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based on the GRACE risk score upon admission&#44; using the cutoff points &#40;low&#44; medium and high risk&#41; pre-established in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;14</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In addition to the risk level&#44; a retrospective analysis was made of different variables available in the registry&#44; such as the baseline clinical&#8211;demographic parameters&#44; patient treatment and evolution&#44; and possible catheterization predictors previously described in the literature&#46; Bleeding risk was quantified by means of an <span class="elsevierStyleItalic">ad hoc</span> index based on the number of independent predictors of major bleeding contemplated by the GRACE&#44;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;16</span></a> categorized as high or low risk according to the presence of some or no risk factor&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">The descriptive analysis comprised the calculation of proportions &#40;in the case of categorical variables&#41; and medians&#44; with the corresponding interquartile range &#40;in the case of continuous variables&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The contrasting of hypotheses referred to proportions was carried out using the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test &#40;or the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test for trends&#41;&#46; In the case of quantitative variables&#44; contrasting was based on the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test &#40;comparisons between 2 groups&#41;&#44; the Kruskal&#8211;Wallis test &#40;3 or more groups&#41; or the Cuzick test &#40;trends in 3 or more groups&#41;&#46; All contrasts were two-sided&#44; with an alpha level of significance of 5&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">With the purpose of identifying independent predictors of early catheterization&#44; the variables found in the univariate analysis to be associated to the adoption of EIS with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;10 were entered in a multiple logistic regression model&#44; adopting a backwards stepwise analytical strategy in which the least significant variable was eliminated in each step&#46; Finally&#44; the association between each of the predictor variables and the implementation of EIS was evaluated by calculating the adjusted odds ratios &#40;ORs&#41; and their corresponding 95&#37; confidence intervals &#40;CI&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">The profile of the patients&#44; stratified according to GRACE risk level&#44; was consistent with that of other registries<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9&#44;11</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The high risk group was characterized by older age&#44; a greater proportion of women&#44; increased comorbidity &#40;diabetes&#44; previous infarction&#44; renal failure&#41;&#44; the existence of heart failure upon admission&#44; a high baseline bleeding risk&#44; and increased mortality&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Regarding the drug treatment administered from symptoms onset and during admission to the ICU &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; the patients at high risk were less often treated with statins and beta-blockers&#44; with no other significant differences among the three risk levels&#46; Likewise&#44; risk level was directly correlated to the use of noninvasive mechanical ventilation&#44; with a negative association to the adoption of EIS&#8212;though the differences failed to reach statistical significance&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The variables associated to the implementation of EIS are summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; Basically&#44; the group of patients with NSTE ACS subjected to early invasive treatment were younger&#44; with a lesser prevalence of diabetes and of heart failure upon admission&#44; a lesser bleeding risk&#44; and were admitted to a hospital with the availability of a hemodynamics laboratory&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The logistic regression analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41; identified the availability of a hemodynamics laboratory&#44; the presence of ST-segment changes&#44; the absence of diabetes&#44; the absence of tachycardia upon admission&#44; and the existence of low bleeding risk as independent predictors of the use of an invasive treatment strategy&#46; Previous coronariography was not independently correlated to the adoption of EIS &#40;adjusted OR 0&#46;77&#44; 95&#37;CI 0&#46;50&#8211;1&#46;21&#41;&#44; and did not act as an effect modifier of the association between the GRACE level and the implementation of EIS &#40;interaction <span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;8425&#41;&#46; On replacing heart rate with the Killip class&#44; the presence of class &#62;1 was found to be significantly associated to a lesser utilization of invasive strategies &#40;OR 0&#46;64&#44; 95&#37;CI 0&#46;42&#8211;0&#46;96&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">The results of the present study confirm the inverse relationship between the risk of events and the use of an EIS in NSTE ACS&#44; detected in previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;8&#8211;11&#44;17&#44;18</span></a> At first sight this is paradoxical&#44; since it would indicate that the patients who could benefit most from such treatment are precisely the individuals in which it is least used&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;12</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The reasons for this paradoxical situation have not been fully clarified&#46; Given the greater proportion of women and elderly people in the high risk stratum&#44; the hypothesis of lesser therapeutic effort could be considered in these individuals&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;17&#44;19&#44;20</span></a> However&#44; in our study there were no other indications of inequalities in therapeutic effort according to the risk stratum involved &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; and neither age nor gender were found to be independently associated to the implementation of EIS&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Given the increased frequency of prior coronariography in the patients at high risk&#44; we must consider the possibility that improved prior knowledge of the coronary anatomy could have favored the use of a conservative strategy in these patients&#46; However&#44; in the multivariate analysis&#44; antecedents of coronariography did not act as an effect modifier &#40;interaction <span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;8425&#41;&#44; and were not independently associated to the implementation of EIS &#40;adjusted <span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;2501&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The dose-response association between bleeding risk and the adoption of EIS is an important finding in this study&#44; suggesting that the lesser utilization of EIS in the patients with high GRACE scores is at least partly due to the increased bleeding risk of these patients&#46; Form this perspective&#44; the existence of a certain dissociation between the guides &#40;designed in reference to ideal patients&#44; with a single disease&#41; and actual clinical practice &#40;individual patients with comorbidities&#41; could be understandable&#46; However&#44; this argument loses strength on considering the radial access&#8212;much less susceptible to bleeding phenomena than the femoral access&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#8211;25</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The scant utilization of an early invasive strategy in diabetic patients&#44; reported in many studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7&#44;9&#44;26</span></a> is more difficult to explain&#46; Clinicians may presume the existence of multiple vessel disease not amenable to revascularization in diabetic individuals&#44; and therefore an unfavorable risk-benefit ratio in such cases&#46; However&#44; this explanation does not fit well with the repeatedly demonstrated benefits derived from coronary intervention in diabetics&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#8211;29</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The association between tachycardia upon admission &#40;an indicator of heart failure&#41; and scant interventional practices is less well known&#46; This association possible may be attributable to chance &#40;type I error&#41;&#46; However&#44; the negative association between a Killip class of &#62;1 and the implementation of an early invasive strategy suggests that the association is real&#46; Alternatively&#44; difficulties in transferring unstable patients &#40;within or between hospital centers&#41; to the hemodynamics laboratory&#44; or limitations of therapeutic effort&#44; may possibly contribute to lesser utilization of invasive strategies in these patients&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; there is a tendency to concentrate the utilization of EIS among patients with NSTE ACS exhibiting scant comorbidity&#46; This paradoxical situation is still far from being resolved&#46; Clinicians therefore should carefully revise the risk&#8211;benefit relationship of interventionism in their patients&#44;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;25</span></a> particularly among diabetics&#44; patients with heart failure&#44; and patients at high bleeding risk&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Funding</span><p id="par0115" class="elsevierStylePara elsevierViewall">The ARIAM registry is a project financed by the <span class="elsevierStyleGrantSponsor">Sociedad Espa&#241;ola de Medicina