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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Acute coronary syndrome &#40;ACS&#41; registries have been introduced in Spain&#44; making it possible to know the patient profile&#44; management practices and evolution of the disease during the period of the registry&#44; and allowing assessment of the impact of the adoption of clinical practice guides referred to ACS&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">1&#8211;5</span></a> The outcomes must be analyzed within a concrete time frame&#46; Furthermore&#44; the methodology underlying these registries is not homogeneous&#44; and comparisons of the results obtained therefore must be made with caution&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In our Autonomous Community &#40;the Balearic Islands&#41;&#44; the first data on acute myocardial infarction &#40;AMI&#41; were published by the IBERICA study &#40;Investigation&#44; Specific Search and Registry of Acute Coronary Ischemia &#91;<span class="elsevierStyleItalic">Investigaci&#243;n&#44; B&#250;squeda Espec&#237;fica y Registro de Isquemia Coronaria Aguda</span>&#93;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">7&#44;8</span></a> The IBERICA study was a population-based registry of patients with AMI documenting the data referred to hospital management in 7 Spanish regions&#46; The Hospital Acute Myocardial Infarction Registry Project &#40;<span class="elsevierStyleItalic">Proyecto de Registro de Infarto Agudo de Miocardio Hospitalario</span>&#44; PRIAMHO&#41; allowed periodic evaluation of the management of patients with AMI and&#44; in particular&#44; the use of reperfusion techniques&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">9&#44;10</span></a> The MASCARA study<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">11</span></a> and the ARIAM registry<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">3</span></a> &#40;Analysis of Delay in Acute Myocardial Infarction &#91;<span class="elsevierStyleItalic">An&#225;lisis del Retraso en el Infarto Agudo de Miocardio</span>&#93;&#41; in turn are important registries&#44; because they offered us a view of the management of ST-segment elevation acute coronary syndrome &#40;STE-ACS&#41;&#44; reflecting an increase in the use of invasive strategies&#46; A number of both national<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">12&#44;13</span></a> and international registries<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">14&#8211;16</span></a> have shown that the implementation of primary angioplasty &#40;PA&#41; programs results in shortened intervention times&#44; with improved outcomes in terms of patient mortality&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The IBERICA registry included individuals between 25 and 74 years of age residing on the island of Mallorca and treated due to AMI in both the public and private healthcare settings&#44; with a follow-up of 28 days&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">7</span></a> There was no concrete intervention program during the period of the registry &#40;1 June 1996 to 31 December 1998&#41;&#46; In March 2008 the Balearic Islands Infarction Code &#40;<span class="elsevierStyleItalic">C&#243;digo Infarto de les Illes Balears</span>&#44; CI-IB&#41; care program was launched from the public healthcare setting&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">17</span></a> The aim of this initiative was to afford immediate STE-ACS management based on mechanical revascularization as the first treatment option in the reference hospital&#46; A registry was carefully designed to document all the variables derived from the care process&#44; and was formalized by the legislation of the Autonomous Community&#46; An electronic format was used&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The present study comprises a comparative analysis of the data of the IBERICA registry and the CI-IB in patients with STE-ACS presenting an evolution of less than 24<span class="elsevierStyleHsp" style=""></span>h and admitted to Son Dureta University Hospital&#44; with the determination of differences in mortality after 28 days of follow-up following a decade of changes&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Design</span><p id="par0025" class="elsevierStylePara elsevierViewall">The IBERICA registry was designed as a prospective&#44; population-based&#44; continuous multicenter study of AMI involving individuals between 25 and 74 years of age residing in different areas of the Balearic Islands&#44; Castilla-La Mancha&#44; Catalonia&#44; Murcia&#44; Navarra&#44; the Basque Country and Valencia&#46; The study period was from 1 July 1996 to 31 December 1998&#46; During this period there were no consensus-based protocols&#44; and the hospital intervention strategy was fundamented upon the recommendations of the clinical practice guides of the American Heart Association&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">18</span></a> Quality control was established&#44; guaranteeing homogeneity of the methods and of the data collected&#46; The variables were recorded using non-electronic case report forms&#46; The investigators were trained and certified in the study coordinating center&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The CI-IB<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">17</span></a> is a prospective&#44; community-based&#44; continuous multicenter registry involving patients diagnosed with STE-ACS presenting an evolution of less than 24<span class="elsevierStyleHsp" style=""></span>h&#44; with activation of the Infarction Code&#44; and seen in any setting of the public healthcare network&#46; Within the intervention strategy&#44; a primary percutaneous coronary intervention model was defined&#44; establishing agreement of the protocols according to the clinical practice guides<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">19</span></a> with all the implicated