{"paper_id":"15b92005-e2ec-4141-96bf-9cac376a2ae0","body_text":"Infective endocarditis due to beta-haemolytic streptococci | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Infective endocarditis due to beta-haemolytic streptococci Gabriela Dornikova, David Mannion, Aoife Page, Emer Lee, Margaret M Hannan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7621588/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Beta-haemolytic streptococci (BHS) produce number of toxins that play crucial roles in colonization, pathogenesis and dissemination. Infections caused by BHS include, but are not limited to pharyngitis, skin and soft tissue infections, pneumonia, infective endocarditis (IE), puerperal infection, and meningitis. The aim of the current study was to analyse cases of IE due to BHS at Mater Misericordiae University Hospital, Dublin in 14-year period. Clinical features and outcome was compared to the cases caused by viridans group streptococci (VGS). IE was diagnosed according to the 2000 and 2023 Criteria for infective endocarditis. 16 cases of IE due to BHS and 66 cases due to VGS were identified. BHS were represented by group B streptococci in 8 cases (50.0%), and by group C/G in 8 cases (50.0%). All isolates were sensitive to penicillin and vancomycin, 25.0% were resistant to macrolides. Demographic data showed, that patients with IE due to BHS were older (55.8 versus 49.3 years), and male/female ratio was lower (1.7 versus 2.0) in comparison with the cases due to VGS. Cases of IE due to BHS yielded higher rate of valve abscesses (18.7% versus 12.1%), valve perforation (12.5% versus 10.6%), as well as higher rate of embolic events (37.5% versus 33.3%) in comparison with VGS cases. In conclusion, IE due to BHS was infrequent in our hospital setting in studied period 2010–2023. However, clinical presentation was severe, and all-cause mortality at 6 months was 31.2% in BHS group, significantly higher than 6.1% in VGS group. Hospital Medicine Cardiac & Cardiovascular Systems Infective endocarditis due to beta-haemolytic streptococci infective endocarditis due to viridans group streptococci clinical presentation all-cause mortality in infective endocarditis Introduction Beta-haemolytic streptococci (BHS) produce number of toxins (haemolysins, proteases, superantigens, and miscellaneous toxins), that play crucial roles in colonization, pathogenesis and dissemination [ 1 ]. Infections caused by BHS include, but are not limited to pharyngitis, skin and soft tissue infections, pneumonia, infective endocarditis (IE), puerperal infection, and meningitis [ 2 ]. IE caused by BHS is infrequently seen [ 3 ]. The aim of the current study was to analyse cases of IE due to BHS at Mater Misericordiae University Hospital, Dublin in 14-year period. Clinical features and outcome was compared to the cases caused by viridans group streptococci (VGS). Materials and methods IE was diagnosed according to the 2000 and 2023 Criteria for infective endocarditis [ 4 , 5 ]. We conducted a retrospective study of all cases of IE of BHS and VGS origin, admitted to the MMUH, in 14-year period, from1st January 2010 throughout to 31st December 2023. MMUH is a level 4 teaching hospital and a tertiary referral centre for cardiothoracic surgery, the national centre for heart and lung transplant, as well as the national centre for numerous diseases and procedures in cardiology, spinal surgery, haematology, oncology, and genetics Results 16 cases of IE due to BHS and 66 cases due to VGS were identified. BHS were represented by group B streptococci in 8 cases (50.0%), and by group C/G in 8 cases (50.0%). All isolates were sensitive to penicillin and vancomycin, 25.0% were resistant to macrolides. Demographic data showed, that patients with IE due to BHS were older (55.8 versus 49.3 years), and male/female ratio was lower (1.7 versus 2.0) in comparison with the cases due to VGS. Cases of IE due to BHS yielded higher rate of valve abscesses (18.7% versus 12.1%), valve perforation (12.5% versus 10.6%), as well as higher rate of embolic events (37.5% versus 33.3%) in comparison with VGS cases. Clinical presentation was more severe in BHS group. Surgery was performed in 18.7% of BHS cases, which was significantly less than 59.1% of VGS cases. All-cause mortality at 6 months was 31.2% in BHS group, significantly higher than 6.1% in VGS group. The most frequent comorbidities in BHS group were chronic heart failure (43.7%), and chronic liver disease (25.0%), that correlated with relatively high proportion of IVDU (25.0%). In VGS group the most frequent comorbidity was congenital heart disease (57.6%), followed by chronic heart failure (36.4%), diabetes mellitus (10.6%), and chronic renal disease (10.6%). Further analysis of congenital heart disease showed only one case (6.2%) in BHS group (bicuspid aortic valve, and coarctation of aorta), and 38 cases (57.6%) in VGS group, of which bicuspid aortic valve was the most prevalent (n = 15; 22.7%), followed by ventricular septal defect (n = 7; 10.6%), and aortic valve stenosis (n = 5; 7.6%). Clinical presentation was more severe in BHS group. 