Intensiva</span>&#44; <span class="elsevierStyleGrantSponsor">Cr&#237;tica y Unidades Coronarias &#40;SEMICYUC&#41;</span>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Observational studies have reported a paradoxical inverse relationship between the use of an early invasive strategy &#40;EIS&#41; and the risk of events in patients with non-ST-segment elevation acute coronary syndrome &#40;NSTE ACS&#41;&#46; The study objectives are&#58; &#40;1&#41; to examine the association between baseline risk in patients with NSTE ACS and the use of EIS&#59; and &#40;2&#41; to identify some of the factors independently associated to the use of EIS&#46;</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort study&#46;</p> <span class="elsevierStyleSectionTitle">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Intensive care units participating in the SEMICYUC ARIAM Registry&#46;</p> <span class="elsevierStyleSectionTitle">Patients</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Consecutive patients admitted with a diagnosis of NSTE-ACS within 48<span class="elsevierStyleHsp" style=""></span>h of evolution between the months of April and July 2010&#46;</p> <span class="elsevierStyleSectionTitle">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">None&#46;</p> <span class="elsevierStyleSectionTitle">Main outcomes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Coronary angiography with or without angioplasty within 72<span class="elsevierStyleHsp" style=""></span>h&#44; risk stratification using the GRACE scale&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We analyzed 543 patients with NSTE-ACS&#44; of which 194 were of low risk&#44; 170 intermediate risk and 179 high risk&#46; The EIS was used in 62&#46;4&#37; of the patients at low risk&#44; in 60&#46;2&#37; of those with intermediate risk&#44; and in 49&#46;7&#37; of those at high risk &#40;<span class="elsevierStyleItalic">p</span> for tendency 0&#46;0144&#41;&#46; The EIS was used preferentially in patients with low severity and comorbidity&#46; In the logistic regression model&#44; EIS was independently associated to the availability of a catheterization laboratory &#40;OR 2&#46;22 &#91;95&#37;CI 1&#46;55&#8211;3&#46;19&#93;&#41;&#44; the presence of ST changes on ECG &#40;OR 1&#46;80 &#91;1&#46;23&#8211;2&#46;64&#93;&#41;&#44; or the existence of a low risk of bleeding &#40;OR 0&#46;76 &#91;0&#46;66&#8211;0&#46;88&#41;&#93;&#46; Conversely&#44; EIS was less prevalent in patients with diabetes &#40;OR 0&#46;60 &#91;0&#46;41&#8211;0&#46;88&#93;&#41; or tachycardia upon admission &#40;OR 0&#46;54 &#91;0&#160;36&#8211;0&#46;82&#93;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In 2010 there remained a lesser relative use of EIS in patients at high risk&#44; due in part to an increased risk of bleeding in these patients&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Algunos estudios observacionales han comunicado una parad&#243;jica menor utilizaci&#243;n de la estrategia invasiva precoz &#40;EIP&#41; en los pacientes con s&#237;ndrome coronario agudo sin elevaci&#243;n de ST &#40;SCASEST&#41; de alto riesgo&#46; Los objetivos del estudio son&#58; &#40;1&#41; Examinar la asociaci&#243;n entre el riesgo basal de los pacientes con SCASEST y el uso de una estrategia invasiva precoz &#40;EIP&#41; en la pr&#225;ctica cl&#237;nica actual&#59; &#40;2&#41; identificar algunos de los factores asociados de forma independiente con el uso de EIP&#46;</p> <span class="elsevierStyleSectionTitle">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes retrospectivo</p> <span class="elsevierStyleSectionTitle">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Unidades de cuidados intensivos participantes en el registro ARIAM-SEMICYUC&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Pacientes consecutivos ingresados con diagn&#243;stico de SCASEST de menos de 48 horas de evoluci&#243;n entre los meses de abril-julio de 2010&#46;</p> <span class="elsevierStyleSectionTitle">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Ninguna&#46;</p> <span class="elsevierStyleSectionTitle">Variables principales</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Realizaci&#243;n de coronariograf&#237;a con o sin angioplastia en las primeras 72 horas&#44; estratificaci&#243;n del riesgo mediante la escala GRACE&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 543 pacientes con SCASEST&#44; de los cuales 194 eran de bajo riesgo&#44; 170 de riesgo intermedio y 179 de riesgo alto&#46; La EIP se utiliz&#243; en el 62&#44;4&#37; de los pacientes de bajo riesgo&#44; el 60&#44;2&#37; de los de riesgo intermedio y el 49&#44;7&#37; de los de riesgo alto &#40;p para la tendencia 0&#44;0144&#41;&#46; La EIP se utiliz&#243; de forma preferente en pacientes con baja gravedad y comorbilidad&#46; En el modelo de regresi&#243;n log&#237;stica&#44; la EIP se asoci&#243; de forma directa con la disponibilidad de laboratorio de hemodin&#225;mica &#40;OR 2&#44;22&#44; &#91;intervalo de confianza al 95&#37; 1&#44;55 a 3&#44;19&#93;&#44; la presencia de cambios de ST en el ECG &#40;OR 1&#44;80 &#91;1&#44;23 a 2&#44;64&#93;&#41; y la existencia de un bajo riesgo hemorr&#225;gico &#40;OR 0&#44;76 &#91;0&#44;66 a 0&#44;88&#93;&#41;&#46; Por el contrario&#44; la EIP se asoci&#243; de forma negativa con la presencia de diabetes &#40;OR 0&#44;60 &#91;0&#44;41 a 0&#44;88&#93;&#41; o de taquicardia al ingreso &#40;OR 0&#44;54 &#91;0&#44;36 a 0&#44;82&#93;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">En el a&#241;o 2010&#44; persiste una menor utilizaci&#243;n relativa de la EIP en los pacientes de alto riesgo&#44; debido en parte al mayor riesgo hemorr&#225;gico de estos pacientes&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Latour-P&#233;rez J&#44; et al&#46; Uso de la estrategia invasiva precoz en el s&#237;ndrome coronario agudo sin elevaci&#243;n de ST&#46; La paradoja contin&#250;a&#46; Med Intensiva&#46; 2012&#59;36&#58;95&#8211;102&#46;</p>"
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Luis Mart&#237;n Vill&#233;n&#59; Hospital Maz&#44; Zaragoza&#58; Isabel Yuste Serrano&#59; Hospital Universitario Miguel Servet&#44; Zaragoza&#58; Joaqu&#237;n Joven Lafont&#44; Jos&#233; Luis Ib&#225;&#241;ez Langa and Alejandra Mor&#243;n&#46; <span class="elsevierStyleItalic">Navarre&#58;</span> Hospital Virgen del Camino&#44; Pamplona&#47;Iru&#241;a&#58; Jos&#233; Ramos Castro&#46; <span class="elsevierStyleItalic">Castilla y Le&#243;n&#58;</span> Hospital Felipe II&#44; Valladolid&#58; Juan Jos&#233; Sanz Hern&#225;n&#59; Hospital Universitario del R&#237;o Hortega&#44; Valladolid&#58; Marta Garc&#237;a Garc&#237;a and Rub&#233;n Herr&#225;n Monge&#46; <span class="elsevierStyleItalic">Castilla-La Mancha&#58;</span> Hospital General de Ciudad Real&#44; Ciudad Real&#58; Carmen Mart&#237;n Rodr&#237;guez&#44; Mariana Portilla Botelho and Alfonso Ambros Checa&#59; Hospital Universitario de Guadalajara&#58; Elena Y&#225;&#241;ez Parareda&#59; Hospital Santa B&#225;rbara&#44; Puertollano&#58; Francisca Prieto Valderrey and Emilio Moreno Mill&#225;n&#46; <span class="elsevierStyleItalic">Catalonia&#58;</span> Hospital General de L&#8217;Hospitalet&#44; L&#8217;Hospitalet de Llobregat&#58; Jos&#233; Juli&#225;n Berrade Zubiri&#59; Hospital de Sabadell&#44; Sabadell&#58; Consuelo Gu&#237;a Rambla&#59; Hospital de Sant Boi&#44; Sant Boi de Llobregat&#58; Alejandra Fern&#225;ndez Trujillo&#59; Hospital General de Catalunya&#44; Sant Cugat del Vall&#232;s&#58; Elisabet Manero Caballero and Roc&#237;o Toledo&#59; Hospital de Terrassa&#44; Terrassa&#58; Joaqu&#237;n Amador Amerigo&#46; <span class="elsevierStyleItalic">Valencian Community&#58;</span> Hospital General Universitario de Alicante&#44; Alicante&#58; Jos&#233; C&#225;novas Robles&#44; M&#243;nica D&#237;az Barranco and Francisco &#193;ngel Jaime S&#225;nchez&#59; Hospital Universitario de la Ribera&#44; Alzira&#58; Lucia Arias Portaceli&#44; Ana Abalos Garc&#237;a&#44; Mart&#237;n Parejo Montell and Juan Fern&#225;ndez Cabrera&#59; Hospital General de Castell&#243;&#44; Castell&#243;n de la Plana&#58; Patricia Casero Roig&#44; Susana Altaba Tena and Amparo Ferr&#225;ndiz&#59; Hospital General de Elche&#44; Elche&#58; Jaime Latour P&#233;rez&#44; Eva de Miguel Balsa and Francisco Javier Coves Orts&#59; Hospital de Manises&#44; Manises&#58; M&#243;nica Talavera Peregrina&#46; Hospital Vega Baja&#44; Orihuela&#58; Cristina Portillo Requena&#59; Hospital de Requena&#44; Valencia&#58; Carlos Jos&#233; Folgado Bisbal&#59; Hospital de Sagunto&#44; Sagunto&#58; Regina Calvo Embuena&#59; Hospital Universitario de San Juan de Alicante&#44; San Juan de Alicante&#58; Cristina Molla Jim&#233;nez&#59; Cl&#237;nica Quir&#243;n de Valencia&#44; Valencia&#58; Javier Tornero L&#243;pez&#59; Hospital Arnau de Vilanova&#44; Valencia&#58; Mercedes Garc&#237;a&#44; Mois&#233;s Rico Sala&#44; Mercedes Garc&#237;a Sanz and Eugenia de la Fuente O&#8217;Connor&#59; Hospital Cl&#237;nico Universitario&#44; Valencia&#58; Ricardo Oltra Chord&#225;&#59; Hospital Universitario La Fe&#44; Valencia&#58; M&#46;&#170; Paz Fuset Cabanes&#44; Isabel Madrid L&#243;pez&#44; Karla Vacacela Cordova and Esther Villarreal Tello&#59; Hospital de Vinaros&#44; Vinar&#242;s&#58; M&#46;&#170; Desamparados Oliva Gimeno&#46; <span class="elsevierStyleItalic">Extremadura&#58;</span> Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#58; Eduardo Corchero&#44; Elena Gallego Curto&#44; Alberto Fern&#225;ndez Zapata and Abilio Arrasqueta Llanes&#59; Hospital Don Benito-Villanueva de la Serena&#58; Juan Diego Jim&#233;nez Delgado&#59; Hospital de M&#233;rida&#44; M&#233;rida&#58; Marcelo P&#233;rez Arriaga&#44; Mercedes Antona D&#237;ez and Guadalupe Borge Rodr&#237;guez&#59; Hospital Virgen del Puerto&#44; Plasencia&#58; Eva Guerra Nevado and Anton Arana Llanderal&#59; Hospital de Zafra&#44; Zafra&#58; Miguel Gonz&#225;lez Lar and Hilario Badiola Villa&#46; <span class="elsevierStyleItalic">Galicia&#58;</span> Hospital