CLINICAL AND HEALTH-CARE COST CONSEQUENCES OF INFECTIVE ENDOCARDITIS IN MITRAL-VALVE PROLAPSE

Although mitral valve prolapse (MVP) predisposes to infective endocarditis (IE), both the clinical consequences of IE and the increment in health care costs it imposes on patients with MVP remain uncertain. Accordingly, 21 MVP patients with IE and 41 age- and sex-matched control subjects with initially uncomplicated MVP were followed (95% complete) a mean of 8 years. Outcomes included death, complications, health care use and cumulative incremental costs. More MVP patients with IE died (25 vs 5%, p <0.05), underwent valve surgery (40 vs 8%, p <0.01), had heart failure (50 vs 5%, p <0.01) or embolization (53 vs 11%, p <0.01), underwent cardiac catheterization (40 vs 13%), and saw their physicians >2 times per year (88 vs 33%). The cumulative incremental cost of IE (1990 dollars) was $46,132 per cage. Thus, IE in patients with MVP causes considerable cumulative morbidity and incremental health care costs.