Аңдатпа
Abstract Background Infective endocarditis (IE) remains a life-threatening disease associated with high morbidity and mortality. Contemporary data describing the clinical profile, complications, and outcomes of IE in Central Asia, including Kazakhstan, are scarce. Aim To evaluate the clinical characteristics, heart failure (HF) burden, and in-hospital outcomes of patients with IE in a real-world cohort from Kazakhstan. Methods This retrospective observational study included 59 consecutive patients diagnosed with IE according to the 2023 ESC criteria. Patients were admitted to three tertiary hospitals in Aktobe between January 2022 and December 2025 (Figure 1). Clinical data were collected by review of in-hospital medical records. Demographic characteristics, clinical presentation, standard laboratory parameters, instrumental investigations, and in-hospital outcomes were analysed. Patients were stratified according to the presence of HF. Statistical analysis was performed using SPSS (v.25) and STATISTICA (v.10) software with descriptive statistical methods. Results The mean age was 49 ± 14.8 years; 16.7% (n=10) were aged ≥65 years, and 66.6% (n=40) were male. Median symptom duration prior to diagnosis was 28 (12–49) days, and the median Charlson index was 5 (3–7). Left-sided IE was identified in 56.7% (n=34), most frequently involving the mitral valve (44.1%, n=26). Prosthetic valve IE accounted for 23.3% (n=14), predominantly affecting biological prostheses; cardiac device-related IE was rare (1.7%, n=1). Anemia was present in 81.0% (n=47), leukocytosis in 39.7% (n=23), and thrombocytopenia in 37.9% (n=22). Elevated C-reactive protein was observed in 61.0% (n=36). Median NT-proBNP levels were significantly higher in patients with HF compared with those without HF 1465.5 (841.5;6559.8) vs 291 (72.2;591.0) pg/mL, p<0.001). Clinical characteristics and in-hospital outcomes of patients with infective endocarditis according to HF status are summarised in Table 1. HF was the most frequent complication, occurring in 58.3% (n=35), followed by embolic events (16.7%, n=10) and acute kidney injury (15.3%, n=9). Overall in-hospital mortality was 25% (n=15) and occurred exclusively in patients with HF (42.9% vs 0%, p<0.001). Conclusion Infective endocarditis predominantly affected middle-aged patients with native valve involvement. Heart failure was the most frequent complication and the main contributor to in-hospital mortality. Higher NT-proBNP levels were associated with the presence of heart failure, reflecting haemodynamic deterioration in infective endocarditis.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.