Eisen, Damon P., Corey, G. Ralph, McBryde, Emma S., Fowler, Vance G., Miro, Jose M., Cabell, Chris H., Street, Alan C., Paiva, Marcelo Goulart, Ionac, Adina, Tan, Ru-San, Tribouilloy, Christophe, Pachirat, Orathai, Jones, Sandra Braun, Chipigina, Natalia, Naber, Christoph, Pan, Angelo, Ravasio, Veronica, Gattringer, Rainer, Chu, Vivian H., and Bayer, Arnold S. (2009) Reduced valve replacement surgery and complication rate in Staphylococcus aureus endocarditis patients receiving acetyl-salicylic acid. Journal of Infection, 58 (5). pp. 332-338.

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Abstract

Objectives: To assess the influence of acetyl-salicylic acid (ASA) on clinical outcomes in Staphylococcus aureus infective endocarditis (SA-IE).

Methods: The International Collaboration on Endocarditis e Prospective Cohort Study database was used in this observational study. Multivariable analysis of the SA-IE cohort compared outcomes in patients with and without ASA use, adjusting for other predictive variables, including: age, diabetes, hemodialysis, cancer, pacemaker, intracardiac defibrillator and methicillin resistance.

Results: Data were analysed from 670 patients, 132 of whom were taking ASA at the time of SAIE diagnosis. On multivariable analysis, ASA usage was associated with a significantly decreased overall rate of acute valve replacement surgery (OR 0.58 [95% CI 0.35e0.97]; p < 0.04), particularly where valvular regurgitation, congestive heart failure or periannular abscess was the indication for such surgery (OR 0.46 [0.25e0.86]; p < 0.02). There was no reduction in the overall rates of clinically apparent embolism with prior ASA usage, and no increase in hemorrhagic strokes in ASA-treated patients.

Conclusions: In this multinational prospective observational cohort, recent ASA usage was associated with a reduced occurrence of acute valve replacement surgery in SA-IE patients. Future investigations should focus on ASA's prophylactic and therapeutic use in high-risk and newly diagnosed patients with SA bacteremia and SA-IE, respectively.

Item ID:	39774
Item Type:	Article (Research - C1)
ISSN:	1532-2742
Keywords:	Staphylococcus aureus; endocarditis; acetyl-salicylic acid; surgery
Funders:	Spanish Network for Research in Infectious Diseases (REIPI), National Institutes of Health (NIH), American Heart Association (AHA)
Projects and Grants:	REIPI RD06/0008, NIH 2RO1 AI039108-1, AHA 067502
Date Deposited:	02 Sep 2015 03:28
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 40% 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 40% 16 STUDIES IN HUMAN SOCIETY > 1605 Policy and Administration > 160508 Health Policy @ 20%
SEO Codes:	92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 60% 92 HEALTH > 9203 Indigenous Health > 920309 Pacific Peoples Health - Health System Performance (incl. Effectiveness of Interventions) @ 20% 92 HEALTH > 9202 Health and Support Services > 920207 Health Policy Evaluation @ 20%
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