43.7% cases presented with sepsis, among them, 1 case with meningitis, whereas in VGS group only 1.5% cases were septic. Surgery was performed in 18.7% of BHS cases, which was significantly less than 59.1% of VGS cases. Demographic and clinical data is illustrated in Table 1 . Table 1. Comparison of demographic and clinical data of cases of IE due to BHS and VGS in period 2010 – 2023 Organism BHS VGS Number of patients n=16 n=66 Mean age, in years 55.8 49.3 Male/Female ratio 10/6 = 1.7 44/22 = 2.0 Comorbidities: Congenital heart disease 1 ( 6.2% ) 38 ( 57.6% ) Diabetes mellitus 0 ( 0.0% ) 7 ( 10.6% ) Chronic pulmonary disease 3 ( 18.7% ) 3 ( 4.5% ) Malignancy 2 ( 12.5% ) 1 ( 1.5% ) Chronic renal disease 2 ( 12.5% ) 7 ( 10.6% ) Chronic liver disease 4 ( 25.0% ) 6 ( 9.1% ) Chronic heart failure 7 ( 43.7% ) 24 ( 36.4% ) Rheumatoid heart disease 1 ( 6.2% ) 3 ( 4.5% ) Autoimmune disease 1 ( 6.2% ) 5 ( 7.6% ) IVDU 4 ( 25.0% ) 5 ( 7.6% ) Pregnancy 0 ( 0.0% ) 1 ( 1.5% ) Liver/renal transplant 0 ( 0.0% ) 2 ( 3.0% ) Vegetation detected on: Aortic valve 6 ( 37.5% ) 34 ( 51.5% ) Mitral valve 7 ( 43.7% ) 28 ( 42.4% ) Tricuspid valve 1 ( 6.2% ) 5 ( 7.6% ) Pulmonic valve 0 ( 0.0% ) 2 ( 3.0% ) CIED 0 ( 0.0% ) 3 ( 4.5% ) Native valve IE 12 (75.0% 58 ( 87.9 ) Prosthetic valve IE 4 (25.0%) 13 ( 19.7% ) Valve abscess present 3 ( 18.7% ) 8 ( 12.1% ) Valve perforated 2 ( 12.5% ) 7 ( 10.6% ) Embolic event: 6 (37.5%) 22 ( 33.3% ) Embolic event to brain 4 ( 25.0% ) 10 ( 15.1% ) Embolic event to lung 1 ( 6.2% ) 9 ( 13.6% ) Embolic event other 1 ( 6.2% ) 3 ( 4.5% ) Clinical presentation: Sepsis 7 (1-meningitis) ( 43.7% ) 1 ( 1.5% ) Systemic infection 8 ( 50.0% ) 62 ( 93.9% ) Symptoms of embolic event 1 ( 6.2% ) 3 ( 4.5% ) Surgery performed 3 ( 18.7% ) 39 ( 59.1% ) Clinical outcome: All-cause mortality at 6 months 5 ( 31.2% ) 4 ( 6.1% ) Conclusions IE due to BHS was infrequent in our hospital setting in studied period 2010–2023. However, clinical presentation was severe, with 43.7% cases presenting with sepsis, and one case with meningitis. Patients in BHS group yielded higher rate of valve abscesses (18.7% versus 12.1%), valve perforation (12.5% versus 10.6%), as well as higher rate of embolic events (37.5% versus 33.3%) in comparison with VGS cases. All-cause mortality at 6 months was 31.2% in BHS group, significantly higher than 6.1% in VGS group. Declarations A statement on participant consent: The participants consented to participate on the study. The need for consent was waived by the approving ethics committee at MMUH. Conflicts of interest: The authors report there are no competing interests to declare. MMUH Ethics Committee approval number: 1/378/2344 TMR. Funding: No funding was granted to this study. Data availability: Data is available upon reasonable request to corresponding author. References Barnett TC, Cole JN, Rivera-Hernandez T, Henningham A, Paton JC, Nizet V et al (2015) Streptococcal toxins: role in pathogenesis and disease. Cell Microbiol: 03 Oct. https://doi.org/10.1111/cmi.12531 Babiker A, Kadri SS (2022) ICU Management of Invasive β-Hemolytic Streptococcal Infections. Infect Dis Clin North Am. ; 36(4): 861–887. 10.1016/j.idc.2022.07.007 . PMID: 36328640 Baddour LM (1998) Infective endocarditis caused by beta-hemolytic streptococci. The Infectious Diseases Society of America's Emerging Infections Network. Clin Infect Dis. ; 26(1):66–71. 10.1086/516266 . PMID: 9455511 Delgado V, Marsan NA, De Waha S, Bonaros N, Brida M, Burri H et al (October 2023) 2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM), European Heart Journal, 44, Issue 39. 14:3948–4042. https://doi.org/10.1093/eurheartj/ehad193 Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T et al (2000) Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 30:633–638 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-7621588\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Short Report\",\"associatedPublications\":[],\"authors\":[{\"id\":515395388,\"identity\":\"8958785b-419f-4ef1-9e86-7c1d7425ee78\",\"order_by\":0,\"name\":\"Gabriela Dornikova\",\"email\":\"data:image/png;base64,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\",\"orcid\":\"https://orcid.org/0009-0008-6134-0830\",\"institution\":\"Mater Misericordiae University Hospital, Dublin\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Gabriela\",\"middleName\":\"\",\"lastName\":\"Dornikova\",\"suffix\":\"\"},{\"id\":515395389,\"identity\":\"8a9c5329-2c75-4068-b8bd-d15d4b2db5d1\",\"order_by\":1,\"name\":\"David Mannion\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Mater Misericordiae University Hospital, Dublin\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"David\",\"middleName\":\"\",\"lastName\":\"Mannion\",\"suffix\":\"\"},{\"id\":515395390,\"identity\":\"0ff4fd6a-c9fb-4a1a-8789-6e7540e5b077\",\"order_by\":2,\"name\":\"Aoife Page\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Mater Misericordiae University