患者在 IE 入院期间复发或死亡的风险最高[比值比 (OR) 分别为 266 和 215]。这些风险在有人工瓣膜（OR 70 和 62）和既往瓣膜修复（OR 77 和 60）的患者中也很高。先天性瓣膜异常患者（目前被认为是“中度风险”）具有相似的风险水平（OR 66 和 57），其他“中度风险”条件下的风险也不低很多。用假体材料修复的先天性心脏病 (CHC)（目前在手术后 6 个月内被认为是“高风险”）的风险低于所有“中等风险”条件——即使在前 6 个月也是如此。心血管植入式电子设备患者感染性心内膜炎的风险也很大。结论 这些数据证实了既往有 IE、瓣膜置换或修复病史的患者的高 IE 风险。然而，一些“中等风险”患者的 IE 风险与几种“高风险”条件相似，并且高于修复的 CHC。