Atrial septal defect patients have an elevated risk for infective endocarditis

Figures & data

Table 1. Descriptive characteristics and comorbidities during the follow-up.

	ASD	ASD endocarditis	Control	Control endocarditis	p-value	p-value
	n = 8298	n = 24	n = 39 227	n = 10	Endocarditis	overall
Sex female	5001 (60.3%)	8 (33.3%)	23 450 (59.8%)	2 (20.0%)	.68	.003
Age at the SOF	7.95 (0.50;27.8)	43.20 (30.60;51.00)	15.6 (1.57;31.1)	37.2 (20.5;56.2)	.34	<.001
Age, endocarditis dg	NA	47.8 (19.0)	NA	49.8 (27.6)	.84	NA
Valvular disease	654 (7.9%)	12 (50.0%)	708 (1.8%)	5 (50.0%)	1.0	<.001
Stroke	1028 (12.4%)	5 (20.8%)	2040 (5.2%)	0 (0.00%)	NA	NA
Myocardial infarction	390 (4.7%)	4 (16.7%)	1407 (3.6%)	2 (20.0%)	1.0	<.001
Congestive HF	1090 (13.1%)	10 (41.7%)	1803 (4.6%)	4 (40.0%)	1.0	<.001
Atrial fibrillation	1661 (20.0%)	8 (33.3%)	2390 (6.1%)	2 (20.0%)	.68	<.001

Age endocarditis dg refers to the age at the time of the endocarditis diagnosis. Values are presented as median (interquartile range) or n (percentage). The first p-value compares ASD endocarditis and control endocarditis groups. The second p-value compares all four groups. Kruskal–Wallis test was used to compare medians and fisher’s exact test was used to compare categorical variables. ASD: atrial septal defect; HF: heart failure; SOF: Start of the follow-up.

Figure 1. Age distribution of infective endocarditis patients.

Figure 2. Cumulative incidence of endocarditis, follow-up starts from the study periods first hospital contact. p-value is calculated using the log-rank method.

Table 2. Endocarditis in Patients with ASD and controls.

	ASD	Control
	n = 8322	n = 39,237
Endocarditis (n)	24	10
FU years	215,019	870,683
Event rate per 1000 PY	0.11	0.011
Crude risk ratio (95% CI)	9.72 (4.65–20.32)	Reference
Adjusted risk ratio	13.51 (6.20–29.46)	Reference

ASD: atrial septal defect; CI: confidence interval; FU: follow-up; PY: person-years.

Figure 3. Kaplan–Meier curve of long-term survival compared to individualized controls. Follow-up starts from the time of endocarditis diagnosis. p-value is calculated using the log-rank method.

Data availability statement

The data supporting our findings are available from Statistics Finland and the FHDR. Still, restrictions apply to data availability, which was used under license for the current research and is not publicly available. Data are, however, available from the authors upon reasonable request and with permission from Statistics Finland and the FHDR.