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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years&#44; there has been an increase in the number of patients requiring a surgical intervention or invasive diagnostic or therapeutic procedure&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a> And given the longer life expectancy in Western countries&#44; with the consequent increase in the prevalence of patients with cardiovascular disease requiring antiplatelet therapy&#44; it is increasingly common for many of these patients undergoing invasive procedures to be receiving these drugs prior to the intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> Moreover&#44; their use&#44; usually in secondary prevention of atherothrombotic disease&#44; has multiplied&#44; given the increase in percutaneous coronary intervention procedures and the results of most studies recommending their prolongation&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3&#8211;5</span></a> The decision to withdraw or maintain antiplatelet therapy is determined by the relationship between the patient&#39;s thrombotic risk and the bleeding risk of the intervention&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">6&#8211;8</span></a> Discontinuation may increase the risk of ischemic events&#44; while maintenance may increase the risk of major bleeding&#46; To avoid this risk&#44; it is important to know the indications and the exact timing of discontinuation&#44; if required&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">There are various consensus documents and statements on the use of antiplatelet drugs in the perioperative period in different situations&#44; which have attempted to simplify decision-making in clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">9&#8211;12</span></a> These include a national consensus document coordinated by the Working Group on Cardiovascular Thrombosis of the Spanish Society of Cardiology and certified by more than 20 Spanish scientific societies on the perioperative&#47;periprocedural use of antithrombotic drugs&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> These recommendations are close similar to those of the more recently published 2022 ESC guidelines on patients undergoing non-cardiac surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> Despite these recommendations&#44; the &#8220;real world&#8221; impact of patients treated with antiplatelet drugs requiring intervention is unknown&#46; A recent Spanish study&#44; the REQXAA registry&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">15</span></a> has analyzed the incidence of inappropriate management of antithrombotic drugs &#40;antiplatelet and anticoagulant&#41; globally in this situation&#44; finding an inappropriate use rate of 42&#46;7&#37; and a higher incidence of thrombotic and hemorrhagic events and total mortality in the inappropriate management group&#46; The aim of the present study is to specifically analyze the correct or incorrect adherence to the recommendations for antiplatelet agents in a population of patients undergoing surgery&#47;procedures&#44; and to evaluate the implication of their withdrawal or maintenance on the incidence of adverse cardiovascular and&#47;or hemorrhagic events&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">The REQXAA registry &#40;Registro Espa&#241;ol sobre el manejo periCirugia&#47;periprocedimiento de los f&#225;rmacos Anticoagulantes y Antiagregantes&#41; is an observational&#44; prospective&#44; multicentre study of patients on antithrombotic treatment requiring surgery or an invasive diagnostic or therapeutic procedure&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">15</span></a> This study analyses patients with antiplatelet therapy included in the REQXAA&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study population</span><p id="par0020" class="elsevierStylePara elsevierViewall">Patients aged<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>18 years undergoing any type of intervention &#40;surgery or procedure&#41; on chronic treatment with at least one antiplatelet drug &#40;acetylsalicylic acid&#44; clopidogrel&#44; prasugrel&#44; ticagrelor&#41; were included&#46; Exclusion criteria were lack of informed consent and&#47;or inability to follow up for 30 days after the intervention&#46; Patients with associated anticoagulant therapy were also excluded for this analysis&#46; Demographic data&#44; medical history&#44; laboratory values and concomitant medication were obtained from the anamnesis and medical history of the patients prior to the intervention&#46; The thrombotic risk of the patient and the bleeding risk of the procedure were defined according to the recommendations of the Spanish consensus document already described&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> In summary&#44; patient thromboembolic risk was defined according to CHA2DS2-VASC score for atrial fibrillation&#44; location of valve prostheses and associated comorbidities&#44; angiographic data &#40;type of coronary stent&#41; and time since the previous acute event &#40;acute coronary syndrome&#44; stroke&#44; venous thromboembolic disease&#41; that indicated antiplatelet therapy&#46; Bleeding risk was considered according to the consequences that a possible hemorrhage could entail high&#44; if it would compromise the patient&#39;s life or the outcome of surgery&#59; moderate&#44; if it could increase the risk of transfusion or reoperation&#59; and low if it was potentially controllable&#46; Whether or not the antiplatelet drug was continued&#44; the time