physicians and Departments&#46; This registry was started on 1 March 2008&#46; The variables are recorded in electronic format in a core database managed by the public <span class="elsevierStyleItalic">Ib-Salut</span> service of the Balearic Islands&#46; In order to guarantee quality and homogeneity of data collection&#44; all the investigators participating in the field work were trained and placed in charge of follow-up&#44; data quality control and logistic support in the data monitoring processes&#46; No new variables have been added in either registry&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Study setting</span><p id="par0035" class="elsevierStylePara elsevierViewall">The Autonomous Community of the Balearic Islands has a population of 1&#44;106&#44;049 inhabitants&#46; A single reference hospital is available&#44; with a hemodynamics laboratory&#44; operating 24<span class="elsevierStyleHsp" style=""></span>h a day&#44; every day of the year&#46; The Coronary Unit&#44; ascribed to the Department of Intensive Care Medicine&#44; has 8 beds&#46; Up until November 2010&#44; the reference center was Son Dureta University Hospital&#44; which was replaced by Son Espases University Hospital&#44; opened in December 2010&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study population</span><p id="par0040" class="elsevierStylePara elsevierViewall">The IBERICA study only included patients between 25 and 74 years of age&#46; In order to allow comparison of the two cohorts&#44; inclusion was limited to those patients with STE-ACS of anterior and inferior location that met electrocardiographic reperfusion criteria in both periods&#44;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">18&#44;19</span></a> limiting the age to 25&#8211;74 years&#44; and comprising patients attended in the same reference hospital with a definitive diagnosis of AMI defined by myocardial enzyme values &#40;e&#46;g&#46;&#44; creatine kinase&#41; over twice the upper limit of normal&#44; and with a follow-up period of 28 days from the time of the event&#46; Patients from other centers were excluded&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Study variables</span><p id="par0045" class="elsevierStylePara elsevierViewall">The study variables were stratified into 5 groups&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Demographic characteristics&#58; age&#44; gender&#44; cardiovascular risk factors &#40;hypertension&#44; smoking&#44; dyslipidemia&#44; insulin-dependent diabetes mellitus&#44; non-insulin-dependent diabetes mellitus&#41;&#44; history of ischemic heart disease &#40;previous infarction or chest pain&#41; and Killip class<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">20</span></a> upon admission&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Reperfusion treatment&#58; fibrinolysis and PA&#46; The administration of aspirin&#44; beta-blockers and angiotensin converting enzyme inhibitors &#40;ACEIs&#41; was also documented&#46; The criteria for fibrinolysis in the IBERICA group were atypical chest pain for over 20<span class="elsevierStyleHsp" style=""></span>min&#44; with ST-segment elevation &#62;1<span class="elsevierStyleHsp" style=""></span>mm on two or more consecutive leads and within the first 24<span class="elsevierStyleHsp" style=""></span>h of evolution&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">18</span></a> The CI-IB registry considered activation of the Infarction Code with the aim of performing mechanical reperfusion when the ECG tracing showed an ST-segment elevation of &#62;1<span class="elsevierStyleHsp" style=""></span>mm on at least two limb leads&#44; or an elevation of at least 2<span class="elsevierStyleHsp" style=""></span>mm on two or more contiguous chest leads&#44; accompanied by typical chest pain for over 20<span class="elsevierStyleHsp" style=""></span>min within the first 12<span class="elsevierStyleHsp" style=""></span>h of evolution&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">19</span></a> Each patient was individualized after between 12 and 24<span class="elsevierStyleHsp" style=""></span>h&#46; In cases with an evolution of under three hours&#44; with non-availability of the hemodynamics room&#44; pre-hospital fibrinolysis was carried out in the medicalized ambulance &#40;061&#41;&#44; in the Emergency Care Department&#44; on in the Department of Intensive Care Medicine&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0060" class="elsevierStylePara elsevierViewall">The following time intervals were defined&#58; time from symptoms onset until the first diagnostic ECG&#44; and time from the first diagnostic ECG to reperfusion treatment&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Surgery was included as follow-up procedure 28 days after the event&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0070" class="elsevierStylePara elsevierViewall">The complications studied during follow-up were&#58; severe arrhythmias &#40;ventricular fibrillation or sustained ventricular tachycardia&#41;&#44; Killip class&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">20</span></a> stroke &#40;hemorrhagic and&#47;or ischemic&#41; and mechanical complications &#40;interventricular communication&#44; mitral valve rupture and free wall rupture&#41;&#46; Survival 28 days after the event was analyzed&#46; Discharged patients were contacted in the outpatient clinic or by telephone&#46;</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Ethical considerations</span><p id="par0075" class="elsevierStylePara elsevierViewall">The Research Ethics Committee did not consider the obtainment of informed consent to be necessary&#44; since the registries were anonymous&#46; Data dissociation was carried out to ensure anonymity&#44; eliminating any link capable of identifying the patient&#46; Confidentiality of the information was observed at all times as specified by Organic Act 15&#47;1999 of 13 December&#44; referred to Personal Data Protection&#44; and Act 41&#47;2002 