Hospital, Dublin\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Aoife\",\"middleName\":\"\",\"lastName\":\"Page\",\"suffix\":\"\"},{\"id\":515395391,\"identity\":\"3a3f6e4c-e920-4d11-93dd-7f83421854a5\",\"order_by\":3,\"name\":\"Emer Lee\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Mater Misericordiae University Hospital, Dublin\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Emer\",\"middleName\":\"\",\"lastName\":\"Lee\",\"suffix\":\"\"},{\"id\":515395392,\"identity\":\"97cb7e71-225d-4970-810a-b9d664c7d478\",\"order_by\":4,\"name\":\"Margaret M Hannan\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Mater Misericordiae University Hospital, Dublin\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Margaret\",\"middleName\":\"M\",\"lastName\":\"Hannan\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2025-09-15 14:20:02\",\"currentVersionCode\":1,\"declarations\":{\"humanSubjects\":true,\"vertebrateSubjects\":false,\"conflictsOfInterestStatement\":false,\"humanSubjectEthicalGuidelines\":true,\"humanSubjectConsent\":true,\"humanSubjectClinicalTrial\":false,\"humanSubjectCaseReport\":false,\"vertebrateSubjectEthicalGuidelines\":false},\"doi\":\"10.21203/rs.3.rs-7621588/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-7621588/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":91606446,\"identity\":\"e08f02d3-c234-4129-8ece-d4663c32a6a0\",\"added_by\":\"auto\",\"created_at\":\"2025-09-18 09:23:52\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":557054,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-7621588/v1/7981220c-7609-477b-80bf-e8412db724f5.pdf\"}],\"financialInterests\":\"The authors declare no competing interests.\",\"formattedTitle\":\"\\u003cp\\u003e\\u003cstrong\\u003eInfective endocarditis due to beta-haemolytic streptococci\\u003c/strong\\u003e\\u003c/p\\u003e\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eBeta-haemolytic streptococci (BHS) produce number of toxins (haemolysins, proteases, superantigens, and miscellaneous toxins), that play crucial roles in colonization, pathogenesis and dissemination [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. Infections caused by BHS include, but are not limited to pharyngitis, skin and soft tissue infections, pneumonia, infective endocarditis (IE), puerperal infection, and meningitis [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e]. IE caused by BHS is infrequently seen [\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. The aim of the current study was to analyse cases of IE due to BHS at Mater Misericordiae University Hospital, Dublin in 14-year period. Clinical features and outcome was compared to the cases caused by viridans group streptococci (VGS).\\u003c/p\\u003e\"},{\"header\":\"Materials and methods\",\"content\":\"\\u003cp\\u003eIE was diagnosed according to the 2000 and 2023 Criteria for infective endocarditis [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. We conducted a retrospective study of all cases of IE of BHS and VGS origin, admitted to the MMUH, in 14-year period, from1st January 2010 throughout to 31st December 2023.\\u003c/p\\u003e\\u003cp\\u003eMMUH is a level 4 teaching hospital and a tertiary referral centre for cardiothoracic surgery, the national centre for heart and lung transplant, as well as the national centre for numerous diseases and procedures in cardiology, spinal surgery, haematology, oncology, and genetics\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003e16 cases of IE due to BHS and 66 cases due to VGS were identified. BHS were represented by group B streptococci in 8 cases (50.0%), and by group C/G in 8 cases (50.0%). All isolates were sensitive to penicillin and vancomycin, 25.0% were resistant to macrolides.\\u003c/p\\u003e\\n\\u003cp\\u003eDemographic data showed, that patients with IE due to BHS were older (55.8 versus 49.3 years), and male/female ratio was lower (1.7 versus 2.0) in comparison with the cases due to VGS.\\u003c/p\\u003e\\n\\u003cp\\u003eCases of IE due to BHS yielded higher rate of valve abscesses (18.7% versus 12.1%), valve perforation (12.5% versus 10.6%), as well as higher rate of embolic events (37.5% versus 33.3%) in comparison with VGS cases.\\u003c/p\\u003e\\n\\u003cp\\u003eClinical presentation was more severe in BHS group. Surgery was performed in 18.7% of BHS cases, which was significantly less than 59.1% of VGS cases. All-cause mortality at 6 months was 31.2% in BHS group, significantly higher than 6.1% in VGS group.\\u003c/p\\u003e\\n\\u003cp\\u003eThe most frequent comorbidities in BHS group were chronic heart failure (43.7%), and chronic liver disease (25.0%), that correlated with relatively high proportion of IVDU (25.0%). In VGS group the most frequent comorbidity was congenital heart disease (57.6%), followed by chronic heart failure (36.4%), diabetes mellitus (10.6%), and chronic renal disease (10.6%).