Xeral de Lugo&#44; Lugo&#58; Mar&#237;a Luisa Mart&#237;nez Rodr&#237;guez and Rebeca &#193;lvarez-Lata&#59; Complejo Hospitalario de Ourense&#58; Mar&#237;a Jos&#233; de la Torre and Rom&#225;n Rodr&#237;guez &#193;lvarez-Granada&#59; Hospital Miguel Dom&#237;nguez&#44; Pontevedra&#58; Ra&#250;l Jos&#233; Gonz&#225;lez Gonz&#225;lez&#46; <span class="elsevierStyleItalic">La Rioja&#58;</span> Hospital San Pedro&#44; Logro&#241;o&#58; M&#46;&#170; de la Concepci&#243;n Pav&#237;a Pesquera and Lidia Mart&#237;nez Camarero&#46; <span class="elsevierStyleItalic">Madrid&#58;</span> Hospital Universitario Pr&#237;ncipe de Asturias&#44; Alcal&#225; Henares&#58; Jos&#233; Andr&#233;s Cambronero Galache and Cristina Mart&#237;nez&#59; Hospital del Henares&#44; Coslada&#58; In&#233;s Torrej&#243;n P&#233;rez&#59; Hospital de Fuenlabrada&#44; Fuenlabrada&#58; Mercedes Rubio Regidor and Febechi Afamefule Afamefule&#59; Hospital Severo Ochoa&#44; Legan&#233;s&#58; Frutos del Nogal S&#225;ez&#59; Hospital La Moraleja&#44; Madrid&#58; Miguel &#193;ngel Palma Gamiz&#46; <span class="elsevierStyleItalic">Basque Country&#58;</span> Hospital de Cruces&#44; Barakaldo&#58; Katherine Garcia Castillo and Victoria Boado Varela&#46; <span class="elsevierStyleItalic">Asturias&#58;</span> Hospital San Agust&#237;n&#44; Avil&#233;s&#58; Josefa Rengel Jim&#233;nez&#46; <span class="elsevierStyleItalic">Murcia&#58;</span> Hospital Rafael M&#233;ndez&#44; Lorca&#58; Carlos Luis Albacete Moreno&#59; Hospital General Universitario Reina Sof&#237;a&#44; Murcia&#58; Francisco Felices Abad&#44; Isabel Cremades Naval&#243;n&#44; Lisa Ort&#237;n Katnich&#44; F&#225;tima Mart&#237;nez-Lozano Aranaga&#44; Jos&#233; Luis Espinosa Berenguel&#44; C&#233;sar Palaz&#243;n S&#225;nchez&#44; Mart&#237;n Vigil Velis and Carmen M&#46; Susarte Juli&#225;&#59; Hospital J&#46;M&#46; Morales Meseguer&#44; Murcia&#58; Manuel Jos&#233; P&#225;rraga Ram&#237;rez&#44; Jos&#233; Antonio Garc&#237;a Olivas and Jes&#250;s C&#225;novas Vera&#46;</p>"
            "etiqueta" => "Annex 1"
            "titulo" => "Investigators and centers participating in the survey 2010"
            "identificador" => "sec0050"
          ]
        ]
      ]
    ]
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="3" align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">GRACE</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">p</span>-Value for the trend&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Low &#40;&#8804;108&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Medium &#40;109&#8211;140&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">High &#40;&#8805;141&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Age&#58; median &#40;</span><span class="elsevierStyleItalic"><span class="elsevierStyleBold">P</span></span><span class="elsevierStyleInf"><span class="elsevierStyleBold">25</span></span><span class="elsevierStyleItalic"><span class="elsevierStyleBold">P</span></span><span class="elsevierStyleInf"><span class="elsevierStyleBold">75</span></span><span class="elsevierStyleBold">&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">67 &#40;57&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;47&#46;5&#46; 60&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;63&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;72&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Females&#58; &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">138&#47;502 &#40;27&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#47;181 &#40;16&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#47;163 &#40;30&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#47;158 &#40;37&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="6" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Antecedents</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Active smoker &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">140&#47;543 &#40;26&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#47;194 &#40;51&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#47;170 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#47;179 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dyslipidemia &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">281&#47;543 &#40;51&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#47;194 &#40;51&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">82&#47;170 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#47;179 &#40;55&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3641&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hypertension &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">353&#47;543 &#40;65&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&#47;194 &#40;52&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#47;170 &#40;66&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#47;179 &#40;77&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Diabetes &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">177&#47;543 &#40;32&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#47;194 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#47;170 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#47;179 &#40;47&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Angina &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108&#47;543 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#47;194 &#40;13&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40&#47;170 &#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42&#47;179 &#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous infarction &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">121&#47;543 &#40;22&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">56&#47;179 &#40;31&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous coronariography &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">114&#47;543 &#40;21&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36&#47;170 &#40;21&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">51&#47;179 &#40;28&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0006&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous coronary surgery &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#47;194 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#47;170 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0032&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous heart failure &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">35&#47;543 &#40;6&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#47;170 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26&#47;179 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Stroke &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">34&#47;543 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#47;194 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#47;170 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17&#47;179 &#40;9&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0562&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Peripheral arterial disease &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">37&#47;543 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#47;194 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#47;170 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18&#47;179 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0075&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Chronic renal failure &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#47;543 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#47;194 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#47;170 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#47;179 &#40;15&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Presentation</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cardiac arrest &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">8&#47;543 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#47;194 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#47;170 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5&#47;179 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1664&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Heart rate&#58; median &#40;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">25</span></span><span class="elsevierStyleItalic">&#8211;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">75</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78 &#40;66&#46; 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;5 &#40;64&#46; 84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;65&#46; 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;70&#46;102&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Systolic BP upon admission in ICU median &#40;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">25</span></span><span class="elsevierStyleItalic">&#8211;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">75</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">140 &#40;120&#46; 160&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">149&#46;5 &#40;130&#46;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">140 &#40;121&#46; 160&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130 &#40;110&#46;149&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Killip &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Other hospital</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#47;543 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#47;177 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8&#47;159 &#40;5&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;157 &#40;5&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Ward</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">491&#47;543 &#40;90&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">164&#47;177 &#40;92&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150&#47;159 &#40;94&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136&#47;157 &#40;86&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0585&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab8652.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Profile of the patients with NSTE ACS according to baseline risk&#46;</p>"
