JAMA study: Cardiac implants worsen endocarditis risk

Cardiac implants carry a high risk of an infection known as infective endocarditis, and contracting it is often lethal for patients, according to a new study from Duke University and colleagues in Australia, Germany, Spain, Italy, France, Ireland and elsewhere.

The study, published in the Journal of the American Medical Association (JAMA), indicts permanent pacemakers, implantable cardioverter defibrillators and other cardiac implants. (We're curious how Medtronic ($MDT), Boston Scientific ($BSX), St. Jude Medical ($STJ), and all of the other companies that make cardiac implants will respond to their conclusions.)

According to the findings as detailed in MedPage Today, nearly 15% of cardiac implant patients with infective endocarditis died before leaving the hospital. Another 23.2% died in 12 months. But the study authors also noted that taking out the device when initially in the hospital helped reduce the risk of dying in that first crucial year. The Mayo Clinic describes endocarditis as a bacterial infection that attaches to damaged areas of the heart that can destroy the organ or valves connecting to it. Patients with a damaged or artificial heart valve are at particular risk for the infection, the hospital notes (and now so are other cardiac implant patients, apparently.) Antibiotics can help in some cases; surgery, too, when it gets really bad.

The international research team came to its conclusions by evaluating data from the International Collaboration on Endocarditis-Prospective Cohort study, a 28-country endeavor conducted from June 2000 to August 2006 at 61 different centers. Of the 2,760 adults who took part of the study, 6.4% had an implanted cardiac device. Nearly 86% had pacemakers, while under 12% of the implant patients had an ICD. (The rest, about 2.3% can be classified as "other.")

As MedPage Today notes, American Heart Association recommendations support removing a device and leads for patients with related infection that has affected the device's viability.

- here's the JAMA study abstract
- read MedPage Today's take
- check out Cardiovascular Business' story