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Article ; Online: Factors associated with severe sepsis or septic shock in complicated pyelonephritis.

Ruiz-Mesa, Juan D / Marquez-Gomez, Ignacio / Sena, Gabriel / Buonaiuto, Veronica A / Mora-Ordoñez, Juan / Salido, Manuel / Plata Ciézar, Antonio / Valiente-De Santis, Lucía / Mediavilla, Concepción / Colmenero, Juan D

Medicine

2017 Volume 96, Issue 43, Page(s) e8371

Abstract: Severe sepsis or septic shock are the main factors influencing the prognosis of acute pyelonephritis (APN). Our aim was to analyze factors associated with the development of severe sepsis or septic shock in a large sample of patients with acute ... ...

Abstract	Severe sepsis or septic shock are the main factors influencing the prognosis of acute pyelonephritis (APN). Our aim was to analyze factors associated with the development of severe sepsis or septic shock in a large sample of patients with acute complicated pyelonephritis (ACPN).This prospective observational study comprised 1507 consecutive patients aged 14 years or older who were admitted to a tertiary care hospital because of ACPN between 1997 and 2015. Covariates associated in univariate analysis with severe sepsis or septic shock were then analyzed by multivariate logistic regression.Of the 1507 patients, 423 (28.1%) fulfilled the criteria for severe sepsis or septic shock at the time of admission. Crude and attributable mortality at 30 days were 17.7% and 11.7% in patients with severe sepsis or septic shock versus 1.7% and 0.6% in patients without severe sepsis or septic shock, P < .0001 and P < .0005, respectively. An age > 65 years, urinary instrumentation in the previous 2 weeks, the lack of mictional syndrome or costovertebral tenderness, an ectasia ≥ grade II, and bacteremia were independent risk factors associated with severe sepsis or septic shock.The prevalence of severe sepsis and septic shock in patients with ACPN is high. Some factors associated with severe sepsis are easy to identify in any emergency department. The information provided here could be useful when deciding which patients should be admitted to receive immediate treatment.
MeSH term(s)	Acute Disease ; Aged ; Female ; Hospitalization ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Prospective Studies ; Pyelonephritis/microbiology ; Pyelonephritis/mortality ; Risk Factors ; Sepsis/microbiology ; Sepsis/mortality ; Shock, Septic/microbiology ; Shock, Septic/mortality
Language	English
Publishing date	2017-12-19
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000008371
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Article ; Online: Establishing the diagnosis of tuberculous vertebral osteomyelitis.

Colmenero, Juan D / Ruiz-Mesa, Juan D / Sanjuan-Jimenez, Rocío / Sobrino, Beatriz / Morata, Pilar

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2012 Volume 22 Suppl 4, Page(s) 579–586

Abstract: Purpose: The aim of this article has been to analyze the clinical and radiological data suggesting tuberculous vertebral osteomielitis (TVO), and then discuss the steps to be followed to achieve an aetiological diagnosis.: Methods: A thorough ... ...

Abstract	Purpose: The aim of this article has been to analyze the clinical and radiological data suggesting tuberculous vertebral osteomielitis (TVO), and then discuss the steps to be followed to achieve an aetiological diagnosis. Methods: A thorough literature search was carried out to identify the best clinical and microbiological evidence for a fast and efficient diagnosis of TVO. Results: The clinical and radiological diagnosis of spinal tuberculosis suffers from serious limitations, with a high percentage of cases requiring vertebral biopsy to reach a definitive diagnosis. The increasing incidence of multidrug-resistant tuberculosis has highlighted the insufficiency of the histopathological diagnosis and the need for microbiological diagnosis. Unfortunately, the maximum sensitivity of spinal tuberculosis cultures is 80 %, and traditional methods require 6 to 8 weeks for the isolation, identification and sensitivity study. New culture media and identification methods have improved sensitivity and reduced the time required for the identification. Molecular methods have now been integrated into a single test, with identification of the mycobacterium responsible and its sensitivity to rifampicin. Additionally, multiplex-PCR tests have been developed that allow a rapid differential diagnosis between granulomatous spondylodiscitis. Conclusions: All patients with subacute inflammatory back or neck pain showing suggestive radiological findings should be studied to rule out TVO. If there is no clear evidence of tuberculosis from another location or indication for surgery, a percutaneous vertebral biopsy should be performed. When TVO is suspected, all spinal or paravertebral tissue samples should be sent simultaneously to pathology and microbiology laboratories for appropriate processing.
MeSH term(s)	Humans ; Osteomyelitis/diagnosis ; Osteomyelitis/microbiology ; Tuberculosis, Spinal/diagnosis
Language	English
Publishing date	2012-05-11
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-012-2348-2
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Article: Physical Activity in Work and Leisure Time during Pregnancy, and Its Influence on Maternal Health and Perinatal Outcomes.

