Accepted Manuscript Comparison of Clinical Features of Left-Sided Infective Endocarditis Involving Previously Normal versus Previously Abnormal Valves Carmen Olmos, MD Isidre Vilacosta, MD, PhD Cristina Fernández, MD, PhD Cristina Sarriá, MD, PhD Javier López, MD, PhD María Del Trigo, MD Carlos Ferrera, MD David Vivas, MD, PhD Luis Maroto, MD, PhD Miguel Hernández, MD Enrique Rodríguez, MD, PhD José Alberto San Román, MD, PhD PII:

S0002-9149(14)01050-9

DOI:

10.1016/j.amjcard.2014.04.036

Reference:

AJC 20440

To appear in:

The American Journal of Cardiology

Received Date: 25 March 2014 Revised Date:

22 April 2014

Accepted Date: 23 April 2014

Please cite this article as: Olmos C, Vilacosta I, Fernández C, Sarriá C, López J, Del Trigo M, Ferrera C, Vivas D, Maroto L, Hernández M, Rodríguez E, San Román JA, Comparison of Clinical Features of Left-Sided Infective Endocarditis Involving Previously Normal versus Previously Abnormal Valves, The American Journal of Cardiology (2014), doi: 10.1016/j.amjcard.2014.04.036. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT

Comparison of Clinical Features of Left-Sided Infective Endocarditis

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Involving Previously Normal versus Previously Abnormal Valves

Running head: Normal native valve infective endocarditis.

Carmen Olmos MDa; Isidre Vilacosta MD, PhDa; Cristina Fernández, MD, PhDa; Cristina

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Sarriá MD, PhDb; Javier López, MD, PhDc; María Del Trigo MDa; Carlos Ferrera MDa; David Vivas MD, PhDa; Luis Maroto MD, PhDa; Miguel Hernández MDb; Enrique

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Rodríguez MD, PhDa; José Alberto San Román MD, PhDb

Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid; bServicio de Medicina Interna

Servicio de Medicina Interna-Infecciosas, Instituto de Investigación Sanitaria del Hospital

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Universitario de la Princesa, Madrid; cInstituto de Ciencias del Corazón (ICICOR), Hospital Universitario de Valladolid, Valladolid. Spain.

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Financial support and disclosures: none.

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Address for correspondence: Dr. C. Olmos, MD

Instituto Cardiovascular. Hospital Clínico San Carlos. Prof. Martín Lagos s/n, 28040 Madrid, Spain. Tel: +34 913302712 - FAX: 0034913303290 Email: [email protected]

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ACCEPTED MANUSCRIPT

ABSTRACT

Native valve infective endocarditis (IE) among patients with normal valves has

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increased in the last decades. Whether patients with normal valves present a similar prognosis to those with pathological valves is unresolved. Our aim is to describe epidemiological and clinical differences between patients with left-sided IE and

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normal valves, and those with native pathological valves. We analyzed 945

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consecutive episodes of IE, 435 of whom involved left-sided non-prosthetic IE. They were classified into 2 groups: episodes in normal valves (normal group, n=173), and episodes in pathological valves (abnormal group, n=262). Patients in the normal group were younger, S.aureus and S.bovis were more frequently isolated, and

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vegetations were more frequently found. Heart failure, septic shock, and the need for surgery or death were more common. Multivariable analysis identified the following as factors independently associated with normal valve IE: age