of 14 November&#44; regulating patient autonomy and the rights and obligation referred to clinical documentation and information&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Statistical analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">A descriptive analysis was made of the variables&#44; calculating the mean and standard deviation &#40;SD&#41; in the case of quantitative variables with a normal distribution&#44; and the median and quartiles in those with a non-normal distribution&#46; Qualitative variables in turn were reported as frequencies and percentages&#44; with the corresponding 95&#37; confidence interval &#40;95&#37;CI&#41;&#46; The contrasting of hypotheses was based on the Student <span class="elsevierStyleItalic">t</span>-test&#44; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test and the chi-squared&#47;Fisher exact test&#44; respectively&#46; Survival was analyzed based on the Kaplan&#8211;Meier method for estimating the curves after 28 days&#44; and the log-rank test was used to compare both periods&#46; Multivariate analysis was also performed based on a Cox proportional hazards model to explore the relationship between the most relevant variables&#44; the prognostic and all the potentially confounding parameters&#44; and mortality up to 28 days&#46; In sum&#44; patient age&#44; gender&#44; diseases associated to cardiovascular risk and their treatment&#44; time from symptoms onset to first monitoring&#44; initial reperfusion treatment received&#44; severity upon admission &#40;Killip class&#41;&#44; and complications were analyzed&#46; The results were expressed as hazard ratios with the corresponding 95&#37;CI&#46; Statistical significance was considered for <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; The IBM<span class="elsevierStyleSup">&#174;</span> SPSS<span class="elsevierStyleSup">&#174;</span> version 22&#46;0 statistical package was used throughout&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Results</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Demographic characteristics</span><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 889 cases of AMI were recorded during the IBERICA-Mallorca study period&#44; and of these 442 met the inclusion criteria&#46; In the CI-IB registry we selected 847 consecutive patients with STE-ACS&#46; Of these&#44; 498 were included in the comparative analysis&#46; The demographic and clinical characteristics are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The median age was 64 years in the IBERICA period and 58 years in the CI-IB period&#44; with a predominance of males in both periods&#46; There was a greater proportion of patients with hypertension and dyslipidemia&#44; and a lesser proportion with previous angina and previous AMI&#44; in the group of patients corresponding to the CI-IB period&#46; No differences were observed in terms of the site of AMI or in Killip class upon admission&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Intervention times</span><p id="par0090" class="elsevierStylePara elsevierViewall">In the patients subjected to reperfusion treatment&#44; the introduction of the CI-IB led to shortening of the intervention times versus the IBERICA cohort&#46; A significant decrease was observed in the median interval between symptoms onset and first ECG &#40;90 vs 120<span class="elsevierStyleHsp" style=""></span>min&#44; respectively&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and in the interval between first ECG and fibrinolysis treatment &#40;35 vs 60<span class="elsevierStyleHsp" style=""></span>min&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Treatment</span><p id="par0095" class="elsevierStylePara elsevierViewall">The percentage of patients that received no reperfusion treatment was lower in the CI-IB than in the IBERICA cohort &#40;9&#46;2&#37; vs 45&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; In the CI-IB group we observed an increase in the use of beta-blockers &#40;76&#46;1&#37; vs 58&#46;5&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; ACEIs &#40;67&#46;5&#37; vs 39&#46;5&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and aspirin&#44; though in the latter case statistical significance was not reached&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Prognosis</span><p id="par0100" class="elsevierStylePara elsevierViewall">The in-hospital complications&#44; including malignant ventricular arrhythmias and the poorest Killip classes &#40;III&#8211;IV&#41; were similar in both periods &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The mortality rate after 28 days of follow-up was lower in the CI-IB cohort &#40;7&#46;2&#37; vs 12&#46;2&#37;&#59; hazard ratio 0&#46;560&#59; 95&#37;CI 0&#46;360&#8211;0&#46;872&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;010&#41;&#46; The survival curves are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; A Cox model was developed with the variables associated to mortality up to 28 days after the event &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">We also constructed Cox proportional hazards models referred to survival after 28 days corresponding to the CI-IB cohort versus the IBERICA group&#46; The hazard ratio for the period was 0&#46;658 &#40;95&#37;CI 0&#46;429&#8211;1&#46;009&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;055&#41; on adjusting for age and gender&#44; and 1&#46;597 &#40;95&#37;CI 0&#46;429&#8211;1&#46;009&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;156&#41; on introducing revascularization with fibrinolysis or PA &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">The results of this study reveal a positive evolution following introduction of the Infarction Code strategy in our Community&#44; with a decrease in mortality mainly due to a marked increase in the use of reperfusion treatment&#44; particularly PA&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Disease registries are useful because they evaluate the effects of treatment