Early Surgery No Help In Valve Infection
Patients with prosthetic valve endocarditis (PVE) continue to have a high mortality risk that early surgical intervention does not reduce, results of a large multinational trial showed.
An unadjusted analysis controlling only for treatment selection suggested a large benefit from early surgery. A fully adjusted analysis, however, showed no benefit of surgery versus medical therapy for in-hospital (HR 0.90) or 1-year mortality (HR 1.04), according to Tahaniyat Lalani, MD, of Naval Medical Center Portsmouth in Virginia, and co-authors.
A propensity analysis that examined the probability of surgery showed that patients in the top surgical quintile had significantly lower in-hospital and 1-year mortality, and patients in the fourth surgical quintile had lower 1-year mortality as compared with similar patients treated medically, they reported online in JAMA Internal Medicine.