Male Diabetics with infective endocarditis have lower in-hospital mortality compared to females

A recent study found that Type 2 diabetic male patients had a higher incidence of infective endocarditis and lower rates of in-hospital mortality than women. The study was published in the journal Cardiovascular Diabetology.  

Infective endocarditis is an infection with increased incidence in comorbid conditions like diabetes. Type 2 diabetics are at an increased risk of infection and show worse outcomes. But literature shows that the incidence and outcomes differ by sex. Hence researchers from Spain conducted a study to assess the sex differences in incidence, clinical characteristics, use of therapeutic procedures, and in-hospital outcomes in patients with infective endocarditis (IE) according to T2DM status from 2016 to 2020. 

A retrospective cohort study was done using data from the Spanish National Hospital Discharge Database. The incidence of hospitalizations for IE in men and women aged ≥ 40 years with and without T2DM was estimated. Propensity score matching (PSM) and multivariable logistic regression were used to compare subgroups according to sex and the presence of T2DM.

Results

• IE was found in 9,958 patients and T2DM was diagnosed in 2,668.
• The incidence of IE increased significantly from 15.29 cases per 100,000 persons with T2DM in 2016 to 17.69 in 2020 (p < 0.001).
• The increase was significant only among men with T2DM from 19.47 cases per 100,000 in 2016 to 22.84 in 2020.
• The age-adjusted incidence of IE was significantly higher in people with T2DM (both sexes) than in those without T2DM.
• The incidence of IE was higher in men with T2DM than with T2DM.
• After PSM, in-hospital mortality (IHM) was higher among T2DM women than matched T2DM men. 
• The presence of T2DM was not associated with IHM in men or women. 

Thus, though T2DM was associated with an increased incidence of hospitalization for IE it was not associated with in-hospital mortality in IE in men or women. But T2 diabetics who had IE showed higher incidence and lower rates of in-hospital mortality in men. 

Lopez-de-Andres, A., Jimenez-Garcia, R., Hernández-Barrera, V. et al. Sex-related disparities in the incidence and outcomes of infective endocarditis according to type 2 diabetes mellitus status in Spain, 2016–2020. Cardiovasc Diabetol 21, 198 (2022). https://doi.org/10.1186/s12933-022-01633-2