        ]
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      1 => array:7 [
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">AG IIb&#47;IIIa&#58; glycoprotein IIb&#47;IIIa antagonists&#59; CVS&#58; cardiovascular surgery&#59; LMWH&#58; low molecular weight heparin&#59; PCI&#58; percutaneous coronary intervention&#59; ACEIs&#47;ARA&#58; angiotensin converting enzyme inhibitors&#47;aldosterone receptor antagonists&#59; MV&#58; mechanical ventilation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">GRACE</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span>-Value for the trend&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Low &#40;&#8804;108&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Medium &#40;109&#8211;140&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">High &#40;&#8805;141&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aspirin in the first 24<span class="elsevierStyleHsp" style=""></span>h &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">489&#47;543 &#40;90&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179&#47;194 &#40;92&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">153&#47;170 &#40;90&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">157&#47;179 &#40;87&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1419&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clopidogrel &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">471&#47;543 &#40;86&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">171&#47;194 &#40;88&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">148&#47;170 &#40;87&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">152&#47;179 &#40;84&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3607&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-fractionated heparin &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#47;543 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#47;194 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#47;170 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;179 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5434&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LMWH &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">318&#47;543 &#40;58&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">117&#47;194 &#40;60&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#47;170 &#40;57&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103&#47;179 &#40;57&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5837&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fondaparinux &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#47;543 &#40;17&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#47;194 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#47;170 &#40;18&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#47;179 &#40;15&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;381&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AG IIb&#47;IIIa &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96&#47;543 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#47;194 &#40;19&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#47;170 &#40;21&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#47;179 &#40;12&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACEIs&#47;ARA &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">304&#47;543 &#40;56&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107&#47;194 &#40;55&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#47;170 &#40;57&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#47;179 &#40;55&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;9669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beta-blockers &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">277&#47;543 &#40;51&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#47;194 &#40;58&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#47;170 &#40;51&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#47;179 &#40;43&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beta-blockers &#40;excluding contraindication&#41; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">276&#47;476 &#40;58&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#47;178 &#40;63&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#47;154 &#40;56&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#47;144 &#40;52&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0504&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Calcium antagonists &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#47;543 &#40;9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#47;194 &#40;8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#47;170 &#40;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">20&#47;179 &#40;11&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3406&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Statins &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">445&#47;543 &#40;82&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">166&#47;194 &#40;85&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144&#47;170 &#40;84&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">135&#47;179 &#40;75&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catheterization &#60;72<span class="elsevierStyleHsp" style=""></span>h &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">121&#47;194 &#40;62&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">103&#47;170 &#40;60&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#47;179 &#40;49&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVS &#40;including transfers&#41; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">25&#47;543 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10&#47;194 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;170 &#40;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">6&#47;179 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;4137&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early PCI &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161&#47;543 &#40;29&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#47;194 &#40;32&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#47;170 &#40;31&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#47;179 &#40;25&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1905&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Invasive MV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;543 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#47;194 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#47;170 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#47;179 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1878&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Noninvasive MV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#47;543 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;194 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;170 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;179 &#40;5&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Echocardiogram &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">187&#47;543 &#40;34&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#47;194 &#40;34&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#47;170 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#47;179 &#40;40&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;2239&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab8655.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Drug treatment and diagnostic&#8211;therapeutic procedures according to baseline risk during admission to the Intensive Care Unit&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">No early catheterization&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">EIS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;4 categories&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;61&#46; 78&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                      "titulo" => "ACC&#47;AHA 2007 guidelines for the management of patients with unstable angina&#47;non-ST-elevation myocardial infarction&#58; a report of the American College of Cardiology&#47;American Heart Association Task Force on Practice Guidelines &#40;writing committee to revise the 2002 guidelines for the management of patients with unstable angina&#47;non-ST-elevation myocardial infarction&#41; developed in collaboration with the American College of Emergency Physicians&#44; the Society for Cardiovascular Angiography and Interventions&#44; and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine"
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                            5 => "D&#46;E&#46; Casey Jr&#46;"
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                      "doi" => "10.1016/j.jacc.2007.02.013"
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                      "titulo" => "2011 ACCF&#47;AHA focused update incorporated into the ACC&#47;AHA 2007 guidelines for the management of patients with unstable angina&#47;non-ST-elevation myocardial infarction&#58; a report of the American College of Cardiology Foundation&#47;American Heart Association Task Force on Practice Guidelines developed in collaboration with the American Academy of Family Physicians&#44; Society for Cardiovascular Angiography and Interventions&#44; and the Society of Thoracic Surgeons"
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Original
Early invasive strategy in non-ST-segment elevation acute coronary syndrome. The paradox continues
Uso de la estrategia invasiva precoz en el síndrome coronario agudo sin elevación de ST. La paradoja continúa
J. Latour-Péreza,
Corresponding author
jlatour@coma.es

Corresponding author.
