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Cardiac surgery in patients with cardiac implantable electronic devices and risk of device infections: a nationwide nested case-control study
Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review
DOI
- https://doi.org/10.1007/s10840-022-01236-7
Forlagets udgivne version
- Maria Hee Jung Park Frausing
- Jens Cosedis Nielsen
- Jens Brock Johansen, Syddansk Universitet, Dansk Pacemaker og ICD Register ,
- Ole Dan Jørgensen, Syddansk Universitet, Dansk Pacemaker og ICD Register ,
- Thomas Olsen, Syddansk Universitet ,
- Jens Kristensen ,
- Christian Gerdes ,
- Mads Brix Kronborg
PURPOSE: Cardiac surgery in patients with cardiac implantable electronic devices (CIEDs) has been associated with a higher risk of infective endocarditis, but how it influences risk of CIED-specific infections is not known. Our aim was to examine risk of systemic CIED infections after cardiac surgery in patients with CIEDs.
METHODS: Based on data obtained from Danish administrative registries and the Danish Pacemaker and ICD Register, we conducted a case-control study nested within a nationwide cohort of patients who underwent a de novo CIED implantation in Denmark between 1998 and 2017. We defined cases as incident systemic CIED infections resulting in device system extraction. Controls were sampled 1:100 on time, age, sex and device type using risk set sampling. Exposure was defined as coronary artery bypass graft, or cardiac heart valve replacement or repair surgery.
RESULTS: From a study cohort comprising 67,621 patients, we identified 170 cases and 16,788 controls. In the minimally adjusted model, the incidence rate ratio (IRR) for systemic CIED infection was 6.4 (95% confidence interval (CI) 3.8-10.7) with cardiac surgery, and after additional confounder adjustment, 5.4 (95% CI 3.2-9.2). IRRs were higher with restriction to heart valve replacement surgery (adjusted IRR 7.5, 95% CI 4.0-16.6), and when limiting our exposure time window to one year (adjusted IRR 10.1, 95% CI 4.5-22.3).
CONCLUSION: Cardiac surgery in patients with de novo CIEDs was associated with a high risk of systemic CIED infections. Highest risk was observed after heart valve replacement surgery and within the first year of surgery.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Interventional Cardiac Electrophysiology |
| Vol/bind | 66 |
| Nummer | 4 |
| Sider (fra-til) | 897-904 |
| Antal sider | 8 |
| ISSN | 1383-875X |
| DOI | |
| Status | Udgivet - jun. 2023 |
Bibliografisk note
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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