@article{10902/32930,
year = {2024},
url = {https://hdl.handle.net/10902/32930},
abstract = {Background: Several aspects of the occurrence and management of mycotic aneurysm (MA) in patients with infective endocarditis (IE) have not been studied. Objectives: To determine the incidence and factors associated with MA presence and rupture and to assess the evolution of those initially unruptured MA. Methods: Prospective multicenter cohort including all patients with definite IE between January 2008 and December 2020. Results: Of 4548 IE cases, 85 (1.9%) developed MA. Forty-six (54.1%) had intracranial MA and 39 (45.9%) extracranial MA. Rupture of MA occurred in 39 patients (45.9%). Patients with ruptured MA had higher 1-year mortality (hazard ratio, 2.33; 95% confidence interval, 1.49-3.67). Of the 55 patients with initially unruptured MA, 9 (16.4%) presented rupture after a median of 3 days (interquartile range, 1-7) after diagnosis, being more frequent in intracranial MA (32% vs 3.3%, P = .004). Of patients with initially unruptured MA, there was a trend toward better outcomes among those who received early specific intervention, including lower follow-up rupture (7.1% vs 25.0%, P = .170), higher rate of aneurysm resolution in control imaging (66.7% vs 31.3%, P = .087), lower MA-related mortality (7.1% vs 16.7%, P = .232), and lower MA-related sequalae (0% vs 27.8%, P = .045). Conclusions: MA occurred in 2% of the patients with IE. Half of the Mas occurred in an intracranial location. Their rupture is frequent and associated with poor prognosis. A significant proportion of initially unruptured aneurysms result from rupture during the first several days, being more common in intracranial aneurysms. Early specific treatment could potentially lead to better outcomes.},
organization = {No funding was received for this article.},
publisher = {Oxford University Press},
publisher = {Open Forum Infectious Diseases, 2024, 11(3), ofae121},
title = {Epidemiology and risk factors of mycotic aneurysm in patients with infective endocarditis and the impact of its rupture in outcomes. Analysis of a national prospective cohort},
author = {Calderón-Parra, Jorge and Domínguez, Fernando and González Rico, Claudia and Arnáiz de las Revillas Almajano, Francisco and Goenaga, Miguel Ángel and Álvarez, I. and Muñoz, Patricia and Alonso, David and Rodríguez-García, Raquel and Miró, José María and Alarcón González, Arístides de and Antorrena, Isabel and Goikoetxea-Agirre, Josune and Moral-Escudero, Encarnación and Ojeda-Burgos, Guillermo and Ramos-Martínez, Antonio},
}