González-Cazorla, Ernesto / Brenes-Romero, Ana Pilar / Sánchez-Gómez, María José / Estévez-Ruiz, Elena / Díaz-Enjuto, Antonio / Cantón-Cisneros, Ana / Lubián-López, Daniel / Mozas-Moreno, Juan / González-Mesa, Ernesto S

Journal of clinical medicine

2024 Volume 13, Issue 3

Abstract: Background: Physical inactivity during pregnancy has been shown to be linked to an increased risk of complications. However, during pregnancy, doubts arise about what type, intensity and frequency of physical activity are most recommended.: Objective!# ...

Abstract	Background: Physical inactivity during pregnancy has been shown to be linked to an increased risk of complications. However, during pregnancy, doubts arise about what type, intensity and frequency of physical activity are most recommended. Objective: Our main objective was to know the level of physical activity (PA) and sedentary lifestyle in a representative sample of pregnant women in Málaga, one of the most populated cities in Spain. Also, we aimed to find out the effects of PA on obstetric and perinatal outcomes and on the mental health of pregnant women, differentiated according to PA intensity and domain. Methods: Five hundred and forty full-term pregnant women who had their obstetric checks in the maternity ward of the Regional University Hospital of Málaga were recruited through consecutive sampling. Participants answered a questionnaire that included the WHO Global Physical Activity Questionnaire (GPAQ), the Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder Scale (GAD-7) and some other sociodemographic and health-related questions. Subsequently, information about perinatal outcomes was obtained after birth. Results: Only 50.8% of women followed the WHO recommendations on activity. We found a high proportion of obese pregnant women and a direct effect of a sedentary lifestyle on the rate of cesarean sections and vulvovaginal tears in spontaneous births, as well as on the mental health of future mothers. Women's age, the number of children, BMI at the beginning of pregnancy and leisure time physical activity (LTPA) explained anxiety scores, and age, LTPA, BMI at the end of pregnancy and intense work-related physical activity (WTPA) predicted depression scores. Conclusions: LTPA improves obstetric outcomes, helping to reduce the rate of cesarean sections and vulvovaginal tears, as well as reducing prenatal anxiety and depression.
Language	English
Publishing date	2024-01-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13030723
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Article ; Online: Clinical and epidemiological features and prognosis of complicated pyelonephritis: a prospective observational single hospital-based study.

Buonaiuto, Veronica A / Marquez, Ignacio / De Toro, Inmaculada / Joya, Carolina / Ruiz-Mesa, Juan D / Seara, Raimundo / Plata, Antonio / Sobrino, Beatriz / Palop, Begoña / Colmenero, Juan D

BMC infectious diseases

2014 Volume 14, Page(s) 639

Abstract: Background: Complicated pyelonephritis (cPN), a common cause of hospital admission, is still a poorly-understood entity given the difficulty involved in its correct definition. The aim of this study was to analyze the main epidemiological, clinical, and ...

