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Infective endocarditis in patients with diabetes

https://doi.org/10.30629/0023-2149-2021-99-9-10-548-553

Abstract

Diabetes mellitus (DM) is an adverse premorbid background for the development, course and outcome of infective endocarditis (IE), and therefore the combination of these diseases requires study. 
Objective: to study the clinical features and outcomes of infective endocarditis in patients with diabetes mellitus. 
Material and methods A retrospective (from 2001 to 2007) and a prospective (from 2008 to 2018) analysis of 347 patients with specifi c IE, 243 men and 104 women, aged from 17 to 83 (median age 44.8; 34–54). 
Results. 22 patients with IE, were diagnosed with diabetes, that is, the incidence of this pathology was 6.3%. Type 1 diabetes was observed in 7 (2% of the total number of patients and 32% among patients with a combination of IE and diabetes). Type 2 diabetes was diagnosed in 15 patients (4.3% and 68%, respectively). In subgroups of patients with IE and diabetes and without it, statistically signifi cant diff erences in age (p < 0.05), Charlson comorbidity index (p < 0.001), incidence of neurological complications ((p < 0.05), hospital mortality (p < 0.05) were noted, while patients with IE on the background of type 1 diabetes, had a more severe course of the disease. According to key characteristics of the pathological process in IE, localization, severity of systemic infl ammation, clinical and biochemical parameters, no signifi cant diff erences in the studied groups were found. 
Findings. The obtained results confi rm the literature data on fundamentally identical regularities of the course of IE in patients with and without diabetes. At the same time, the development of IE on the background of diabetes is a prognostically unfavorable combination of comorbid conditions, which requires special attention of physicians to such a contingent of patients, interaction of specialists for their successful management.

About the Authors

E. Yu. Ponomareva
Saratov State Medical University named after Razumovsky V.I., Department of Hospital Therapy of the Faculty of Medicine
Russian Federation

Elena Yu. Ponomareva — MD, PhD, Associate Professor of the Department

410012, Saratov



M. A. Kunitsyna
Saratov State Medical University named after Razumovsky V.I., Department of Hospital Therapy of the Faculty of Medicine
Russian Federation

Kunitsyna Marina Alekseevna

410012, Saratov



References

1. Habib G., Lancellotti P., Manuel J. et al. 2015 ESC Guidelines for the management of infective endocarditis. The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). European Heart Journal. Advance Access published August 29, 2015.

2. Tyurin V.P. Infectious endocarditis. M.: GEOTAR-media, 2013:368. (in Russian)

3. Dedov I.I., Shestakova M.V., Vikulova O.K. et al. Diabetes mellitus in the Russian Federation: prevalence, morbidity, mortality, parameters of carbohydrate metabolism and the structure of glucose-lowering therapy according to the fede ral register of diabetes mellitus, status 2017 g. Saharnyj diabet. 2018;21(3):144–159. (in Russian)

4. Pasechnik I.N., Ryabov A.L., Vershinina M.G. Sepsis and diabetes mellitus: state of the problem. Hirurgiya. 2016;1:80–84. (in Russian)

5. Kukushkin G.V., Starostina Е.G. Infections in patients with diabetes. RMZH. 2016;20:1327–1333. (in Russian)

6. Olmos C., Vilacosta I., Pozo E. et al. Prognostic implications of diabetes in patients with left-sided endocarditis: fi ndings from a large cohort study. Medicine (Baltimore). 2014;93(2):114–119.

7. Chirillo F., Bacchion F., Pedrocco A. et al. Infective endocarditis in patients with diabetes mellitus. J. Heart Valve Dis. 2010;19(3):312–20.

8. Duval X., Alla F., Doco-Lecompte T. et al Diabetes mellitus and infective endocarditis: the insulin factor in patient morbidity and mortality. European Heart Journal 2007;28:59–64. DOI:10.1093/eurheartj/ehl318

9. García-Granja P.E., López J., Vilacosta I. et al. Infective Endocarditis due to Listeria Monocytogenes: A Report of 4 Patients. Rev. Esp. Cardiol. 2016;69(7):700–2. DOI: 10.1016/j.rec.2016.04.006n

10. Morris N.A., Matiello M., Lyons J.L., Samuels M.A. Neurologic complications in infective endocarditis: identifi cation, management, and impact on cardiac surgery. Neurohospitalist. 2014;4(4):213–22.

11. Wei X.-B., Liu Y.-H., Huang J.-L. et al. Prediabetes and diabetes are both risk factors for adverse outcomes in infective endocarditis. Diabetic Medicine. 2018;35(11):1499–1507.

12. Dedov I.I., Shestakova M.V. Vascular brain damage in diabetes mellitus: resolved and unresolved issues. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2015;115(8):79–82. (in Russian)

13. Yoshioka D., Toda K., Yokoyama J.-Y., Matsuura R., Miyagawa S., Kainuma S. et al. Diabetes mellitus adversely aff ects mortality and recurrence after valve surgery for infective endocarditis. (e5.) J. Thorac. Cardiovasc. Surg. 2018;155:1021–1029.

14. Coselli, J.S., Petersson, G.B., Hussain, S.T. et al. The American Association for Thoracic Surgery (AATS) consensus guidelines: surgical treatment of infective endocarditis: executive summary. J. Thorac. Cardiovasc. Surg. 2017;153:1241–1258.e29.


Review

For citations:


Ponomareva E.Yu., Kunitsyna M.A. Infective endocarditis in patients with diabetes. Clinical Medicine (Russian Journal). 2021;99(9-10):548-553. (In Russ.) https://doi.org/10.30629/0023-2149-2021-99-9-10-548-553

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ISSN 0023-2149 (Print)
ISSN 2412-1339 (Online)