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?:abstract
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Background: Rheumatic heart disease (RHD) is a significant cause of morbidity and mortality in New Zealand, Australia and the Pacific Infective endocarditis (IE) is a feared complication of valvular heart disease In this study, we provide a description of the disease characteristics and clinical course from a broad group of patients with endocarditis Method: All cases of IE at Auckland City Hospital between 2016 to 2018 were reviewed Patients treated surgically were from a reference population of >2 million Cases with congenital heart disease and device-related endocarditis were excluded Results: A total of 155 cases were identified, with 22 having a history of RHD Mean age at index hospitalisation was 61 3, and 105 were male There were 55 cases of prosthetic valve endocarditis Staphylococcus aureus was the most frequent infecting organism, followed by Viridans group Steptococci and Enterococci Complications included stroke(32), conduction abnormalities(24) and de novo heart failure(17) Benzylpenicillin was the most frequently-used antibiotic and 86 patients required surgery At latest follow-up, 39 patients had died Patients with RHD were younger at index presentation, and Kaplan-Meier survival indicated a higher mortality rate compared to patients without RHD, although this was not statistically significant Conclusion: Infective endocarditis continues to be associated with serious morbidity and mortality in all patient groups Patients with RHD in our population were younger and had higher mortality rates than those without RHD Complications of acute rheumatic fever and RHD lead to reduced life expectancy, and prevention strategies to reduce endocarditis in RHD populations are therefore critical
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