Abstract	Background: Complicated pyelonephritis (cPN), a common cause of hospital admission, is still a poorly-understood entity given the difficulty involved in its correct definition. The aim of this study was to analyze the main epidemiological, clinical, and microbiological characteristics of cPN and its prognosis in a large cohort of patients with cPN. Methods: We conducted a prospective, observational study including 1325 consecutive patients older than 14 years diagnosed with cPN and admitted to a tertiary university hospital between 1997-2013. After analyzing the main demographic, clinical and microbiological data, covariates found to be associated with attributable mortality in univariate analysis were included in a multivariate logistic regression model. Results: Of the 1325 patients, 689 (52%) were men and 636 (48%) women; median age 63 years, interquartile range [IQR] (46.5-73). Nine hundred and forty patients (70.9%) had functional or structural abnormalities in the urinary tract, 215 (16.2%) were immunocompromised, 152 (11.5%) had undergone a previous urinary tract instrumentation, and 196 (14.8%) had a long-term bladder catheter, nephrostomy tube or ureteral catheter. Urine culture was positive in 813 (67.7%) of the 1251 patients in whom it was done, and in the 1032 patients who had a blood culture, 366 (34%) had bacteraemia. Escherichia coli was the causative agent in 615 episodes (67%), Klebsiella spp in 73 (7.9%) and Proteus ssp in 61 (6.6%). Fourteen point one percent of GNB isolates were ESBL producers. In total, 343 patients (25.9%) developed severe sepsis and 165 (12.5%) septic shock. Crude mortality was 6.5% and attributable mortality was 4.1%. Multivariate analysis showed that an age >75 years (OR 2.77; 95% CI, 1.35-5.68), immunosuppression (OR 3.14; 95% CI, 1.47-6.70), and septic shock (OR 58.49; 95% CI, 26.6-128.5) were independently associated with attributable mortality. Conclusions: cPN generates a high morbidity and mortality and likely a great consumption of healthcare resources. This study highlights the factors directly associated with mortality, though further studies are needed in the near future aimed at identifying subgroups of low-risk patients susceptible to outpatient management.
MeSH term(s)	Adolescent ; Adult ; Aged ; Bacteremia/complications ; Bacteremia/microbiology ; Cohort Studies ; Escherichia coli/isolation & purification ; Female ; Hospitalization/statistics & numerical data ; Hospitals, University ; Humans ; Klebsiella/isolation & purification ; Logistic Models ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Pyelonephritis/complications ; Pyelonephritis/epidemiology ; Pyelonephritis/microbiology ; Pyelonephritis/mortality ; Risk Factors ; Spain/epidemiology ; Young Adult
Language	English
Publishing date	2014-12-10
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-014-0639-4
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Article: Automated Global Longitudinal Strain Assessment in Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia.

Gonzalez-Manzanares, Rafael / Castillo, Juan C / Molina, Jose R / Ruiz-Ortiz, Martin / Mesa, Dolores / Ojeda, Soledad / Anguita, Manuel / Pan, Manuel

Cancers

2022 Volume 14, Issue 6

Abstract: There is limited evidence that supports the use of the global longitudinal strain (GLS) in long-term cardiac monitoring of childhood acute lymphoblastic leukemia survivors (CLSs). Our aim was to assess the utility of automated GLS to detect left ... ...

Abstract	There is limited evidence that supports the use of the global longitudinal strain (GLS) in long-term cardiac monitoring of childhood acute lymphoblastic leukemia survivors (CLSs). Our aim was to assess the utility of automated GLS to detect left ventricular systolic dysfunction (LVSD) in long-term CLSs. Asymptomatic and subclinical LVSD were defined as LVEF < 50% and GLS < 18.5%, respectively. Echocardiographic measurements and biomarkers were compared with a control group. Inverse probability weighting was used to reduce confounding. Regression models were used to identify factors associated with LVEF and GLS in the survivors. Ninety survivors with a median follow-up of 18 (11−26) years were included. The prevalence of LVSD was higher using GLS than with LVEF (26.6% vs. 12.2%). The measurements were both reduced as compared with the controls (p < 0.001). There were no differences in diastolic parameters and NT-ProBNP. Survivors were more likely to have Hs-cTnI levels above the detection limit (40% vs. 17.2%, p = 0.006). The dose of anthracycline was associated with LVEF but not with GLS in the survivors. Biomarkers were not associated with GLS or LVEF. In conclusion, LVSD detection using automated GLS was higher than with LVEF in long-term CLSs. Its incorporation into clinical routine practice may improve the surveillance of these patients.
Language	English
Publishing date	2022-03-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14061513
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Article ; Online: Multiplex real-time polymerase chain reaction: a practical approach for rapid diagnosis of tuberculous and brucellar vertebral osteomyelitis.

Colmenero, Juan D / Morata, Pilar / Ruiz-Mesa, Juan D / Bautista, Dolores / Bermúdez, Pilar / Bravo, María José / Queipo-Ortuño, María Isabel

Spine

2010 Volume 35, Issue 24, Page(s) E1392–6

Abstract: Study design: Case-control study for assessing a diagnostic test.: Objective: The aim of this study was to analyze the diagnostic yield of a multiplex real-time polymerase chain reaction (PCR) assay in the differential diagnosis of tuberculous ... ...