of discontinuation until the procedure&#44; the use or not of bridging therapy&#44; as well as the time of reintroduction were recorded&#46; Perioperative use of antiplatelet therapy was at the discretion of the physician responsible for the patient&#44; with no intervention by the investigators in the decision to discontinue&#44; maintain and reintroduce therapy&#46; Clinical follow-up was conducted during the first 30 days after surgery and the incidence of adverse events was recorded&#46; The study was designed to recruit all consecutive patients meeting the inclusion&#47;exclusion criteria for 1 year&#46; However&#44; due to the difficulties that the COVID-19 pandemic posed for patient inclusion and follow-up&#44; the coordinating committee decided to extend the registry by 2 years&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The study was conducted in accordance with the Declaration of Helsinki&#44; was approved by the Ethics Committee of the Hospital Cl&#237;nico San Carlos de Madrid and was authorized by the other participating centers&#46; All patients agreed to participate in writing by signing the informed consent form for participation in the study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The primary objective of the study was the incidence of the net clinical adverse event at 30 days after the intervention&#44; defined as the composite of&#58; all-cause mortality&#44; non-fatal myocardial infarction&#44; coronary stent thrombosis&#44; non-fatal ischemic stroke&#44; peripheral embolism&#44; venous thromboembolic disease and&#47;or bleeding complications of grade<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 according to the BARC classification&#46; The secondary objective of the study was to compare the incidence of adverse events according to the appropriateness of perioperative&#47;periprocedural antiplatelet therapy&#44; defined according to the recommendations of the Spanish consensus document&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> The criteria for defining the subgroups of appropriate and inappropriate management of antiplatelet therapy were derived from the Spanish consensus document mentioned above&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> considering the patient&#39;s ischemic risk and the bleeding risk of the intervention or procedure&#46; In summary&#44; the consensus document proposes to limit the use of bridging therapy to patients at high thromboembolic risk&#44; to maintain periprocedural acetylsalicylic acid in almost all interventions &#40;except for neurosurgery&#41; and to consider maintaining dual antiplatelet therapy in surgeries with low hemorrhagic risk&#46; The appropriate&#47;inappropriate use of antiplatelet therapy was assessed by independent investigators using the QxAApp web application&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> developed to implement the recommendations of the Spanish consensus document&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">Categorical variables are presented as counts &#40;percentages&#41; and continuous variables are summarized as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or median &#40;interquartile range&#41; according to their distribution&#44; that was assessed using the Shapiro&#8211;Wilk test and <span class="elsevierStyleItalic">Q</span>&#8211;<span class="elsevierStyleItalic">Q</span> plots&#46; Between-group comparisons were performed by using the Chi-squared test or the Fisher&#39;s exact test for categorical data and the Student&#39;s <span class="elsevierStyleItalic">t</span>-test or the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test for continuous data&#44; as appropriate&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">To estimate the effect of inappropriate management on clinical adverse events&#44; odds ratios were obtained from logistic regression models using an inverse probability of treatment weighting &#40;IPTW&#41;-based approach<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a> Propensity scores &#40;PS&#41; were calculated using a logistic regression analysis that modeled the probability of inappropriate management on 29 baseline covariates that included demographics&#44; cardiovascular risk factors&#44; bleeding related variables&#44; and antithrombotic treatment&#46; Inappropriate management was assigned a stabilized weight of 1&#47;PS and appropriate management a stabilized weight of 1&#47;1-PS&#46; Standardized mean differences before and after the weighting were used to evaluate the balance of the groups regarding the covariates&#46; A difference below 0&#46;1 was considered to indicate good balance&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A multivariable logistic regression analysis including clinical and treatment covariates was conducted to examine independent factors associated with receiving an inappropriate management&#46; The model was tested for collinearity and was built using backward stepwise elimination&#44; initially including clinically relevant variables and those with a <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;100 in the univariable models&#46; Statistical analyses were performed using R software &#40;version 4&#46;2&#46;1&#59; R Foundation for Statistical Computing&#44; Vienna&#44; Austria&#41;&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Baseline features</span><p id="par0050" class="elsevierStylePara elsevierViewall">During the period May 2020&#8211;May 2022&#44; 682 patients were included&#46; Complete valid data during the peri-operative&#47;peri-procedural period was available