, M.P. Fuset-Cabanesb, M. Ruano Marcob, F. del Nogal Sáezc, F.J. Felices Abadd, J. Cuñat de la Hozb, Grupo ARIAM
a Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, Spain
b Servicio de Medicina Intensiva, Hospital La Fe, Valencia, Spain
c Servicio de Medicina Intensiva, Hospital Severo Ochoa, Leganés, Madrid, Spain
d Servicio de Medicina Intensiva, Hospital Reina Sofía, Murcia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Based on the existing scientific evidence&#44; the main clinical practice guides recommend an early invasive strategy &#40;EIS&#41; in patients with medium-high risk non-ST-segment elevation acute coronary syndrome &#40;NSTE ACS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;5</span></a> However&#44; some registry-based studies have documented a paradoxically lesser utilization of early invasive strategies in high risk patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;12</span></a> The ARIAM-SEMICYUC study offers an opportunity to re-examine this problem based on the recent Spanish data&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The objectives of the present study are&#58; &#40;1&#41; to describe the use of EIS in relation to the baseline risk of patients with NSTE ACS admitted to intensive care units &#40;ICUs&#41;&#59; and &#40;2&#41; to identify the independent predictors of the application of EIS in patients admitted due to NSTE ACS&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patients</span><p id="par0015" class="elsevierStylePara elsevierViewall">The ARIAM-SEMICYUC project is a voluntary registry of patients with acute coronary syndrome &#40;ACS&#41; admitted to ICUs in Spain and Andorra&#46; At present&#44; trimestrial surveying is made&#44; including all the consecutive patients admitted during the time period&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The present study includes the patients admitted with a diagnosis of NSTE ACS with an evolution of at least 48<span class="elsevierStyleHsp" style=""></span>h from symptoms onset&#44; and covering the period between 1 April and 15 July 2010&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">During this period&#44; a total of 43 hospitals participated in the survey &#40;see <a class="elsevierStyleCrossRef" href="#sec0050">Annex 1</a>&#41;&#44; with the inclusion of 1379 patients&#44; of which 665 were admitted with a diagnosis of NSTE ACS&#46; The GRACE score<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a> was available in 570 of these patients&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Variables</span><p id="par0030" class="elsevierStylePara elsevierViewall">The primary outcome variable of the study was cardiac catheterization &#40;with or without intervention&#41; in the first 72<span class="elsevierStyleHsp" style=""></span>h after admission&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The patients were stratified according to the risk of suffering major cardiac events&#44; based on the GRACE risk score upon admission&#44; using the cutoff points &#40;low&#44; medium and high risk&#41; pre-established in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;14</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In addition to the risk level&#44; a retrospective analysis was made of different variables available in the registry&#44; such as the baseline clinical&#8211;demographic parameters&#44; patient treatment and evolution&#44; and possible catheterization predictors previously described in the literature&#46; Bleeding risk was quantified by means of an <span class="elsevierStyleItalic">ad hoc</span> index based on the number of independent predictors of major bleeding contemplated by the GRACE&#44;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;16</span></a> categorized as high or low risk according to the presence of some or no risk factor&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">The descriptive analysis comprised the calculation of proportions &#40;in the case of categorical variables&#41; and medians&#44; with the corresponding interquartile range &#40;in the case of continuous variables&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The contrasting of hypotheses referred to proportions was carried out using the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test &#40;or the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test for trends&#41;&#46; In the case of quantitative variables&#44; contrasting was based on the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test &#40;comparisons between 2 groups&#41;&#44; the Kruskal&#8211;Wallis test &#40;3 or more groups&#41; or the Cuzick test &#40;trends in 3 or more groups&#41;&#46; All contrasts were two-sided&#44; with an alpha level of significance of 5&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">With the purpose of identifying independent predictors of early catheterization&#44; the variables found in the univariate analysis to be associated to the adoption of EIS with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;10 were entered in a multiple logistic regression model&#44; adopting a backwards stepwise analytical strategy in which the least significant variable was eliminated in each step&#46; Finally&#44; the association between each of the predictor variables and the implementation of EIS was evaluated by calculating the adjusted odds ratios &#40;ORs&#41; and their corresponding 95&#37; confidence intervals &#40;CI&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">The profile of the patients&#44; stratified according to GRACE risk level&#44; was consistent with that of other registries<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9&#44;11</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The high risk group was characterized by older age&#44; a greater proportion of women&#44; increased comorbidity &#40;diabetes&#44; previous infarction&#44; renal failure&#41;&#44; the existence of heart failure upon admission&#44; a high baseline bleeding risk&#44; and increased mortality&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Regarding the drug treatment administered from symptoms onset and during admission to the ICU &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; the patients at high risk were less often treated with statins and beta-blockers&#44; with no other significant differences among the three risk levels&#46; Likewise&#44; risk level was directly correlated to the use of noninvasive mechanical ventilation&#44; with a negative association to the adoption of EIS&#8212;though the differences failed to reach statistical significance&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The variables associated to the implementation of EIS are summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; Basically&#44; the group of patients with NSTE ACS subjected to early invasive treatment were younger&#44; with a lesser prevalence of diabetes and of heart failure upon admission&#44; a lesser bleeding risk&#44; and were admitted to a hospital with the availability of a hemodynamics laboratory&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The logistic regression analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41; identified the availability of a hemodynamics laboratory&#44; the presence of ST-segment changes&#44; the absence of diabetes&#44; the absence of tachycardia upon admission&#44; and the existence of low bleeding risk as independent predictors of the use of an invasive treatment strategy&#46; Previous coronariography was not independently correlated to the adoption of EIS &#40;adjusted OR 0&#46;77&#44; 95&#37;CI 0&#46;50&#8211;1&#46;21&#41;&#44; and did not act as an effect modifier of the association between the GRACE level and the implementation of EIS &#40;interaction <span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;8425&#41;&#46; On replacing heart rate with the Killip class&#44; the presence of class &#62;1 was found to be significantly associated to a lesser utilization of invasive strategies &#40;OR 0&#46;64&#44; 95&#37;CI 0&#46;42&#8211;0&#46;96&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">The results of the present study confirm the inverse relationship between the risk of events and the use of an EIS in NSTE ACS&#44; detected in previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;8&#8211;11&#44;17&#44;18</span></a> At first sight this is paradoxical&#44; since it would indicate that the patients who could benefit most from such treatment are precisely the individuals in which it is least used&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;12</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The reasons for this paradoxical situation have not been fully clarified&#46; Given the greater proportion of women and elderly people in the high risk stratum&#44; the hypothesis of lesser therapeutic effort could be considered in these individuals&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;17&#44;19&#44;20</span></a> However&#44; in our study there were no other indications of inequalities in therapeutic effort according to the risk stratum involved &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; and neither age nor gender were found to be independently associated to the implementation of EIS&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Given the increased frequency of prior coronariography in the patients at high risk&#44; we must consider the possibility that improved prior knowledge of the coronary anatomy could have favored the use of a conservative strategy in these patients&#46; However&#44; in the multivariate analysis&#44; antecedents of coronariography did not act as an effect modifier &#40;interaction <span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;8425&#41;&#44; and were not independently associated to the implementation of EIS &#40;adjusted <span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;2501&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The dose-response association between bleeding risk and the adoption of EIS is an important finding in this study&#44; suggesting that the lesser utilization of EIS in the patients with high GRACE scores is at least partly due to the increased bleeding risk of these patients&#46; Form this perspective&#44; the existence of a certain dissociation between the guides &#40;designed in reference to ideal patients&#44; with a single disease&#41; and actual clinical practice &#40;individual patients with comorbidities&#41; could be understandable&#46; However&#44; this argument loses strength on considering the radial access&#8212;much less susceptible