Abstract	Study design: Case-control study for assessing a diagnostic test. Objective: The aim of this study was to analyze the diagnostic yield of a multiplex real-time polymerase chain reaction (PCR) assay in the differential diagnosis of tuberculous vertebral osteomyelitis (TVO) and brucellar vertebral osteomyelitis (BVO). Summary of background data: Vertebral osteomyelitis (VO) is one of commonest osteoarticular complications of tuberculosis and brucellosis. However, the very similar clinical, radiologic, and histologic characteristics of these entities mean that diagnosis requires etiological confirmation, but conventional microbiologic methods have important limitations. Methods: Fifteen vertebral samples from patients with TVO or BVO and 9 from pyogenic and nontuberculous mycobacteria VO were studied by multiplex PCR and conventional microbiologic techniques. To identify Brucella DNA, we used a fragment of 207 bp from the conserved region of the gene coding for an immunogenic membrane protein of 31 kDa of B. abortus (BCSP31) and for Mycobacterium tuberculosis complex, a fragment of 164 bp from the intergenic region SenX3-RegX3. Results: The histopathologic findings were inconclusive in 4 of 14 cases (28.6%) with TVO or BVO and cultures were positive in 11 of 15 cases (73.3%). Multiplex PCR correctly identified 14 of the 15 samples from patients with TVO and BVO and was negative in all the control samples. Thus, the overall sensitivity and specificity of the multiplex PCR were 93.3% and 90%, respectively, with an accuracy of 92% (95% CI, 81.4%-100%). Conclusion: These results suggest that multiplex real-time PCR is far more sensitive than conventional cultures, and this, together with its speed, makes this technique a very practical approach for the differential diagnosis between TVO and BVO.
MeSH term(s)	Adult ; Aged ; Biopsy ; Brucella/genetics ; Brucella/isolation & purification ; Brucellosis/diagnosis ; Brucellosis/microbiology ; Brucellosis/pathology ; Case-Control Studies ; DNA, Bacterial/isolation & purification ; Diagnosis, Differential ; Female ; Humans ; Lumbar Vertebrae/microbiology ; Lumbar Vertebrae/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mycobacterium tuberculosis/genetics ; Mycobacterium tuberculosis/isolation & purification ; Osteomyelitis/diagnosis ; Osteomyelitis/microbiology ; Osteomyelitis/pathology ; Polymerase Chain Reaction ; Predictive Value of Tests ; Sacrum/microbiology ; Sacrum/pathology ; Sensitivity and Specificity ; Spain ; Spinal Diseases/diagnosis ; Spinal Diseases/microbiology ; Spinal Diseases/pathology ; Thoracic Vertebrae/microbiology ; Thoracic Vertebrae/pathology ; Time Factors ; Tuberculosis, Spinal/diagnosis ; Tuberculosis, Spinal/microbiology ; Tuberculosis, Spinal/pathology ; Young Adult
Chemical Substances	DNA, Bacterial
Language	English
Publishing date	2010-11-15
Publishing country	United States
Document type	Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0b013e3181e8eeaf
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Article ; Online: Improvement of left ventricular ejection fraction in patients with heart failure with reduced ejection fraction: Predictors and clinical impact.

Perea-Armijo, Jorge / López-Aguilera, José / Sánchez-Prats, Rocío / Castillo-Domínguez, Juan Carlos / González-Manzanares, Rafael / Ruiz-Ortiz, Martín / Mesa-Rubio, Dolores / Anguita-Sánchez, Manuel

Medicina clinica

2023 Volume 161, Issue 1, Page(s) 1–10

Abstract: Background: A percentage of patients with heart failure with reduced ejection fraction (HFrEF) improve left ventricular ejection fraction (LVEF) in the evolution. This entity, defined for the first time in an international consensus as heart failure ... ...