for 667 patients&#44; with 15 lost due to missing follow-up data&#46; Of the 667 patients&#44; 24 were also excluded because they were taking associated oral anticoagulants&#46; Therefore&#44; 643 patients were finally included in the analysis&#46; Follow-up data during the first 30 days after surgery were therefore obtained in 97&#46;2&#37; of the patients&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the baseline characteristics of the overall sample and the comparison between the subgroups of appropriate and inappropriate management of antiplatelet therapy&#46; Mean age was 70&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;3 years and 31&#46;9&#37; of the overall sample were women&#46; The prevalence of cardiovascular risk factors and comorbidities was high &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; A history of stroke was found in 21&#46;7&#37; of patients&#44; coronary heart disease in 44&#46;9&#37;&#44; atrial fibrillation in 11&#46;9&#37;&#44; peripheral vascular disease in 23&#46;0&#37; and heart failure in 13&#46;1&#37;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the antithrombotic treatments received by the patients and the categories of thrombotic and hemorrhagic risk&#46; Of all patients&#44; 85&#46;3&#37; received simple antiplatelet therapy&#44; mainly aspirin at a dose of 100<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#44; and 20&#46;3&#37; clopidogrel&#46; The use of prasugrel or ticagrelor was infrequent &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Thrombotic risk was low in 74&#46;3&#37; of cases&#44; moderate in 14&#46;8&#37; and high in only 11&#46;9&#37;&#46; The bleeding risk of the intervention was low in 51&#46;6&#37; of cases&#44; moderate in 32&#46;9&#37; and high in 15&#46;5&#37; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Management of perioperative&#47;periprocedural antiplatelet treatment</span><p id="par0055" class="elsevierStylePara elsevierViewall">The management of peri-procedural&#47;peri-operative antiplatelet therapy was considered appropriate in 397 patients &#40;61&#46;7&#37;&#41; and inappropriate in 246 &#40;38&#46;3&#37;&#41;&#46; Of these 246 cases of inappropriate management&#44; 25&#46;8&#37; were due to failure to discontinue antiplatelet therapy when it should have been discontinued&#44; 1&#46;4&#37; due to late withdrawal and 72&#46;8&#37; due to discontinuation in cases in which they should not have been stopped&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the comparison of baseline characteristics in both groups of patients&#46; Those with inappropriate management tended to be more often female&#44; and had a higher prevalence of hypertension&#44; previous stroke&#44; heart failure&#44; anemia and liver failure&#44; and a lower prevalence of coronary heart disease &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the comparison between the two groups in relation to previous treatment and thrombotic and hemorrhagic risk&#46; Inappropriately managed patients were less frequently receiving aspirin&#44; more often clopidogrel and dual antiplatelet therapy&#44; and were more often at high bleeding risk&#46; Thrombotic risk was similar in both groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the univariable and multivariable logistic regression models for inappropriate management&#46; Female sex&#44; history of hypertension&#44; prior stroke&#44; prior heart failure&#44; double antiaggregant therapy and concomitant use of oral anticoagulants were independent predictors of inappropriate management in the multivariable study&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Incidence of events at 30 days and predictors of the primary composite event</span><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> &#40;graphical abstract&#41; shows the main features and results of our study&#46; The incidence of the combined event defined as the primary endpoint of the study during the first 30 days after surgery was 7&#46;4&#37; &#40;48 patients&#41;&#44; being significantly more frequent in the inappropriate management group &#40;12&#46;1&#37; versus 5&#46;0&#37;&#41;&#46; There were no differences according to the cause of inappropriate management&#44; inadequate withdraw or inadequate maintenance&#46; Odds ratio was 2&#46;63 &#40;95&#37; IC 1&#46;42&#8211;4&#46;60&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001 in the non-adjusted model&#41;&#46; In addition&#44; the effect of inappropriate management on the primary composite endpoint was calculated using an IPTW-adjusted logistic regression model&#46; The propensity score included 29 baseline covariates &#40;demographics&#44; cardiovascular risk factors&#44; bleeding related variables&#44; and antithrombotic treatment&#41; that showed an excellent balance after the weighting&#44; with standardized mean differences<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&#46; Covariate balance before and after the weighting is shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; In the IPTW-adjusted model&#44; inappropriate periprocedural antiplatelet drug treatment management continued to be associated with a significant increase of the primary combined endpoint &#40;OR&#58; 2&#46;53&#46; 95&#37; CI 1&#46;42&#8211;4&#46;60&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> also shows the 30-day incidence of the various component events of the primary endpoint within 30 days of the procedure or surgery and details the distribution of other events in both management groups&#46; Total mortality was also significantly higher in the inappropriately