Abstract 14774: Differences in the In-Patient Mortality in Marantic Endocarditis Per Etiology: Systematic Review of Case Reports

Abstract

Introduction: Non-bacterial thrombotic endocarditis (NBTE; also known as marantic endocarditis) is a unique entity characterized by sterile fibrin deposits on valves caused by hypercoagulability and endocardial injury. Literature is limited regarding the distinction between its causes based on in-hospital mortality. Hypothesis: Would a significant difference in in-patient mortality be present in NBTE admissions depending on etiology? Methods: A review of the literature using the PubMed, Embase, Cochrane, and Web of Science databases was conducted to obtain case reports and series reporting NBTE from inception to September 2022. Crude and univariate analyses were performed. Results: 396 case reports and 20 case series were identified, of which 450 patients were extracted. Females represented 64% of our sample (median age: 46, interquartile range [IQR]: 32 - 60) while 36% were males (median age: 50, IQR: 36 - 64). Overall all-cause in-hospital mortality was 36%. NBTE was associated with cancer in 202 (47%), autoimmune disease in 191 (45%), and other causes in 34 (8%) cases. Older population and cancer etiology were associated with higher mortality (OR: 1.77, CI 95%: 1.19 - 2.62 & OR: 8.29, CI 95%: 4.97 - 13.83, respectively). A significant decrease in mortality is noted in the more recent years compared to the 20 th century (OR: 0.10, 95% CI: 0.06 - 0.18). Conclusions: Although an improvement in all-cause in-hospital mortality for admission related to NBTE has been noticed in recent years, cancer as an etiology and old age are two risk factors associated with higher mortality.