J Am Coll Cardiol
Department of Medicine, Division of Cardiology, Weill Cornell Medicine-New York Presbyterian Hospital and Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York, USA. Electronic address:
Published: May 2023
Background: Cardiac implantable electronic device (CIED)-associated infections are associated with substantial morbidity, mortality, and costs. Guidelines have cited endocarditis as a Class I indication for transvenous lead removal/extraction (TLE) among patients with CIEDs.
Objectives: The authors sought to study utilization of TLE among hospital admissions with infective endocarditis using a nationally representative database.
Methods: Using the Nationwide Readmissions Database (NRD), 25,303 admissions for patients with CIEDs and endocarditis between 2016 and 2019 were evaluated on the basis of International Classification of Diseases-10th Revision, Clinical-Modification (ICD-10-CM) codes.
Results: Among admissions for patients with CIEDs and endocarditis, 11.5% were managed with TLE. The proportion undergoing TLE increased significantly from 2016 to 2019 (7.6% vs 14.9%; P trend < 0.001). Procedural complications were identified in 2.7%. Index mortality was significantly lower among patients managed with TLE (6.0% vs 9.5%; P < 0.001). Presence of Staphylococcus aureus infection, implantable cardioverter-defibrillator, and large hospital size were independently associated with TLE management. TLE management was less likely with older age, female sex, dementia, and kidney disease. After adjustment for comorbidities, TLE was independently associated with significantly lower odds of mortality (adjusted OR: 0.47; 95% CI: 0.37-0.60 by multivariable logistic regression, and adjusted OR: 0.51; 95% CI: 0.40-0.66 by propensity score matching).
Conclusions: Utilization of lead extraction among patients with CIEDs and endocarditis is low, even in the presence of low rates of procedural complications. Lead extraction management is associated with significantly lower mortality, and its use has trended upward between 2016 and 2019. Barriers to TLE for patients with CIEDs and endocarditis require investigation.
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http://dx.doi.org/10.1016/j.jacc.2023.02.042 | DOI Listing |
J Pharm Pract
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Emergency Medicine, Department of Pharmacy, Long Island Jewish Valley Stream, Valley Stream, NY, USA.
Ceftriaxone is a third-generation cephalosporin commonly used for treating bacteremia caused by gram-positive organisms such as and gram-negative organisms such as Enterobacterales. The typical doses for treating bacteremia are either 1 gram or 2 grams daily. Despite its widespread use, there are limited data on the optimal treatment dose for bacteremia.
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Department of Pediatric Rheumatology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Universitat de Barcelona, 08950 Barcelona, Spain.
To investigate the prevalence and clinical spectrum of atypical or non-classical complications in adult-onset Still's disease (AOSD) beyond macrophage activation syndrome (MAS) and to identify factors linked to their occurrence. Multicenter cross-sectional study of AODS cases included in the Spanish registry on Still's disease. This study included 107 patients (67% women), of whom 64 (59.
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Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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.
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January 2025
Consultant in Special Care Dentistry, Guy´s and St Thomas´ NHS Foundation Trust, London, UK.
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Service de cardiologie, Centre Hospitalier Universitaire de Tivoli, 34, Avenue Max Buset, 7100 La Louvière, Belgique.
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