interventions&#44; and thus more closely reflect the real life working conditions&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">21</span></a> Assuming that registries are necessary and useful&#44; since they help determine the resource needs and the results of treatment&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">6</span></a> a relevant aspect of our registries is the fact that they compile data on a continuous and prospective basis&#44; in an attempt to reduce possible information bias&#44; complying with design and quality control criteria&#46; These features allow us to regard the two registries as cohort studies representative of the care of patients with STE-ACS in our region&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">On examining the demographic data we found males to predominate in both registries&#44; and the patients were moreover younger in the CI-IB cohort&#46; This could be attributed to the selection of younger patients sent to the reference hospital for reperfusion treatment with angioplasty&#44; and also to the numerous meetings with the public healthcare centers and emergency services involved to explain them the importance of immediate identification and management of these patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The divergent data obtained regarding the risk factors could be due to changes in criteria&#44; though the selection of cases may have exerted an influence&#46; According to the data of the CORSAIB registry&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">22</span></a> the prevalence of hypertension and hypercholesterolemia in the population between 35 and 75 years of age in the Balearic Islands is 47&#37; and of 24&#37;&#44; respectively&#46; The increase in prevalence of these risk factors in patients of the CI-IB cohort could be due to a change in the cutoff point defining hypercholesterolemia&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">23</span></a> In this analysis&#44; it should be mentioned that despite the smoking cessation campaigns&#44; the percentage of smokers was not reduced in the patients with STE-ACS&#46; The decrease in patients with a history of ischemic heart disease during the CI-IB period could be attributed to the progressive introduction of mechanical reperfusion as a therapeutic option starting in 2003&#44; and to secondary prevention measures&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">24&#44;25</span></a> Primary prevention with an increased use of statins possibly could contribute to reduce the number of ischemic events and modify the form of clinical presentation&#44; with a progressive increase in the number of patients suffering non-ST-segment elevation acute coronary syndrome versus those with STE-ACS&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">26&#44;27</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">The clinical characteristics upon admission were similar in both cohorts&#46; The intervention time interval or delay is one of the parameters used to assess the quality of management in the emergency care setting&#46; In the present study&#44; the CI-IB cohort showed clear improvements in the intervals both from symptoms onset to the first diagnostic ECG tracing and from the first diagnostic ECG tracing to reperfusion treatment&#46; The main reasons for this shortening of intervals could be improved health education&#59; certain qualitative aspects in electrocardiographic diagnosis such as the introduction of a telephone-based ECG transmission application<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">28</span></a>&#59; the maintenance of care dynamics as a key element in CI-IB&#59; and improved efficacy in the decision making process on the part of the out-hospital and in-hospital emergency care services&#46; In this regard&#44; the concept of single three-party telephone contact among the attending physician &#40;at the side of the patient&#41;&#44; the coordinator of the 061 service&#44; and the hemodynamist on duty makes an extremely important contribution to improve intervention efficacy&#46; These results are consistent with those found in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">24&#44;29</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Independently of the different proportions in thrombolysis and mechanical revascularization seen on comparing both periods&#44; an aspect which we consider to be important in our analysis is the significant decrease in patients who did not received reperfusion treatment during the interval 2008&#8211;2010&#46; This finding highlights the great implication and adherence to protocol of the different professionals implicated in the acute ischemic heart disease management program&#46;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">30&#44;31</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In our study&#44; we observed an increased use of beta-blockers and angiotensin converting enzyme inhibitors in the CI-IB cohort &#8211; the percentages being higher than in other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">11&#44;32</span></a> This difference may be due to increased adherence to the recommendations of the clinical practice guides on one hand&#44; and to the efforts to improve and homogenize management in the CI-IB through use of the registry on the other&#46; Aspirin is considered a fundamental part of treatment in AMI with ST-segment elevation&#46; Its use was slightly more prevalent in the CI-IB cohort and more frequent than in other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">30&#8211;32</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The main aspect deserving comment in our analysis is the decrease in 28-day mortality risk in the CI-IB cohort&#46; The mortality rate was approximately twice as high in the IBERICA study&#46; Our results are comparable to those of other both national<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">33&#8211;35</span></a> and international studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">36&#44;37</span></a> A number of factors could contribute to this difference&#46; Firstly&#44; mention must be made of the importance of early revascularization therapy and the increase in the percentage of patients that receive such treatment in the invasive strategy-based program&#46; Secondly&#44; the observed shortening in times to reperfusion treatment would also be a contributing factor&#46; Lastly&#44; there may be differences in the medical management profile&#44; with an increased use of new antiplatelet drugs in the later registry&#46; The validity of these results must be examined with caution&#44; however&#44; since the data come from two cohorts where the main limitation is vulnerability to confounding factors and possible patient screening bias &#8211; the analysis being limited to those patients admitted to the Department of Intensive Care Medicine and assisted in the reference hospital with the availability of a hemodynamics unit 24<span class="elsevierStyleHsp" style=""></span>h a day&#46;</p><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Study limitations</span><p id="par0155" class="elsevierStylePara elsevierViewall">Comparisons between registries have important limitations&#44; due to differences in the populations involved and in the inclusion criteria used&#46; One of the important aspects of our study is that both registries represented exhaustive and consecutive cohorts of patients admitted alive to intensive care with ST-segment elevation&#46; This has been an observational single-center study&#44; and although the variables were documented on a prospective basis in both periods&#44; certain differences in definition may have conditioned the results obtained&#46; We consider that the findings of both registries illustrate the care process in the studied periods&#44; though their comparative analysis may be conditioned by some limitations&#46; On one hand&#44; we cannot rule out the existence of bias referred to both the patient screening criteria and the exclusion criteria&#44; fundamentally referred to the electrocardiographic reperfusion criteria used in the two periods&#46; On the other hand&#44; there may have been confounding variables related to the evolution of infarction from symptoms onset&#44; or to the care process used&#44; in the comparative analysis&#46; Likewise&#44; we do not know the efficacy of fibrinolytic treatment&#44; particularly in the IBERICA cohort&#46; These considerations mean that interpretation of the clinical results must be made with caution&#46; Nevertheless&#44; we believe that introduction of the invasive strategy program in STE-ACS produced the greatest difference in results between the two study periods&#46;</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">The 28-day mortality rate in STE-ACS has decreased over the last decade in Mallorca&#44; mainly as a result of increased reperfusion treatment with PA&#44; and a shortening of the reperfusion times&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Conflict of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors have received no financial support of any kind for carrying out this study&#46; Likewise&#44; no agreements resulting in benefits or payments for the authors have been signed with any commercial entity&#46;</p></span></span>"
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              "titulo" => "Demographic characteristics"
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            1 => array:2 [
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            0 => "Acute coronary syndrome with ST elevation"
            1 => "Acute myocardial infarction"
            2 => "Infarction Code"
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            1 => "Infarto agudo de miocardio"
            2 => "C&#243;digo Infarto"
            3 => "Programa asistencial"
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To investigate the differences in mortality at 28 days and other prognostic variables in 2 periods&#58; IBERICA-Mallorca &#40;1996&#8211;1998&#41; and Infarction Code of the Balearic Islands &#40;IC-IB&#41; &#40;2008&#8211;2010&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Two observational prospective cohorts&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Hospital Universitario Son Dureta&#44; 1996&#8211;1998 and 2008&#8211;2010&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Acute coronary syndrome with ST elevation of &#8804;24<span class="elsevierStyleHsp" style=""></span>h of anterior and inferior site&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Main variables of interest</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Age&#44; sex&#44; cardiovascular risk factors&#44; site of AMI&#44; time delays&#44; reperfusion therapy with fibrinolysis and primary angioplasty&#44; administration of acetylsalicylic acid&#44; beta blockers and angiotensin converting enzyme inhibitors&#46; Killip class&#44; malignant arrhythmias&#44; mechanical complications and death at 28 days were included&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Four hundred and forty-two of the 889 patients included in the IBERICA-Mallorca and 498 of 847 in the IC-IB were analyzed&#46; The site and Killip class on admission were similar in both cohorts&#46; The main significant difference between IBERICA and IC-IB group were age &#40;64 vs&#46; 58 years&#41;&#44; prior myocardial infarction &#40;17&#46;9 vs&#46; 8&#46;1&#37;&#41;&#44; the median symptoms to first ECG time &#40;120 vs&#46; 90<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; median first ECG to fibrinolysis time &#40;60 vs&#46; 35<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; fibrinolytic therapy &#40;54&#46;8 vs&#46; 18&#46;7&#37;&#41;&#44; patients without revascularization treatment &#40;45&#46;9 vs&#46; 9&#46;2&#37;&#41;&#44; primary angioplasty &#40;1&#46;0&#37; vs&#46; 92&#46;0&#37;&#41;&#46; The mortality at 28 days was lower in the IC-IB &#40;12&#46;2 vs&#46; 7&#46;2&#37;&#59; hazard ratio 0&#46;560&#59; 95&#37; CI 0&#46;360&#8211;0&#46;872&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;010&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The 28-day mortality in acute coronary syndrome with ST elevation in Mallorca has declined in the last decade&#44; basically due to increased reperfusion therapy with primary angioplasty and reducing delays time to reperfusion&#46;</p></span>"
