Characteristics of Infective Endocarditis in France in 1991. A 1-year Survey

Objective: To update data on incidence and characteristics of infective endocarditis in France.

Background: Numerous studies have shown that the incidence and course of infective endocarditis remain stable in spite of advances in treatment and of prophylactic recommendations.

Methods: A survey of all consecutive cases of infective endocarditis was conducted over 12 months in all the institutions of three French regions.

Results: Data were collected from 415 cases of definite (32%), probable (53%), and possible (15%) infective endocarditis. The adjusted annual incidence was 24.3 cases per million inhabitants. Thirty-four percent of the patients had no previously known heart disease, 33% had native valve disease, 22% had a prosthetic valve, and 11% had miscellaneous underlying conditions. Infective endocarditis was located solely on the mitral valve in 39%, solely on the aortic valve in 36%, and on the tricuspid valve in 6%. Echocardiography showed a vegetation on the mitral valve in 39%, on the aortic valve in 29%, and on the tricuspid valve in 8%. The causal microorganism was identified in 92%; it was a Streptococcus in 58%, and a Staphylococcus in 23%. Twenty patients were intravenous drug users, and 45 had had a medical or a surgical procedure, which might be associated with the occurrence of infective endocarditis. During the first 2 months after admission, 24% of the patients underwent surgery, and 17% of all patients died.

Conclusions: Despite medical and surgical advances, infective endocarditis remains frequent and severe in France.