Current profile of infective endocarditis in Japan.

Background of IE Patients Mean and median age of the patients in CADRE-IE was 59.5 and 61 years, respectively, and more than 200 were aged between 61 and 80 years. The age distribution were almost similar among this and 3 other large-scale studies (Table), indicating that IE mostly occurs in the older population. The mean age in the NIS data from the USA rose from 58.6 to 60.8 years between 1998 and 2009, and the incidence of IE in all age groups older than 50 years increased while that in younger populations was stable.4 These trends may be related to the increasing elderly population in industrialized countries, which is most remarkable in Japan. The increased number of patients receiving prosthetic valves might be associated with higher espite advances in diagnosis and treatment, the high mortality of infective endocarditis (IE) has not changed in almost 25 years.1 To improve the treatment strategy for IE, it is essential to realize the current status of the disease. In this issue of the Journal, Nakatani et al report the current status of IE in Japan, based on a nation-wide survey, the Cardiac Disease REgistration – Infective Endocarditis (CADRE-IE).2 Their report should be used as a basis for evidence-based treatment in this country. To accentuate the clinical profile of IE in Japan, this editorial compares their results with the recent, large-scale reports from Western countries: a population-based survey from France (the Association pour l’Etude et la Prévention de l’Endocardite Infectieuse study, AEPEI) Study,3 a nation-wide inpatient database (Nationwide Inpatient Sample, NIS) from the United States,4 and an international prospective cohort study from 25 countries in north and south America and Europe (the International CollaboraD