\\u003c/p\\u003e\\n\\u003cp\\u003eFurther analysis of congenital heart disease showed only one case (6.2%) in BHS group (bicuspid aortic valve, and coarctation of aorta), and 38 cases (57.6%) in VGS group, of which bicuspid aortic valve was the most prevalent (n\\u0026thinsp;=\\u0026thinsp;15; 22.7%), followed by ventricular septal defect (n\\u0026thinsp;=\\u0026thinsp;7; 10.6%), and aortic valve stenosis (n\\u0026thinsp;=\\u0026thinsp;5; 7.6%).\\u003c/p\\u003e\\n\\u003cp\\u003eClinical presentation was more severe in BHS group. 43.7% cases presented with sepsis, among them, 1 case with meningitis, whereas in VGS group only 1.5% cases were septic.\\u003c/p\\u003e\\n\\u003cp\\u003eSurgery was performed in 18.7% of BHS cases, which was significantly less than 59.1% of VGS cases.\\u003c/p\\u003e\\n\\u003cp\\u003eDemographic and clinical data is illustrated in Table \\u003cspan class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 1. Comparison of demographic and clinical data of cases of IE due to BHS and VGS in period 2010 \\u0026ndash; 2023\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"border-collapse: collapse;border: none;width: 1026px;\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border: 1pt solid windowtext;background: rgb(118, 113, 113);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:white;\\\"\\u003eOrganism\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;background: rgb(118, 113, 113);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:white;\\\"\\u003eBHS\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;background: rgb(118, 113, 113);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:white;\\\"\\u003eVGS\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eNumber of patients\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003en=16\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003en=66\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eMean age, in years\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e55.8\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e49.3\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eMale/Female ratio\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e10/6 = 1.7\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: white;padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e44/22 = 2.0\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eComorbidities:\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eCongenital heart disease\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 6.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e38 ( 57.6% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eDiabetes mellitus\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e0 ( 0.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e7 ( 10.6% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eChronic pulmonary disease\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 18.7% )\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 4.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eMalignancy\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e2 ( 12.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 1.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eChronic renal disease\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e2 ( 12.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e7 ( 10.6% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eChronic liver disease\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e4 ( 25.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e6 ( 9.1% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eChronic heart failure\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e7 ( 43.7% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e24 ( 36.4% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eRheumatoid heart disease\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 6.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 4.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eAutoimmune disease\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 6.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e5 ( 7.6% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eIVDU\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e4 ( 25.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e5 ( 7.6% 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style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e0 ( 0.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 1.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eLiver/renal transplant\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e0 ( 0.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(183, 236, 255);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e2 ( 3.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eVegetation detected on:\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eAortic valve\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e6 ( 37.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e34 ( 51.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eMitral valve\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e7 ( 43.7% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e28 ( 42.4% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eTricuspid valve\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 6.