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            "titulo" => "Objective"
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            "titulo" => "Design"
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        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Investigar las diferencias en la mortalidad a 28 d&#237;as y otras variables pron&#243;sticas en 2 periodos&#58; IBERICA-Mallorca &#40;1996&#8211;1998&#41; y C&#243;digo Infarto-Illes Balears &#40;CI-IB&#41; &#40;2008&#8211;2010&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Dise&#241;o</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Dos cohortes prospectivas observacionales&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">&#193;mbito</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Hospital Universitario Son Dureta&#44; 1996&#8211;1998 y 2008&#8211;2010&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Pacientes</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">S&#237;ndrome coronario agudo con elevaci&#243;n de ST de<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>24<span class="elsevierStyleHsp" style=""></span>h&#44; de localizaci&#243;n anterior e inferior&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Variables principales de inter&#233;s</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Edad&#44; sexo&#44; factores de riesgo cardiovascular&#44; localizaci&#243;n&#44; tiempos de actuaci&#243;n&#44; tratamiento de reperfusi&#243;n con fibrin&#243;lisis y angioplastia primaria&#44; administraci&#243;n de &#225;cido acetilsalic&#237;lico&#44; betabloqueantes e inhibidores de la enzima conversora de la angiotensina&#46; Se incluyeron el grado de Killip&#44; las arritmias malignas&#44; las complicaciones mec&#225;nicas y el fallecimiento a los 28 d&#237;as&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 442 pacientes de los 889 incluidos en el IBERICA-Mallorca y 498 de los 847 registrados en el CI-IB&#46; La localizaci&#243;n y el Killip fueron similares en ambas cohortes&#46; Las principales diferencias significativas entre el grupo IBERICA y el CI-IB fueron&#58; edad &#40;64 vs&#46; 58 a&#241;os&#41;&#44; infarto previo &#40;17&#44;9 vs&#46; 8&#44;1&#37;&#41;&#44; tiempo s&#237;ntomas-primer ECG &#40;120 vs&#46; 90<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; tiempo primer ECG-fibrin&#243;lisis &#40;60 vs&#46; 35<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; tratamiento fibrinol&#237;tico &#40;54&#44;8 vs&#46; 18&#44;7&#37;&#41;&#44; pacientes sin reperfusi&#243;n &#40;45&#44;9 vs&#46; 9&#44;2&#37;&#41;&#44; angioplastia primaria &#40;1&#44;0 vs&#46; 92&#44;0&#37;&#41;&#46; La mortalidad a los 28 d&#237;as fue inferior en el CI-IB &#40;12&#44;2 vs&#46; 7&#44;2&#37;&#59; hazard ratio 0&#44;560&#59; IC 95&#37; 0&#44;360&#8211;0&#44;872&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;010&#41;&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusi&#243;n</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">La mortalidad a los 28 d&#237;as en el s&#237;ndrome coronario agudo con elevaci&#243;n de ST en Mallorca ha disminuido en la &#250;ltima d&#233;cada&#44; probablemente debido a un mayor tratamiento de reperfusi&#243;n con angioplastia primaria y a una reducci&#243;n de los tiempos de reperfusi&#243;n&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">The names of the members of the CI-IB and IBERICA Research Group are listed in <a class="elsevierStyleCrossRef" href="#sec0090">Annex I</a>&#46;</p>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Socias L&#44; Frontera G&#44; Rubert C&#44; Carrillo A&#44; Peral V&#44; Rodriguez A&#44; et al&#46; An&#225;lisis comparativo de 2 registros de infarto agudo de miocardio tras una d&#233;cada de cambios&#46; Estudio IBERICA &#40;1996&#8211;1998&#41; y C&#243;digo Infarto-Illes Balears &#40;2008&#8211;2010&#41;&#46; Med Intensiva&#46; 2016&#59;40&#58;541&#8211;549&#46;</p>"
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            "apendice" => "<p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Group of investigators of the IBERICA-Mallorca registry</span>&#58; Armando Bethencourt&#44; Jos&#233; Carrasco&#44; Miguel Fiol&#44; Jos&#233; Francisco Forteza&#44; Alfredo G&#243;mez&#44; Jer&#243;nimo Grau&#44; Miguel Ribas&#44; Antonio Rodr&#237;guez&#44; Joan Soler&#44; Salvador Solivellas&#44; Miguel Triola&#44; Jorge Orellana&#44; Pedro Ib&#225;&#241;ez&#44; Enrique Sospedra&#44; Gabriel Redondo&#44; Silvia Carretero&#44; Magdalena Esteva&#44; Jaime Bergad&#225;&#44; Jos&#233; Ignacio Ayestar&#225;n&#44; Catalina Rubert&#44; Josefina Guti&#233;rrez&#44; Francisco Alberti&#44; Ana Rotger&#44; Elena Bosch&#44; Antonio Nicolau and Bernardo Vidal&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Group of investigators of the CI-IB registry&#58;</span> Miquel Fiol&#44; Armando Bethencourt&#44; Andr&#233;s Carrillo&#44; Carlos Fernandez Palomeque&#44; Vicente Peral&#44; Alberto Rodr&#237;guez&#44; Cristina Royo&#44; Mireia Ferreruela&#44; Alfredo G&#243;mez&#44; Rosa Gonz&#225;lez&#44; Marcos Pascual&#44; Mar Alameda &#40;Hospital Universitario Son Espases&#41;&#59; Catalina Rubert&#44; Lorenzo Socias&#44; Catalina Forteza&#44; Joan Torres&#44; Tom&#225;s Ripoll &#40;Hospital Son Ll&#224;tzer&#41;&#59; Ram&#243;n Fern&#225;ndez Cid &#40;Hospital Fundaci&#243; Mateu Orfila&#41;&#59; Sebasti&#225;n Roig&#44; Marga Vilar&#44; Bernardo Garc&#237;a de la Villa &#40;Hospital Manacor&#41;&#59; Marta Generelo &#40;Hospital de Inca&#41;&#59; I&#241;aki Unzaga&#44; Inma Prieto&#44; Juana Mar&#237;a Vidal &#40;SAMU 061&#41;&#59; Guillem Frontera &#40;IdISPa&#41;&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">IB-Salut&#58;</span> Joan Pou&#44; Luis Alegre&#44; Antonia Salv&#225;&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Information Technology Department &#40;OTIC&#41;&#58;</span> Carlos Juan Bermell&#44; Sergio Su&#225;rez&#44; Gabriel Pic&#243;&#44; Luis F&#46; Manzanero&#46; <span class="elsevierStyleItalic">Alamo Consulting&#58;</span> C&#233;sar Aparicio&#44; Marc sansalvador&#44; Sara Serrano&#44; Luis Riesco&#46;</p>"