Abstract	Background: A percentage of patients with heart failure with reduced ejection fraction (HFrEF) improve left ventricular ejection fraction (LVEF) in the evolution. This entity, defined for the first time in an international consensus as heart failure with improved ejection fraction (HFimpEF), could have a different clinical profile and prognosis than HFrEF. Our main aim was to analyze the differential clinical profile between the two entities, as well as the mid-term prognosis. Material-methods: Prospective study of a cohort of patients with HFrEF who had echocardiographic data at baseline and follow-up. A comparative analysis of patients who improved LVEF with those who did not was made. Clinical, echocardiographic and therapeutic variables were analyzed, and the mid-term impact in terms of mortality and hospital readmissions for HF was assessed. Results: Ninety patients were analyzed. Mean age was 66.5(10.4) years, with a male predominance (72.2%). Forty five patients (50%) improved LVEF (Group-1,HFimpEF) and forty five patients (50%) sustained reduced LVEF (Group-2,HFsrEF). The mean time to LVEF improvement in Group-1 was 12.6(5.7) months. Group-1 had a more favorable clinical profile: lower prevalence of cardiovascular risk factors, higher prevalence of de novo HF (75.6% vs. 42.2%; p<0.05), lower prevalence of ischemic etiology (22.2% vs. 42.2%; p<0.05), with less basal dilatation of the left ventricle. At the end of follow-up (mean 19(1) months) Group-1 had a lower hospital readmission rate (3.1% vs. 26.7%; p<0.01), as well as lower mortality (0% vs. 24.4%; p<0.01). Conclusion: Patients with HFimpEF seem to have a better mid-term prognosis in terms of reduced mortality and hospital admissions. This improvement could be conditioned by the clinical profile of patients HFimpEF.
MeSH term(s)	Humans ; Male ; Aged ; Female ; Stroke Volume ; Ventricular Function, Left ; Heart Failure ; Prospective Studies ; Prognosis
Language	Spanish
Publishing date	2023-04-03
Publishing country	Spain
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2023.02.009
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Article ; Online: Clinical findings, therapeutic approach, and outcome of brucellar vertebral osteomyelitis.

Colmenero, Juan D / Ruiz-Mesa, Juan D / Plata, Antonio / Bermúdez, Pilar / Martín-Rico, Patricia / Queipo-Ortuño, María I / Reguera, José M

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2008 Volume 46, Issue 3, Page(s) 426–433

Abstract: Background: Osteoarticular complications are the most common focal complications of brucellosis. Although vertebral osteomyelitis is the most frequent location in adults >30 years of age, little information is available about this serious complication ... ...

Abstract	Background: Osteoarticular complications are the most common focal complications of brucellosis. Although vertebral osteomyelitis is the most frequent location in adults >30 years of age, little information is available about this serious complication of brucellosis, and great confusion surrounds its prognosis and the most appropriate treatment. Methods: We undertook a descriptive, retrospective, observational study of 96 patients who received a diagnosis of brucella vertebral osteomyelitis from September 1982 through December 2005 at a tertiary care hospital. All of the patients were treated for 3 months, after which they were followed up monthly for the first 3 months and then at 2-month intervals for the subsequent 6 months. Results: The incidence of vertebral osteomyelitis was 10.4%. The mean diagnostic delay was 12.7 weeks. Inflammatory spinal pain (occurring in 94.8% of patients) and fever (91.7%) were the most relevant clinical characteristics. Eight patients (8.3%) had motor weakness or paralysis. Paravertebral masses, epidural masses, and psoas abscesses were detected in 45.8%, 27.1%, and 10.4% of patients, respectively. Sixty-three patients (65.6%) received medication only, and 33 (34.4%) required surgical therapy in addition to medication. Twenty percent of patients experienced therapeutic failure. Attributable mortality was 2.1%, and severe functional sequelae were apparent in 6.2% of the patients. No significant differences were seen between patients who were treated with doxycycline-streptomycin and those treated with doxycycline-rifampicin. Conclusions: Vertebral osteomyelitis is a serious complication of brucellosis. It generates a high rate of therapeutic failure and functional sequelae. In the absence of more-powerful controlled studies, the duration of treatment of brucellar vertebral osteomyelitis should be 3 months.
MeSH term(s)	Brucella/isolation & purification ; Brucellosis/microbiology ; Brucellosis/pathology ; Brucellosis/therapy ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis/microbiology ; Osteomyelitis/pathology ; Osteomyelitis/therapy ; Retrospective Studies ; Spinal Diseases/microbiology ; Spinal Diseases/therapy ; Spine/microbiology ; Spine/pathology
Language	English
Publishing date	2008-02-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1086/525266
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Article: The Worsening of Heart Failure with Reduced Ejection Fraction: The Impact of the Number of Hospital Admissions in a Cohort of Patients.

Perea-Armijo, Jorge / López-Aguilera, José / González-Manzanares, Rafael / Pericet-Rodriguez, Cristina / Castillo-Domínguez, Juan Carlos / Heredia-Campos, Gloria / Roldán-Guerra, Álvaro / Urbano-Sánchez, Cristina / Barreiro-Mesa, Lucas / Aguayo-Caño, Nerea / Delgado-Ortega, Mónica / Crespín-Crespín, Manuel / Ruiz-Ortiz, Martín / Mesa-Rubio, Dolores / Osorio, Manuel Pan-Álvarez / Anguita-Sánchez, Manuel

Journal of clinical medicine

2023 Volume 12, Issue 18

Abstract: Background: Worsening heart failure (WFH) includes heart failure (HF) hospitalisation, representing a strong predictor of mortality in patients with heart failure with reduced ejection fraction (HFrEF). However, there is little evidence analysing the ... ...

