Author + information
- Abel E. Moreyra,
- Nora M. Cosgrove,
- Xinbei Yang,
- Sasha-Ann East,
- John B. Kostis,
- Yirui Hu,
- William J. Kostis,
- for the MIDAS Study Group
Background: Since 1990, guideline changes in 1997 and 2007 for the prevention of bacterial endocarditis (BE) have recommended less intensive antibiotic prophylaxis. The effect of these modifications is controversial.
Methods: Using the Myocardial Data Acquisition System (MIDAS), a state database including all admissions with cardiovascular disease in NJ, we identified from 1994 to 2014 all BE admissions (ICD codes 421.0, 421.1, 421.9, 424.9). Incidence was adjusted by age and gender.
Results: Admissions with BE as a secondary diagnosis in patients admitted for another condition (n=28,498) exhibited a significant increase between 2000 and 2007 (slope 0.88±0.06, p<0.001, fitting a piecewise linear model). The reasons for admission (primary diagnoses) of these patients included diseases of the circulatory system (28%), complications of surgery or fracture (10%), infections and parasitic diseases (16%) and diseases of the respiratory and digestive system (9%), other (37%). Sensitivity analysis indicated similar changes in the incidence of BE as a secondary diagnosis regardless of the primary reason for admission. There was no appreciable change in the incidence of BE as primary diagnosis (n=10,744) during the 21 year study period. (Figure)
Conclusions: Changes in BE guidelines in 1997 were associated with an increase incidence of BE as secondary diagnosis in NJ beginning in the year 2000 regardless of the reason for admission. This change was not observed in the incidence of BE as primary diagnosis.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Current Issues in Cardiovascular Epidemiology, Disparities, and Safety
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1148-053
- 2017 American College of Cardiology Foundation