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e5 ( 7.6% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003ePulmonic valve\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e0 ( 0.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e2 ( 3.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eCIED\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e0 ( 0.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 4.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eNative valve IE\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e12 (75.0%\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e58 ( 87.9 )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eProsthetic valve IE\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e4 (25.0%)\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 204, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e13 ( 19.7% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eValve abscess present\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 18.7% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e8 ( 12.1% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eValve perforated\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e2 ( 12.5% )\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e7 ( 10.6% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eEmbolic event:\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e6 (37.5%)\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e22 ( 33.3% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eEmbolic event to brain\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e4 ( 25.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e10 ( 15.1% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eEmbolic event to lung\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 6.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e9 ( 13.6% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eEmbolic event other\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 6.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(255, 255, 153);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 4.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eClinical presentation:\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eSepsis\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e7 (1-meningitis) ( 43.7% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 1.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eSystemic infection\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e8 ( 50.0% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e62 ( 93.9% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eSymptoms of embolic event\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e1 ( 6.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(156, 239, 145);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 4.5% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eSurgery performed\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e3 ( 18.7% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e39 ( 59.1% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eClinical outcome:\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003eAll-cause mortality at 6 months\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.45pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e5 ( 31.2% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 256.5pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;background: rgb(217, 217, 217);padding: 0cm 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0cm;margin-right:0cm;margin-bottom:0cm;margin-left:0cm;font-size:11.0pt;font-family:\\\"Calibri\\\",sans-serif;line-height:normal;'\\u003e\\u003cstrong\\u003e\\u003cspan style=\\\"color:black;\\\"\\u003e4 ( 6.1% )\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eIE due to BHS was infrequent in our hospital setting in studied period 2010\\u0026ndash;2023. However, clinical presentation was severe, with 43.7% cases presenting with sepsis, and one case with meningitis.\\u003c/p\\u003e\\u003cp\\u003ePatients in BHS group yielded higher rate of valve abscesses (18.7% versus 12.1%), valve perforation (12.5% versus 10.6%), as well as higher rate of embolic events (37.5% versus 33.3%) in comparison with VGS cases.\\u003c/p\\u003e\\u003cp\\u003eAll-cause mortality at 6 months was 31.2% in BHS group, significantly higher than 6.1% in VGS group.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003eA statement on participant consent: The participants consented to participate on the study. The need for consent was waived by the approving ethics committee at MMUH.\\u003c/p\\u003e\\u003cp\\u003e\\u003ch2\\u003eConflicts of interest:\\u003c/h2\\u003e\\u003cp\\u003eThe authors report there are no competing interests to declare.\\u003c/p\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003ch2\\u003eMMUH Ethics Committee\\u003c/h2\\u003e\\u003cp\\u003eapproval number: 1/378/2344 TMR.