            "etiqueta" => "Annex I"
            "titulo" => "Group of investigators of the IBERICA and CI-IB registries"
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival analysis after 28 days&#46;</p>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">PTCA&#58; percutaneous transluminal coronary angioplasty&#59; CI-IB&#58; Balearic Islands Infarction Code&#59; ECG&#58; electrocardiogram&#59; AMI&#58; acute myocardial infarction&#59; IBERICA&#58; Investigation&#44; Specific Search and Registry of Acute Coronary Ischemia&#59; ACEIs&#58; angiotensin converting enzyme inhibitors&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IBERICA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">498&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;50&#8211;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gender&#44; males &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">359 &#40;81&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">413 &#40;82&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">History of disease&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">194 &#40;44&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">245 &#40;49&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dyslipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">119 &#40;28&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">197 &#40;39&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">217 &#40;49&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">255 &#40;51&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;461&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Type 1 diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Type 2 diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120 &#40;17&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;906&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Previous AMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79 &#40;17&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;8&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Previous angina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">192 &#40;43&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Location&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">229 &#40;51&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">249 &#40;50&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;625&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Anterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">203 &#40;45&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">236 &#40;47&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;702&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not classifiable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;894&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Killip class upon admission &#8805;2&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108 &#40;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115 &#40;23&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;616&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Intervention times&#44; median &#40;p25</span>&#8211;<span class="elsevierStyleItalic">p75&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Symptoms onset-first ECG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120 &#40;60&#8211;240&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90 &#40;49&#8211;180&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>First ECG-fibrinolysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#40;30&#8211;115&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#40;20&#8211;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>First ECG-PTCA &#40;balloon&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98 &#40;74&#8211;146&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Administered medication&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fibrinolytic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">235 &#40;53&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93 &#40;18&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Aspirin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">415 &#40;93&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">479 &#40;96&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Beta-blockers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">258 &#40;58&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">348 &#40;76&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACEIs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">154 &#40;39&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">309 &#40;67&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Without revascularization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">203 &#40;45&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#40;9&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Procedures&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary angioplasty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">359 &#40;72&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Echocardiogram&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">380 &#40;86&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">470 &#40;95&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Complications of hospitalization&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Severe arrhythmias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71 &#40;16&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;416&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Killip &#8805;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">155 &#40;35&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">188 &#40;37&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mechanical complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;029&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Stroke&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mortality after 28 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">HR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37;CI for HR</th><th class="td" title="table-head  " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lower&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Time symptoms onset-first ECG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Revascularization treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primary angioplasty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;436&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;776&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fibrinolysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;602&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;488&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;505&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;602&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Killip class &#8805;2 upon admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;698&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Severe arrhythmias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;994&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;861&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;147&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">HR&#58; hazard ratio&#59; 95&#37;CI&#58; 95&#37; confidence interval</p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Model 1&#58; adjusted for age and gender&#46;</p><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Model 2&#58; model 1 plus dyslipidemia&#44; smoker&#44; type 1 diabetes&#44; type 2 diabetes&#44; previous AMI and previous angina&#46;</p><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Model 3&#58; model 2 plus fibrinolysis and primary angioplasty&#46;</p><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Model 4&#58; model 3 plus severe arrhythmias&#44; Killip class &#8805;2 and Killip class &#8805;2 upon admission&#46;</p>"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;658&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;429&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;055&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Model 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;709&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;447&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;126&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Model 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;941&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;909&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Model 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;597&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;836&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;156&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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            3 => array:3 [
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            5 => array:3 [
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            6 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Variability in the in-hospital management of acute myocardial infarction in Spain&#46; IBERICA study &#40;Investigaci&#243;n&#44; B&#250;squeda Espec&#237;fica y Registro de Isquemia Coronaria Aguda&#41; Spanish"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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            7 => array:3 [
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              "etiqueta" => "8"
              "referencia" => array:1 [
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                  "host" => array:1 [
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                        "fecha" => "2005"
                        "editorial" => "Departamento de Biolog&#237;a Fonamental i Ci&#232;ncias de la Salut&#46; Universidad de Les Illes Balears"
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            8 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
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        "identificador" => "xack260623"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0170" class="elsevierStylePara elsevierViewall">The authors thank Dr&#46; Jaume Marrugat&#44; of the Institut Municipal d&#8217;Investigaci&#243; M&#232;dica de Barcelona&#44; for his comments and support with the IBERICA registry data&#46;</p> <p id="par0175" class="elsevierStylePara elsevierViewall">We thank the investigators of the CI-IB and IBERICA registries &#40;see <a class="elsevierStyleCrossRef" href="#sec0090">Annex I</a>&#41; for their interest&#44; effort and dedication&#59; development of the study and data compilation would not have been possible without their contribution&#46;</p> <p id="par0180" class="elsevierStylePara elsevierViewall">Thanks are due to the <span class="elsevierStyleItalic">Conseller&#237;a de Salut</span> for its constant support of the project&#46;</p> <p id="par0185" class="elsevierStylePara elsevierViewall">We also wish to thank the OTIC &#40;Information Technology Department of the <span class="elsevierStyleItalic">Servicio de Salut</span>&#41; for software support and maintenance&#58; Carlos Juan Bermell&#44; Sergio Su&#225;rez&#44; Gabriel Pic&#243;&#44; Luis F&#46; Manzanero&#46; Thanks are also due to the Alamo Consulting Department&#58; C&#233;sar Aparicio&#44; Marc Sansalvador&#44; Sara Serrano&#44; Luis Riesco&#46;</p>"
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