Judith Lopez

Hospital Clínico Universitario de Valladolid

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Irene Crespo

Hospital Universitari de Girona Doctor Josep Trueta

Manuel Méndez

Instituto Cajal

Karla Núñez

University of Saint Francis Xavier

Ana Ortolá

Hospital Clínico Universitario de Valladolid

Teresa Ruiz Gracia

Hospital Clínico San Carlos

Javier Marco

Hospital Clínico San Carlos

Isidre Vilacosta

Hospital Clínico San Carlos

Carmen Olmos

Hospital Clínico San Carlos

Alejandra Durán

Hospital Clínico San Carlos

José Alberto San Román

Hospital Clínico Universitario de Valladolid

Cooperative Institutions

Hospital Clínico San Carlos

Centro de Investigación en Red en Enfermedades Cardiovasculares

Instituto de Investigación Sanitaria del Hospital Clínico San Carlos

Complejo Hospitalario Universitario de Santiago

Madrid Health Service

Universidad Complutense de Madrid

Universidade de Santiago de Compostela

Hospital Universitario de La Princesa

Centro de Investigación Biomédica en Red

Hospital Clínico Universitario de Valladolid

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554 Predictors of inappropriate therapy in patients with implantable cardioverter-defibrillators and chagas' cardiomyopathy

Canadian Journal of Cardiology (2011)

Rita Miranda Francisco Femenía Judith Lopez J. Serra Christopher S. Muratore

Medical Therapy

10.1016/j.cjca.2011.07.458

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[Influence of systemic arterial hypertension on mid-term survival of patients with acute myocardial infarction treated with fibrinolytic agents].

PubMed (1997)

J L Martinez Sande José Ramón González‐Juanatey José María García‐Acuña Antonio Amaro Cendón Felipe Fernández Vázquez

TIMI

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Thrombocytopenia, a new marker of bad prognosis in patients with infective endocarditis

European Heart Journal (2013)

Carlos Ferrera Durán Isidre Vilacosta Carmen Olmos Cristina Fernández Judith Lopez

Aim: Thrombocytopenia in patients with sepsis has been described as a marker of bad prognosis. Our purpose was to analyze if the presence of thrombocytopenia has a prognostic impact in patients with left-sided infective endocarditis (IE). Methods: We analyzed 698 consecutive episodes of IE prospectively recruited in three referral hospitals between 1996 and 2011. They were classified in two groups: Group I (n=213) episodes of IE who had thrombocytopenia in blood analysis at admission; and Group II (n=485) those who did not have it. Thrombocytopenia was defined as a platelet count below 150000/μl. Results: The age and gender distribution were similar in both groups. Regarding to comorbidities, diabetes (25.4% vs. 18.3%, p=0.03), chronic anemia (24.5% vs. 17.6%, p= 0.03) and immunosuppression (11.8% vs. 4.5%, p<0.001) were more frequent in Group I. We found a greater percentage of prosthetic valves in Group II, while patients without any previous cardiopathy were more prevalent in Group I (29.6% vs. 21.6%, p=0.02). S. aureus (28.6% vs. 10.9%, p<0.001) and Gram negative bacilli (8% vs. 3.1%, p=0.004) were more frequently isolated in Group I, were S. viridans (8% vs. 15.1%, p=0.01) and culture negative IE (10.3 vs. 16.3, p=0.04) were more common in Group II. Clinical presentation with neurological (p<0.001), renal (p=0.05), cutaneous (p<0.001) manifestations and septic shock (12.2% vs. 3.5%, p<0.001) at admission were more frequent in Group I. These patients showed also more frequency of hemorrhagic skin lesions (11% vs. 4%, p=0.002), splenomegaly (14.2% vs 7.4%, p=0.005) and coma (5.6% vs. 0.8%, p<0.001). Presence of pseudoaneurysms were more frequently found in Group II (12.2% vs. 18.9%, p=0.03). There were no differences in other echocardiographic findings (valvular insufficiency, presence and size of vegetations). During hospitalization, persistent signs of infection (44.5% vs. 31.8%, p=0.001) and septic shock were more frequent in Group I (27% vs. 13.5%, p<0.001). The need of surgery was similar in both groups (53.5% vs. 56.1%, p=0.535), but much higher mortality was observed in patients with thrombocytopenia (40.4% vs. 25.3%, p<0.001). Conclusions: Thrombocytopenia at admission of patients with IE identifies a highest risk group. Causative microorganisms are more virulent in this group. These patients develop septic shock more frequently and showed higher mortality.