Abstract	Background: Worsening heart failure (WFH) includes heart failure (HF) hospitalisation, representing a strong predictor of mortality in patients with heart failure with reduced ejection fraction (HFrEF). However, there is little evidence analysing the impact of the number of previous HF admissions. Our main objective was to analyse the clinical profile according to the number of previous admissions for HF and its prognostic impact in the medium and long term. Methods: A retrospective study of a cohort of patients with HFrEF, classified according to previous admissions: cohort-1 (0-1 previous admission) and cohort-2 (≥2 previous admissions). Clinical, echocardiographic and therapeutic variables were analysed, and the medium- and long-term impacts in terms of hospital readmissions and cardiovascular mortality were assessed. A total of 406 patients were analysed. Results: The mean age was 67.3 ± 12.6 years, with male predominance (73.9%). Some 88.9% (361 patients) were included in cohort-1, and 45 patients (11.1%) were included in cohort-2. Cohort-2 had a higher proportion of atrial fibrillation (49.9% vs. 73.3%; Conclusions: Patients with HFrEF and ≥2 previous admissions for HF have a higher proportion of comorbidities. These patients are associated with worse reverse remodelling and worse medium- and long-term prognoses from the early stages, wherein early identification is essential for close follow-up and optimal intensive treatment.
Language	English
Publishing date	2023-09-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12186082
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Article ; Online: Risk scores for predicting incident heart failure admission in patients with chronic coronary syndromes: Validation in a prospective, monocentric, long-term, cohort study.

López-Baizán, Josué / Ruiz Ortiz, Martín / Delgado Ortega, Mónica / Rodríguez Almodóvar, Ana / Esteban Martínez, Fátima / Sánchez Fernández, Carlos / Sánchez Fernández, José Javier / Mateos de la Haba, Leticia / Barreiro Mesa, Lucas / Ogayar Luque, Cristina / Romo Peñas, Elías / López-Aguilera, José / Carrasco Ávalos, Francisco / Castillo Domínguez, Juan Carlos / Anguita Sánchez, Manuel / Pan, Manuel / Mesa Rubio, Dolores

European journal of clinical investigation

2023 Volume 53, Issue 5, Page(s) e13941

Abstract: Background: Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this endpoint, but none of them has been externally validated.: Objectives: Our ... ...

Abstract	Background: Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this endpoint, but none of them has been externally validated. Objectives: Our aim was to develop point scores for predicting incident HF admission with data from previous studies, to perform an external validation in an independent prospective cohort and to compare their discriminative ability for this event. Methods: Independent predictive variables of HF admission in CCS patients without baseline HF were selected from four previous prospective studies (CARE, PEACE, CORONOR and CLARIFY), generating scores based on the relative magnitude of the coefficients of Cox of each variable. Finally, the scores were validated and compared in a monocentric prospective cohort. Results: The validation cohort included 1212 patients followed for up to 17 years, with 171 patients suffering at least one HF admission in the follow-up. Discriminative ability for predicting HF admission was statistically significant for all, and paired comparisons among them were all nonsignificant except for CORONOR score was superior to CLARIFY score (C-statistic 0.73, 95%CI 0.69-0.76 vs. 0.69, 95% CI 0.65-0.73; p = 0.03). Conclusion: All tested scores showed significant discriminative ability for predicting incident HF admission in this independent validation study. Their discriminative ability was similar, with significant differences only between the two scores with higher and lower performance.
MeSH term(s)	Humans ; Prospective Studies ; Cohort Studies ; Syndrome ; Risk Factors ; Heart Failure/epidemiology ; Prognosis ; Risk Assessment
Language	English
Publishing date	2023-01-05
Publishing country	England
Document type	Journal Article
ZDB-ID	186196-7
ISSN	1365-2362 ; 0014-2972 ; 0960-135X
ISSN (online)	1365-2362
ISSN	0014-2972 ; 0960-135X
DOI	10.1111/eci.13941
Database	MEDical Literature Analysis and Retrieval System OnLINE

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