TY - JOUR
T1 - Bacteraemia after transcatheter aortic valve implantation
T2 - a nationwide cohort study
AU - Hadji-Turdeghal, Katra
AU - Petersen, Jeppe K
AU - Graversen, Peter Laursen
AU - Butt, Jawad Haider
AU - Strange, Jarl Emanuel
AU - Ihlemann, Nikolaj
AU - Dahl, Jordi Sanchez
AU - Povlsen, Jonas Agerlund
AU - Voldstedlund, Marianne
AU - Terkelsen, Christian Juhl
AU - Møller, Christian H
AU - Freeman, Philip
AU - Nissen, Henrik
AU - De Backer, Ole
AU - Koeber, Lars
AU - Østergaard, Lauge
AU - Fosbøl, Emil Loldrup
N1 - © Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.
PY - 2025/4/10
Y1 - 2025/4/10
N2 - BACKGROUND: Bacteraemia and infective endocarditis (IE) are rare but severe complications of transcatheter aortic valve implantation (TAVI). Limited data exist on the incidence and microbiological profile of early bacteraemia in this population. This study aimed to evaluate the 6-month incidence of bacteraemia, IE and associated mortality following TAVI.METHODS: Using Danish nationwide registries, all patients who underwent TAVI from 2012 to 2021 were identified and matched 1:1 by age, sex and index year with patients who underwent elective coronary angiography (CAG). Outcomes were assessed with cumulative incidence functions and adjusted HRs.RESULTS: Among 5990 patients with first-time TAVI (57% male, mean age 80 years, SD 6.9), bacteraemia occurred in 4.2% within 6 months, compared with 2.6% in the CAG group (adjusted HR 1.57, 95% CI 1.26 to 1.96). Common pathogens post-TAVI included Streptococci (20%), Coagulase-negative staphylococci (19%) and Enterococci (18%), differing from the CAG group, where Coagulase-negative staphylococci (22%) and Staphylococcus aureus (16%) predominated. IE developed in 1.1% of patients with TAVI versus 0.1% of patients with CAG (adjusted HR 20.01, 95% CI 5.97 to 67.48).CONCLUSION: Bacteraemia and IE rates are substantially elevated within 6 months following TAVI compared with elective CAG. The bacterial profile post-TAVI suggests that current prophylactic antibiotic regimens may not provide adequate coverage.
AB - BACKGROUND: Bacteraemia and infective endocarditis (IE) are rare but severe complications of transcatheter aortic valve implantation (TAVI). Limited data exist on the incidence and microbiological profile of early bacteraemia in this population. This study aimed to evaluate the 6-month incidence of bacteraemia, IE and associated mortality following TAVI.METHODS: Using Danish nationwide registries, all patients who underwent TAVI from 2012 to 2021 were identified and matched 1:1 by age, sex and index year with patients who underwent elective coronary angiography (CAG). Outcomes were assessed with cumulative incidence functions and adjusted HRs.RESULTS: Among 5990 patients with first-time TAVI (57% male, mean age 80 years, SD 6.9), bacteraemia occurred in 4.2% within 6 months, compared with 2.6% in the CAG group (adjusted HR 1.57, 95% CI 1.26 to 1.96). Common pathogens post-TAVI included Streptococci (20%), Coagulase-negative staphylococci (19%) and Enterococci (18%), differing from the CAG group, where Coagulase-negative staphylococci (22%) and Staphylococcus aureus (16%) predominated. IE developed in 1.1% of patients with TAVI versus 0.1% of patients with CAG (adjusted HR 20.01, 95% CI 5.97 to 67.48).CONCLUSION: Bacteraemia and IE rates are substantially elevated within 6 months following TAVI compared with elective CAG. The bacterial profile post-TAVI suggests that current prophylactic antibiotic regimens may not provide adequate coverage.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve Stenosis/surgery
KW - Bacteremia/epidemiology
KW - Denmark/epidemiology
KW - Endocarditis, Bacterial/epidemiology
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Prosthesis-Related Infections/epidemiology
KW - Registries
KW - Risk Factors
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Aortic valve stenosis
KW - Epidemiology
KW - Transcatheter aortic valve replacement
KW - Endocarditis
U2 - 10.1136/heartjnl-2024-324803
DO - 10.1136/heartjnl-2024-324803
M3 - Article
C2 - 39794926
SN - 1355-6037
VL - 111
SP - 412
EP - 420
JO - Heart
JF - Heart
IS - 9
ER -