Infective Endocarditis

Immunosuppression

10.1093/eurheartj/eht310.p4773

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Citations (3)

Analysis of hypothyroidism in patients admitted to internal medicine wards in Spain 2005-2012

Endocrine Abstracts (2015)

Rona Penso Alejandra Durán Teresa Ruiz Gracia Irene Crespo Ana Ortolá

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

10.1530/endoabs.37.gp.26.06

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Hyponatremia and mortality in patients hospitalised for heart failure (2005-2011)

Endocrine Abstracts (2015)

Javier Marco Irene Crespo Ana Ortolá Teresa Ruiz Gracia Miguel Paz de

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

10.1530/endoabs.37.ep679

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Impact of frailty on elderly patients with infective endocarditis

European Heart Journal (2021)

Carlos Nicolás Pérez García Carmen Olmos Daniel García‐Arribas Judith Lopez Raquel Ladrón

Abstract Introduction Frailty studies focused on patients with infective endocarditis (IE) are scarce and its potential impact on patient outcomes is not well known. The aim of this study is to describe the clinical profile and prognosis of elderly patients with IE, comparing patients who met the frailty criteria versus those who did not. Methods A total of 121 cases of confirmed IE were consecutively collected in three tertiary hospitals between 2017 and 2019. The patients were classified into two groups: Group I (n=49), patients with IE who met the Frail criteria for frailty, and Group II (n=72), those patients without frailty by this scale. Results The median age of our cohort was 77 years (69–82), and 62.8% were men. Frail patients were older than those in Group II, as shown in Table 1. Regarding comorbidity, chronic anemia (40.8% vs 25%; p<0.060) was more common in Group I, as well as rheumatic manifestations at admission (12.2% vs 1.4%; p=0.014). The most frequently isolated microorganisms were S. aureus (n=25), coagulase negative staphylococci (n=25), viridans group streptococci (n=14), and enterococci (n=14). Enterococci (16.3% vs 8.3%, p=0.177) and non-viridans streptococci (10.2% vs 2.8%); p=0.086) were more frequent in frail patients. Vegetation (79.6% vs 80.6%; p=0.896) and periannular complications (24.5% vs 29.2%; p=0.571) were similar in both groups. No significant differences were found regarding the location of the infection. The incidence of in-hospital complications was similar between both groups. Frail patients underwent surgery less frequently than those in Group II, and had higher predicted mortality on surgical risk scale scores. However, the percentage of patients who met the surgical criteria and were considered inoperable was similar (33.3% vs 26.2%; p=0.415). In-hospital mortality was similar in both groups. When analyzing in-hospital mortality according to the therapeutic strategy in Group I, a mortality of 34.5% was observed in frail patients with conservative medical treatment, compared to 47.1% in those patients who underwent surgery in the same group. One third of our patients received outpatient antibiotic treatment, being significantly more frequent in Group I (39.6% vs 29.0%; p=0.232). Conclusions The elderly patients with IE and frailty criteria were older and more frequently had rheumatic symptoms at admission. Enterococci and non-viridans streptococci were isolated more frequently than in non-frailty patients. Surgery was less performed among frail patients, who had a higher predicted surgical risk. Although complications and in-hospital mortality were similar between both groups, in the group of frail patients, those with conservative management showed lower mortality compared to surgery. Funding Acknowledgement Type of funding sources: None.

Infective Endocarditis

10.1093/eurheartj/ehab724.2830

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Hyperthyroidism in Internal Medicine Services in Spain (2005-2012)

Endocrine Abstracts (2015)

Sandra Wilches Durán Judith Lopez Ana Ortolá Irene Crespo Teresa Ruiz Gracia

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

10.1530/endoabs.37.ep1082

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Buttonholes: Some Differences in Gender-related Front Closures