Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study

Gilbert Habib*, Paola Anna Erba, Bernard Iung, Erwan Donal, Bernard Cosyns, Cecile Laroche, Bogdan A. Popescu, Bernard Prendergast, Pilar Tornos, Anita Sadeghpour, Leopold Oliver, Jolanta-Justina Vaskelyte, Rouguiatou Sow, Olivier Axler, Aldo P. Maggioni, Patrizio Lancellotti, Granada, M. Mahia, S. Ressi, F. NacinovichA. Iribarren, P. Fernandez Oses, G. Avegliano, E. Filipini, R. Obregon, M. Bangher, J. Dho, L. Cartasegna, M. L. Plastino, Novas, C. Shigel, G. Reyes, M. Schneider, M. Ahmed, M. Ali, G. Landry, C. Wild, C. Papadopoulos, H. J. Crijns, S. C. Bekkers, E. C. Cheriex, M. Gilbers, B. L. Kietselaer, C. Knackstedt, R. Lorusso, S. Schalla, S. A. Streukens, E. van Dongen, B. Ahmed, A. Ahmed, EURO-ENDO Investigators

*Corresponding author for this work

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Aims The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE).

Methods and results Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). F-18-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated.

Conclusion Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.

Original languageEnglish
Pages (from-to)3222-3232B
Number of pages13
JournalEuropean Heart Journal
Issue number39
Publication statusPublished - 14 Oct 2019


  • Infective endocarditis
  • Registry
  • Valve disease


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