\\u003c/p\\u003e\\u003c/p\\u003e\\u003ch2\\u003eFunding:\\u003c/h2\\u003e\\u003cp\\u003eNo funding was granted to this study.\\u003c/p\\u003e\\u003ch2\\u003eData availability:\\u003c/h2\\u003e\\u003cp\\u003eData is available upon reasonable request to corresponding author.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eBarnett TC, Cole JN, Rivera-Hernandez T, Henningham A, Paton JC, Nizet V et al (2015) Streptococcal toxins: role in pathogenesis and disease. Cell Microbiol: 03 Oct. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1111/cmi.12531\\u003c/span\\u003e\\u003cspan address=\\\"10.1111/cmi.12531\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eBabiker A, Kadri SS (2022) ICU Management of Invasive β-Hemolytic Streptococcal Infections. Infect Dis Clin North Am. ; 36(4): 861\\u0026ndash;887. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.idc.2022.07.007\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.idc.2022.07.007\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. PMID: 36328640\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eBaddour LM (1998) Infective endocarditis caused by beta-hemolytic streptococci. The Infectious Diseases Society of America's Emerging Infections Network. Clin Infect Dis. ; 26(1):66\\u0026ndash;71. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1086/516266\\u003c/span\\u003e\\u003cspan address=\\\"10.1086/516266\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. PMID: 9455511\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eDelgado V, Marsan NA, De Waha S, Bonaros N, Brida M, Burri H et al (October 2023) 2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM), European Heart Journal, 44, Issue 39. 14:3948\\u0026ndash;4042. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1093/eurheartj/ehad193\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/eurheartj/ehad193\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eLi JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T et al (2000) Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 30:633\\u0026ndash;638\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"Mater Misericordiae University Hospital\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Infective endocarditis due to beta-haemolytic streptococci, infective endocarditis due to viridans group streptococci, clinical presentation, all-cause mortality in infective endocarditis\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-7621588/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-7621588/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eBeta-haemolytic streptococci (BHS) produce number of toxins that play crucial roles in colonization, pathogenesis and dissemination. Infections caused by BHS include, but are not limited to pharyngitis, skin and soft tissue infections, pneumonia, infective endocarditis (IE), puerperal infection, and meningitis. The aim of the current study was to analyse cases of IE due to BHS at Mater Misericordiae University Hospital, Dublin in 14-year period. Clinical features and outcome was compared to the cases caused by viridans group streptococci (VGS).\\u003c/p\\u003e\\u003cp\\u003eIE was diagnosed according to the 2000 and 2023 Criteria for infective endocarditis.\\u003c/p\\u003e\\u003cp\\u003e16 cases of IE due to BHS and 66 cases due to VGS were identified. BHS were represented by group B streptococci in 8 cases (50.0%), and by group C/G in 8 cases (50.0%). All isolates were sensitive to penicillin and vancomycin, 25.0% were resistant to macrolides. Demographic data showed, that patients with IE due to BHS were older (55.8 versus 49.3 years), and male/female ratio was lower (1.7 versus 2.0) in comparison with the cases due to VGS.\\u003c/p\\u003e\\u003cp\\u003eCases of IE due to BHS yielded higher rate of valve abscesses (18.7% versus 12.1%), valve perforation (12.5% versus 10.6%), as well as higher rate of embolic events (37.5% versus 33.3%) in comparison with VGS cases.\\u003c/p\\u003e\\u003cp\\u003eIn conclusion, IE due to BHS was infrequent in our hospital setting in studied period 2010\\u0026ndash;2023. However, clinical presentation was severe, and all-cause mortality at 6 months was 31.2% in BHS group, significantly higher than 6.1% in VGS group.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Infective endocarditis due to beta-haemolytic streptococci\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-09-18 09:15:25\",\"doi\":\"10.21203/rs.3.rs-7621588/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"114acca7-cc39-47b8-b333-f49d380752f2\",\"owner\":[],\"postedDate\":\"September 18th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":54750283,\"name\":\"Hospital Medicine\"},{\"id\":54750284,\"name\":\"Cardiac \\u0026 Cardiovascular Systems\"}],\"tags\":[],\"updatedAt\":\"2025-09-18T09:15:25+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-09-18 09:15:25\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-7621588\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-7621588\",\"identity\":\"rs-7621588\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}