Project Details


Infective endocarditis is an uncommon but serious disease, with a
high morbidity and mortality. Because of its seriousness, and
because of the high prevalence of some of its presumed risk
factors, e.g., mitral valve prolapse and dental procedures,
considerable effort and resources are expended on antibiotic
prophylaxis intended to prevent its occurrence. In order to determine the validity of the assumptions about risk
factors which underly the recommendations for these
interventions, a case-control study is planned in the Delaware
Valley. 300 hospitalized incident cases of endocarditis will be
identified and matched by age and sex to a community control
group. This comparison will be used to investigate host risk
factors for endocarditis, especially mitral value prolapse. Then,
for those cases with one of the more common cardiac lesions as
host risk factors, a second control subject will be selected,
matched for age, sex, and that particular cardiac lesion. This
second comparison is expected to involve 150 of the cases and 150
new controls. This comparison will be used to determine whether
certain antecedent procedures which might increase the risk of
bacteremia, especially dental procedures, are in fact risk factors
for developing endocarditis. All subjects will undergo a
structured interview to obtain information on both host factors
and procedures which could represent risk factors for
endocarditis, and their medical and dental records will be
reviewed for additional information and for validation of the
interview data. Univariate analyses, including calculation of odds ratios and
confidence intervals, will be followed by stratification and
multiple logistic regression, enabling us to evaluate the relative
importance of each variable as a risk factor. With this approach,
we should be able to shed additional light on risk factors for this
important and relatively unstudied disease. The current list of
indications for antibiotic prophylaxis can then be refined,
eliminating indications that are not true risk factors and adding
others that are. Resources now being spent on prophylaxis can
then be better focused.
Effective start/end date9/1/878/31/91


  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health


  • Medicine(all)

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