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Upadacitinib may be a suitable treatment for patients with active psoriatic arthritis (PsA) who have insufficient response to non-biologic disease-modifying anti-rheumatic drugs (non-bDMARDs), according to results of the phase III SELECT-PsA-1* trial presented at EULAR 2020.

Infective endocarditis after TAVR tied to mortality, stroke risks

24 Jun 2020

Infective endocarditis after transcatheter aortic valve replacement (TAVR) is commonly caused by Enterococcus species and usually occurs during the early period, reveals a study. It is also associated with significant risks of mortality and stroke.

A total of 7,203 patients underwent TAVR at 15 hospitals in Switzerland during the observational period. Of these, 149 patients had endocarditis during follow-up of 14,832 patient-years. Peri-procedural endocarditis after TAVR had the highest incidence at 2.59 events per 100 person-years, followed by delayed-early and late endocarditis with 0.71 and 0.40 events per 100 person-years, respectively.

The most frequently isolated microorganism among patients with early endocarditis was Enterococcus species (30.1 percent). Among those with peri-procedural endocarditis, 47.9 percent had a pathogen that was not susceptible to the peri-procedural antibiotic prophylaxis.

The following factors correlated independently with endocarditis: younger age (subhazard ratio [SHR], 0.969, 95 percent confidence interval [CI], 0.944–0.994), male sex (SHR, 1.989, 95 percent CI, 1.403–2.818), lack of predilatation (SHR, 1.485, 95 percent CI, 1.065–2.069), and treatment in a catheterization laboratory as opposed to hybrid operating room (SHR, 1.648, 95 percent CI, 1.187–2.287).

Of note, the risks of mortality (HR, 6.55, 95 percent CI, 4.44–9.67) and stroke (HR, 4.03, 95 percent CI, 1.54–10.52) were increased in patients with endocarditis, according to the results of a case-control matched analysis.

This study included consecutive patients from the SwissTAVI Registry between February 2011 and July 2018. Infective endocarditis was classified into early (peri-procedural [<100 days] and delayed-early [100 days to 1 year]) and late (>1 year) endocarditis. The authors assessed clinical events according to the Valve Academic Research Consortium-2 endpoint definitions.

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Most Read Articles
5 days ago
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
Jairia Dela Cruz, 5 days ago
Following vegan and vegetarian diets, which offer plenty of what is good for health, has been reported to have a downside: an increased risk of depression and anxiety, especially for younger adults.
Pearl Toh, 29 Jun 2020
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
Roshini Claire Anthony, 3 days ago

Upadacitinib may be a suitable treatment for patients with active psoriatic arthritis (PsA) who have insufficient response to non-biologic disease-modifying anti-rheumatic drugs (non-bDMARDs), according to results of the phase III SELECT-PsA-1* trial presented at EULAR 2020.