to bleeding phenomena than the femoral access&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#8211;25</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The scant utilization of an early invasive strategy in diabetic patients&#44; reported in many studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7&#44;9&#44;26</span></a> is more difficult to explain&#46; Clinicians may presume the existence of multiple vessel disease not amenable to revascularization in diabetic individuals&#44; and therefore an unfavorable risk-benefit ratio in such cases&#46; However&#44; this explanation does not fit well with the repeatedly demonstrated benefits derived from coronary intervention in diabetics&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#8211;29</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The association between tachycardia upon admission &#40;an indicator of heart failure&#41; and scant interventional practices is less well known&#46; This association possible may be attributable to chance &#40;type I error&#41;&#46; However&#44; the negative association between a Killip class of &#62;1 and the implementation of an early invasive strategy suggests that the association is real&#46; Alternatively&#44; difficulties in transferring unstable patients &#40;within or between hospital centers&#41; to the hemodynamics laboratory&#44; or limitations of therapeutic effort&#44; may possibly contribute to lesser utilization of invasive strategies in these patients&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In conclusion&#44; there is a tendency to concentrate the utilization of EIS among patients with NSTE ACS exhibiting scant comorbidity&#46; This paradoxical situation is still far from being resolved&#46; Clinicians therefore should carefully revise the risk&#8211;benefit relationship of interventionism in their patients&#44;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;25</span></a> particularly among diabetics&#44; patients with heart failure&#44; and patients at high bleeding risk&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Funding</span><p id="par0115" class="elsevierStylePara elsevierViewall">The ARIAM registry is a project financed by the <span class="elsevierStyleGrantSponsor">Sociedad Espa&#241;ola de Medicina Intensiva</span>&#44; <span class="elsevierStyleGrantSponsor">Cr&#237;tica y Unidades Coronarias &#40;SEMICYUC&#41;</span>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Observational studies have reported a paradoxical inverse relationship between the use of an early invasive strategy &#40;EIS&#41; and the risk of events in patients with non-ST-segment elevation acute coronary syndrome &#40;NSTE ACS&#41;&#46; The study objectives are&#58; &#40;1&#41; to examine the association between baseline risk in patients with NSTE ACS and the use of EIS&#59; and &#40;2&#41; to identify some of the factors independently associated to the use of EIS&#46;</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort study&#46;</p> <span class="elsevierStyleSectionTitle">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Intensive care units participating in the SEMICYUC ARIAM Registry&#46;</p> <span class="elsevierStyleSectionTitle">Patients</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Consecutive patients admitted with a diagnosis of NSTE-ACS within 48<span class="elsevierStyleHsp" style=""></span>h of evolution between the months of April and July 2010&#46;</p> <span class="elsevierStyleSectionTitle">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">None&#46;</p> <span class="elsevierStyleSectionTitle">Main outcomes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Coronary angiography with or without angioplasty within 72<span class="elsevierStyleHsp" style=""></span>h&#44; risk stratification using the GRACE scale&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We analyzed 543 patients with NSTE-ACS&#44; of which 194 were of low risk&#44; 170 intermediate risk and 179 high risk&#46; The EIS was used in 62&#46;4&#37; of the patients at low risk&#44; in 60&#46;2&#37; of those with intermediate risk&#44; and in 49&#46;7&#37; of those at high risk &#40;<span class="elsevierStyleItalic">p</span> for tendency 0&#46;0144&#41;&#46; The EIS was used preferentially in patients with low severity and comorbidity&#46; In the logistic regression model&#44; EIS was independently associated to the availability of a catheterization laboratory &#40;OR 2&#46;22 &#91;95&#37;CI 1&#46;55&#8211;3&#46;19&#93;&#41;&#44; the presence of ST changes on ECG &#40;OR 1&#46;80 &#91;1&#46;23&#8211;2&#46;64&#93;&#41;&#44; or the existence of a low risk of bleeding &#40;OR 0&#46;76 &#91;0&#46;66&#8211;0&#46;88&#41;&#93;&#46; Conversely&#44; EIS was less prevalent in patients with diabetes &#40;OR 0&#46;60 &#91;0&#46;41&#8211;0&#46;88&#93;&#41; or tachycardia upon admission &#40;OR 0&#46;54 &#91;0&#160;36&#8211;0&#46;82&#93;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In 2010 there remained a lesser relative use of EIS in patients at high risk&#44; due in part to an increased risk of bleeding in these patients&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Algunos estudios observacionales han comunicado una parad&#243;jica menor utilizaci&#243;n de la estrategia invasiva precoz &#40;EIP&#41; en los pacientes con s&#237;ndrome coronario agudo sin elevaci&#243;n de ST &#40;SCASEST&#41; de alto riesgo&#46; Los objetivos del estudio son&#58; &#40;1&#41; Examinar la asociaci&#243;n entre el riesgo basal de los pacientes con SCASEST y el uso de una estrategia invasiva precoz &#40;EIP&#41; en la pr&#225;ctica cl&#237;nica actual&#59; &#40;2&#41; identificar algunos de los factores asociados de forma independiente con el uso de EIP&#46;</p> <span class="elsevierStyleSectionTitle">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes retrospectivo</p> <span class="elsevierStyleSectionTitle">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Unidades de cuidados intensivos participantes en el registro ARIAM-SEMICYUC&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Pacientes consecutivos ingresados con diagn&#243;stico de SCASEST de menos de 48 horas de evoluci&#243;n entre los meses de abril-julio de 2010&#46;</p> <span class="elsevierStyleSectionTitle">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Ninguna&#46;</p> <span class="elsevierStyleSectionTitle">Variables principales</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Realizaci&#243;n de coronariograf&#237;a con o sin angioplastia en las primeras 72 horas&#44; estratificaci&#243;n del riesgo mediante la escala GRACE&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 543 pacientes con SCASEST&#44; de los cuales 194 eran de bajo riesgo&#44; 170 de riesgo intermedio y 179 de riesgo alto&#46; La EIP se utiliz&#243; en el 62&#44;4&#37; de los pacientes de bajo riesgo&#44; el 60&#44;2&#37; de los de riesgo intermedio y el 49&#44;7&#37; de los de riesgo alto &#40;p para la tendencia 0&#44;0144&#41;&#46; La EIP se utiliz&#243; de forma preferente en pacientes con baja gravedad y comorbilidad&#46; En el modelo de regresi&#243;n log&#237;stica&#44; la EIP se asoci&#243; de forma directa con la disponibilidad de laboratorio de hemodin&#225;mica &#40;OR 2&#44;22&#44; &#91;intervalo de confianza al 95&#37; 1&#44;55 a 3&#44;19&#93;&#44; la presencia de cambios de ST en el ECG &#40;OR 1&#44;80 &#91;1&#44;23 a 2&#44;64&#93;&#41; y la existencia de un bajo riesgo hemorr&#225;gico &#40;OR 0&#44;76 &#91;0&#44;66 a 0&#44;88&#93;&#41;&#46; Por el contrario&#44; la EIP se asoci&#243; de forma negativa con la presencia de diabetes &#40;OR 0&#44;60 &#91;0&#44;41 a 0&#44;88&#93;&#41; o de taquicardia al ingreso &#40;OR 0&#44;54 &#91;0&#44;36 a 0&#44;82&#93;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">En el a&#241;o 2010&#44; persiste una menor utilizaci&#243;n relativa de la EIP en los pacientes de alto riesgo&#44; debido en parte al mayor riesgo hemorr&#225;gico de estos pacientes&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Latour-P&#233;rez J&#44; et al&#46; Uso de la estrategia invasiva precoz en el s&#237;ndrome coronario agudo sin elevaci&#243;n de ST&#46; La paradoja contin&#250;a&#46; Med Intensiva&#46; 2012&#59;36&#58;95&#8211;102&#46;</p>"
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            "apendice" => "<p id="par0125" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Andalusia&#58;</span> Hospital Nuestra Se&#241;ora de Valme&#44; Sevilla&#58; Dolores Herrera Rojas&#44; Ana Loza V&#225;zquez&#44; Antonio Campanario Garc&#237;a&#44; Jos&#233; Antonio S&#225;nchez Rom&#225;n&#44; Mar&#237;a Mar&#237;n Herrero and Alejandro &#218;beda Iglesias&#46; <span class="elsevierStyleItalic">Andorra&#58;</span> Hospital de Nuestra Se&#241;ora de Meritxell&#44; Andorra la Vella&#58; Antonio Margarit Ribas&#46; <span class="elsevierStyleItalic">Aragon&#58;</span> Hospital General San Jorge&#44; Huesca&#58; Juan Carlos L&#243;pez Claver&#44; Lorenzo Labarta Monz&#243;n&#44; Jes&#250;s Escos Orta&#44; Ar&#225;nzazu Lander Azcona&#44; Carlos Ser&#243;n Arbeloa&#44; Isabel Garrido Ram&#237;rez de Arellano and Mar&#237;a Isabel Marquina Lacueva&#59; Hospital Cl&#237;nico Universitario Lozano Blesa&#44; Zaragoza&#58; Emilia Civeira Murillo&#44; Luis Mariano Giner Smith&#44; Luis Mart&#237;n Vill&#233;n&#59; Hospital Maz&#44; Zaragoza&#58; Isabel Yuste Serrano&#59; Hospital Universitario Miguel Servet&#44; Zaragoza&#58; Joaqu&#237;n Joven Lafont&#44; Jos&#233; Luis Ib&#225;&#241;ez Langa and Alejandra Mor&#243;n&#46; <span class="elsevierStyleItalic">Navarre&#58;</span> Hospital Virgen del Camino&#44; Pamplona&#47;Iru&#241;a&#58; Jos&#233; Ramos Castro&#46; <span class="elsevierStyleItalic">Castilla y Le&#243;n&#58;</span> Hospital Felipe II&#44; Valladolid&#58; Juan Jos&#233; Sanz Hern&#225;n&#59; Hospital Universitario del R&#237;o Hortega&#44; Valladolid&#58; Marta Garc&#237;a Garc&#237;a and Rub&#233;n Herr&#225;n Monge&#46; <span class="elsevierStyleItalic">Castilla-La Mancha&#58;</span> Hospital General de Ciudad Real&#44; Ciudad Real&#58; Carmen Mart&#237;n Rodr&#237;guez&#44; Mariana Portilla Botelho and Alfonso Ambros Checa&#59; Hospital Universitario de Guadalajara&#58; Elena Y&#225;&#241;ez Parareda&#59; Hospital Santa B&#225;rbara&#44; Puertollano&#58; Francisca Prieto Valderrey and Emilio Moreno Mill&#225;n&#46; <span class="elsevierStyleItalic">Catalonia&#58;</span> Hospital General de L&#8217;Hospitalet&#44; L&#8217;Hospitalet de Llobregat&#58; Jos&#233; Juli&#225;n Berrade Zubiri&#59; Hospital de Sabadell&#44; Sabadell&#58; Consuelo Gu&#237;a Rambla&#59; Hospital de