40 Two studies reported an increasing trend in IE incidence across the study period; however, there was no significant difference in this trend following guideline updates. 39 , 40 One study found a significant decline in IE incidence across the study period with no significant difference following guideline updates. 38 A summary of IE incidence and the impact of IE guideline updates is presented in Table 5 .
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Epidemiology of infective endocarditis before <i>versus</i> after change of international guidelines: a systematic review.
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