Infective endocarditis in patients with diabetes

Abstract

Diabetes mellitus (DM) is an adverse premorbid background for the development, course and outcome of infective endocarditis (IE), and therefore the combination of these diseases requires study. Objective: to study the clinical features and outcomes of infective endocarditis in patients with diabetes mellitus. Material and methods A retrospective (from 2001 to 2007) and a prospective (from 2008 to 2018) analysis of 347 patients with specifi c IE, 243 men and 104 women, aged from 17 to 83 (median age 44.8; 34–54). Results. 22 patients with IE, were diagnosed with diabetes, that is, the incidence of this pathology was 6.3%. Type 1 diabetes was observed in 7 (2% of the total number of patients and 32% among patients with a combination of IE and diabetes). Type 2 diabetes was diagnosed in 15 patients (4.3% and 68%, respectively). In subgroups of patients with IE and diabetes and without it, statistically signifi cant diff erences in age (p < 0.05), Charlson comorbidity index (p < 0.001), incidence of neurological complications ((p < 0.05), hospital mortality (p < 0.05) were noted, while patients with IE on the background of type 1 diabetes, had a more severe course of the disease. According to key characteristics of the pathological process in IE, localization, severity of systemic infl ammation, clinical and biochemical parameters, no signifi cant diff erences in the studied groups were found. Findings. The obtained results confi rm the literature data on fundamentally identical regularities of the course of IE in patients with and without diabetes. At the same time, the development of IE on the background of diabetes is a prognostically unfavorable combination of comorbid conditions, which requires special attention of physicians to such a contingent of patients, interaction of specialists for their successful management.