Sant Boi&#44; Sant Boi de Llobregat&#58; Alejandra Fern&#225;ndez Trujillo&#59; Hospital General de Catalunya&#44; Sant Cugat del Vall&#232;s&#58; Elisabet Manero Caballero and Roc&#237;o Toledo&#59; Hospital de Terrassa&#44; Terrassa&#58; Joaqu&#237;n Amador Amerigo&#46; <span class="elsevierStyleItalic">Valencian Community&#58;</span> Hospital General Universitario de Alicante&#44; Alicante&#58; Jos&#233; C&#225;novas Robles&#44; M&#243;nica D&#237;az Barranco and Francisco &#193;ngel Jaime S&#225;nchez&#59; Hospital Universitario de la Ribera&#44; Alzira&#58; Lucia Arias Portaceli&#44; Ana Abalos Garc&#237;a&#44; Mart&#237;n Parejo Montell and Juan Fern&#225;ndez Cabrera&#59; Hospital General de Castell&#243;&#44; Castell&#243;n de la Plana&#58; Patricia Casero Roig&#44; Susana Altaba Tena and Amparo Ferr&#225;ndiz&#59; Hospital General de Elche&#44; Elche&#58; Jaime Latour P&#233;rez&#44; Eva de Miguel Balsa and Francisco Javier Coves Orts&#59; Hospital de Manises&#44; Manises&#58; M&#243;nica Talavera Peregrina&#46; Hospital Vega Baja&#44; Orihuela&#58; Cristina Portillo Requena&#59; Hospital de Requena&#44; Valencia&#58; Carlos Jos&#233; Folgado Bisbal&#59; Hospital de Sagunto&#44; Sagunto&#58; Regina Calvo Embuena&#59; Hospital Universitario de San Juan de Alicante&#44; San Juan de Alicante&#58; Cristina Molla Jim&#233;nez&#59; Cl&#237;nica Quir&#243;n de Valencia&#44; Valencia&#58; Javier Tornero L&#243;pez&#59; Hospital Arnau de Vilanova&#44; Valencia&#58; Mercedes Garc&#237;a&#44; Mois&#233;s Rico Sala&#44; Mercedes Garc&#237;a Sanz and Eugenia de la Fuente O&#8217;Connor&#59; Hospital Cl&#237;nico Universitario&#44; Valencia&#58; Ricardo Oltra Chord&#225;&#59; Hospital Universitario La Fe&#44; Valencia&#58; M&#46;&#170; Paz Fuset Cabanes&#44; Isabel Madrid L&#243;pez&#44; Karla Vacacela Cordova and Esther Villarreal Tello&#59; Hospital de Vinaros&#44; Vinar&#242;s&#58; M&#46;&#170; Desamparados Oliva Gimeno&#46; <span class="elsevierStyleItalic">Extremadura&#58;</span> Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#58; Eduardo Corchero&#44; Elena Gallego Curto&#44; Alberto Fern&#225;ndez Zapata and Abilio Arrasqueta Llanes&#59; Hospital Don Benito-Villanueva de la Serena&#58; Juan Diego Jim&#233;nez Delgado&#59; Hospital de M&#233;rida&#44; M&#233;rida&#58; Marcelo P&#233;rez Arriaga&#44; Mercedes Antona D&#237;ez and Guadalupe Borge Rodr&#237;guez&#59; Hospital Virgen del Puerto&#44; Plasencia&#58; Eva Guerra Nevado and Anton Arana Llanderal&#59; Hospital de Zafra&#44; Zafra&#58; Miguel Gonz&#225;lez Lar and Hilario Badiola Villa&#46; <span class="elsevierStyleItalic">Galicia&#58;</span> Hospital Xeral de Lugo&#44; Lugo&#58; Mar&#237;a Luisa Mart&#237;nez Rodr&#237;guez and Rebeca &#193;lvarez-Lata&#59; Complejo Hospitalario de Ourense&#58; Mar&#237;a Jos&#233; de la Torre and Rom&#225;n Rodr&#237;guez &#193;lvarez-Granada&#59; Hospital Miguel Dom&#237;nguez&#44; Pontevedra&#58; Ra&#250;l Jos&#233; Gonz&#225;lez Gonz&#225;lez&#46; <span class="elsevierStyleItalic">La Rioja&#58;</span> Hospital San Pedro&#44; Logro&#241;o&#58; M&#46;&#170; de la Concepci&#243;n Pav&#237;a Pesquera and Lidia Mart&#237;nez Camarero&#46; <span class="elsevierStyleItalic">Madrid&#58;</span> Hospital Universitario Pr&#237;ncipe de Asturias&#44; Alcal&#225; Henares&#58; Jos&#233; Andr&#233;s Cambronero Galache and Cristina Mart&#237;nez&#59; Hospital del Henares&#44; Coslada&#58; In&#233;s Torrej&#243;n P&#233;rez&#59; Hospital de Fuenlabrada&#44; Fuenlabrada&#58; Mercedes Rubio Regidor and Febechi Afamefule Afamefule&#59; Hospital Severo Ochoa&#44; Legan&#233;s&#58; Frutos del Nogal S&#225;ez&#59; Hospital La Moraleja&#44; Madrid&#58; Miguel &#193;ngel Palma Gamiz&#46; <span class="elsevierStyleItalic">Basque Country&#58;</span> Hospital de Cruces&#44; Barakaldo&#58; Katherine Garcia Castillo and Victoria Boado Varela&#46; <span class="elsevierStyleItalic">Asturias&#58;</span> Hospital San Agust&#237;n&#44; Avil&#233;s&#58; Josefa Rengel Jim&#233;nez&#46; <span class="elsevierStyleItalic">Murcia&#58;</span> Hospital Rafael M&#233;ndez&#44; Lorca&#58; Carlos Luis Albacete Moreno&#59; Hospital General Universitario Reina Sof&#237;a&#44; Murcia&#58; Francisco Felices Abad&#44; Isabel Cremades Naval&#243;n&#44; Lisa Ort&#237;n Katnich&#44; F&#225;tima Mart&#237;nez-Lozano Aranaga&#44; Jos&#233; Luis Espinosa Berenguel&#44; C&#233;sar Palaz&#243;n S&#225;nchez&#44; Mart&#237;n Vigil Velis and Carmen M&#46; Susarte Juli&#225;&#59; Hospital J&#46;M&#46; Morales Meseguer&#44; Murcia&#58; Manuel Jos&#233; P&#225;rraga Ram&#237;rez&#44; Jos&#233; Antonio Garc&#237;a Olivas and Jes&#250;s C&#225;novas Vera&#46;</p>"
            "etiqueta" => "Annex 1"
            "titulo" => "Investigators and centers participating in the survey 2010"
            "identificador" => "sec0050"
          ]
        ]
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span>-Value for the trend&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Low &#40;&#8804;108&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Medium &#40;109&#8211;140&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">High &#40;&#8805;141&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Age&#58; median &#40;</span><span class="elsevierStyleItalic"><span class="elsevierStyleBold">P</span></span><span class="elsevierStyleInf"><span class="elsevierStyleBold">25</span></span><span class="elsevierStyleItalic"><span class="elsevierStyleBold">P</span></span><span class="elsevierStyleInf"><span class="elsevierStyleBold">75</span></span><span class="elsevierStyleBold">&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">67 &#40;57&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;47&#46;5&#46; 60&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;63&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;72&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Females&#58; &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">138&#47;502 &#40;27&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#47;181 &#40;16&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#47;163 &#40;30&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#47;158 &#40;37&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Antecedents</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Active smoker &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">140&#47;543 &#40;26&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#47;194 &#40;51&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#47;170 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#47;179 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dyslipidemia &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">281&#47;543 &#40;51&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#47;194 &#40;51&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#47;170 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#47;179 &#40;55&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3641&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hypertension &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">353&#47;543 &#40;65&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&#47;194 &#40;52&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#47;170 &#40;66&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#47;179 &#40;77&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Diabetes &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">177&#47;543 &#40;32&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#47;194 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Angina &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">108&#47;543 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous infarction &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">56&#47;179 &#40;31&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous coronariography &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">114&#47;543 &#40;21&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36&#47;170 &#40;21&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">51&#47;179 &#40;28&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0006&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous coronary surgery &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#47;194 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0032&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Previous heart failure &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">35&#47;543 &#40;6&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#47;170 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26&#47;179 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Stroke &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">34&#47;543 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#47;194 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#47;170 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17&#47;179 &#40;9&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0562&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Peripheral arterial disease &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">37&#47;543 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#47;194 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#47;170 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18&#47;179 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;0075&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Chronic renal failure &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#47;543 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#47;194 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#47;170 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#47;179 &#40;15&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Presentation</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cardiac arrest &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">8&#47;543 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#47;194 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;170 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;179 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1664&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Heart rate&#58; median &#40;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">25</span></span><span class="elsevierStyleItalic">&#8211;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">75</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78 &#40;66&#46; 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;5 &#40;64&#46; 84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;65&#46; 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;70&#46;102&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Systolic BP upon admission in ICU median &#40;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">25</span></span><span class="elsevierStyleItalic">&#8211;P</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">75</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
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          "tablatextoimagen" => array:1 [
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                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="3" align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Low &#40;&#8804;108&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Medium &#40;109&#8211;140&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">High &#40;&#8805;141&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Aspirin in the first 24<span class="elsevierStyleHsp" style=""></span>h &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Clopidogrel &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">148&#47;170 &#40;87&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">152&#47;179 &#40;84&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3607&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-fractionated heparin &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#47;194 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#47;170 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;179 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5434&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LMWH &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">318&#47;543 &#40;58&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">117&#47;194 &#40;60&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#47;170 &#40;57&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103&#47;179 &#40;57&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5837&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fondaparinux &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#47;543 &#40;17&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#47;194 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#47;170 &#40;18&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#47;179 &#40;15&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;381&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AG IIb&#47;IIIa &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96&#47;543 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#47;194 &#40;19&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#47;170 &#40;21&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#47;179 &#40;12&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACEIs&#47;ARA &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">304&#47;543 &#40;56&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107&#47;194 &#40;55&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#47;170 &#40;57&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#47;179 &#40;55&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;9669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beta-blockers &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">277&#47;543 &#40;51&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#47;194 &#40;58&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#47;170 &#40;51&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#47;179 &#40;43&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beta-blockers &#40;excluding contraindication&#41; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">276&#47;476 &#40;58&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#47;178 &#40;63&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#47;154 &#40;56&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#47;144 &#40;52&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0504&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Calcium antagonists &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#47;543 &#40;9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#47;194 &#40;8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#47;170 &#40;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#47;179 &#40;11&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3406&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Statins &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">445&#47;543 &#40;82&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">166&#47;194 &#40;85&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144&#47;170 &#40;84&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">135&#47;179 &#40;75&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catheterization &#60;72<span class="elsevierStyleHsp" style=""></span>h &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">313&#47;543 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">121&#47;194 &#40;62&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103&#47;170 &#40;60&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#47;179 &#40;49&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVS &#40;including transfers&#41; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#47;543 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#47;194 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;170 &#40;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#47;179 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4137&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early PCI &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161&#47;543 &#40;29&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#47;194 &#40;32&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#47;170 &#40;31&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#47;179 &#40;25&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1905&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Invasive MV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;543 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;194 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;170 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#47;179 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1878&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Noninvasive MV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#47;543 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;194 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#47;170 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;179 &#40;5&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Echocardiogram &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">187&#47;543 &#40;34&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#47;194 &#40;34&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#47;170 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#47;179 &#40;40&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;2239&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab8655.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Drug treatment and diagnostic&#8211;therapeutic procedures according to baseline risk during admission to the Intensive Care Unit&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">No early catheterization&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Hospital with hemodynamics &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Bleeding risk factors</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3&#43; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Previous heart failure &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">History of renal failure</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Initial Killip class &#62;</span>1 <span class="elsevierStyleItalic">&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Troponin elevation &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5506&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "ACC&#47;AHA 2007 guidelines for the management of patients with unstable angina&#47;non-ST-elevation myocardial infarction&#58; a report of the American College of Cardiology&#47;American Heart Association Task Force on Practice Guidelines &#40;writing committee to revise the 2002 guidelines for the management of patients with unstable angina&#47;non-ST-elevation myocardial infarction&#41; developed in collaboration with the American College of Emergency Physicians&#44; the Society for Cardiovascular Angiography and Interventions&#44; and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine"
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                            2 => "E&#46;M&#46; Antman"
                            3 => "C&#46;R&#46; Bridges"
                            4 => "R&#46;M&#46; Califf"
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                      "titulo" => "Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;P&#46; Bassand"
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                    0 => array:2 [
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                      "titulo" => "Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data"
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                      "titulo" => "2011 ACCF&#47;AHA focused update incorporated into the ACC&#47;AHA 2007 guidelines for the management of patients with unstable angina&#47;non-ST-elevation myocardial infarction&#58; a report of the American College of Cardiology Foundation&#47;American Heart Association Task Force on Practice Guidelines developed in collaboration with the American Academy of Family Physicians&#44; Society for Cardiovascular Angiography and Interventions&#44; and the Society of Thoracic Surgeons"
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                      "titulo" => "Utilization of early invasive management strategies for high-risk patients with non-ST-segment elevation acute coronary syndromes&#58; results from the CRUSADE quality improvement initiative"
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                            4 => "A&#46;Y&#46; Chen"
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                      "titulo" => "Patterns of use and effectiveness of early invasive strategy in non-ST-segment elevation acute coronary syndromes&#58; an assessment by propensity score"
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                            1 => "G&#46; Permanyer-Miralda"
                            2 => "M&#46; Heras"
                            3 => "J&#46; Cunat"
                            4 => "E&#46; Civeira"
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ISSN: 21735727
Original language: English
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