managed patients &#40;5&#46;2&#37; versus 1&#46;5&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;042&#41;&#44; as was that of BARC hemorrhage<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 &#40;6&#46;9&#37; versus 2&#46;8&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41; and bleeding needing hospital admission &#40;OR 2&#46;84&#44; 95&#37; CI 1&#46;07&#8211;8&#46;17&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;040&#41;&#46; The incidence of stroke&#44; acute coronary syndrome&#44; and other systemic embolisms was low in both groups&#44; with no statistically significant differences&#44; but numerically also higher in the inappropriate management group &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">The results of the REQXAA registry show that in patients on chronic antiplatelet therapy who required some type of surgery or procedure&#44; adherence in the &#8220;real world&#8221; to current recommendations and consensus on their perioperative use is low&#46; Moreover&#44; despite being generally low thrombotic and moderate bleeding risk patients&#44; and a short follow-up time of only 30 days&#44; the incidence of serious thrombotic and bleeding events and even death was significantly higher &#40;2&#8211;3 times higher&#41; in patients in whom antiplatelet therapy was inappropriately managed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; This inappropriate management was an independent predictor of having the combined primary event&#44; with an adjusted OR of 2&#46;53 &#40;95&#37; CI 1&#46;42&#8211;4&#46;60&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41; and was independently associated with a higher mortality and serious bleeding &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The increase in the number of patients on chronic treatment with antiplatelet agents who may require a procedure or surgery during their lifetime has led many scientific societies to develop statements and consensus documents on the management of these drugs in recent years&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">9&#8211;14</span></a> However&#44; many of these recommendations are limited by the lack of scientific evidence&#46; Hence the importance of assessing not only adherence&#44; but also whether such adherence is associated with a lower incidence of adverse events after the intervention&#44; as was done in our study&#46; There are few records in the literature that have studied the local implementation of protocols for perioperative use of antiplatelet therapy&#46; Rossini et al&#46; evaluated the impact of an Italian consensus on the periprocedural use of antiplatelet therapy&#44; with adherence to these recommendations reaching 85&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">18</span></a> although the study was not designed to assess the relationship with the occurrence of cardiovascular events&#46; This percentage contrasts with that obtained in our registry&#44; in which only 61&#46;7&#37; of patients received treatment in accordance with the recommendations of the Spanish consensus document&#46; This proportion was somewhat better than in patients receiving oral anticoagulants&#44; where it was only 49&#46;1&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a> This low non-adherence to the recommendations is particularly striking because&#44; overall&#44; the risk of the patients included in our registry was considered low &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Most of the statement documents agree on maintaining aspirin treatment during the perioperative period&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">10&#44;12&#44;19</span></a> This is particularly important in patients undergoing invasive procedures or emergency surgery&#44; in whom it is not possible to previously stop antiplatelet therapy&#46; In the Spanish consensus document<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> and in the App where the indication for withdrawal or maintenance of antiplatelet therapy was assessed&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> it is stated that in cases requiring surgery or urgent procedures&#44; maintenance of antiplatelet therapy is mandatory&#44; and therefore all these patients were included in our study in the appropriate management group&#46; In any case&#44; the number of these patients was low&#44; less than 5&#37; of the total&#44; and the analysis performed to exclude them did not alter the overall results&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In our study&#44; although most patients had a low thrombotic and hemorrhagic risk&#44; the 30-day incidence of the main combined event was 7&#46;4&#37;&#44; not as low as might be expected&#44; and was significantly higher when antiplatelet management was inappropriate &#40;12&#46;1&#37; versus 5&#46;0&#37;&#41;&#46; Mortality was also statistically higher in this group&#46; The most frequent cause of inappropriate management was discontinuation of antiplatelet therapy when this was not recommended&#44; which occurred in 72&#46;8&#37; of cases&#46; This suggests that the intention of physicians was to reduce the likelihood of bleeding&#44; but this behavior not only leads to an increased incidence of ischemic events and death&#44; but also&#44; paradoxically&#44; of major bleeding&#44; as there were 2&#46;5 times more BARC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 bleedings in the inappropriate management group &#40;6&#46;9&#37; versus 2&#46;8&#37;&#44; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Regarding this point of a higher number of hemorrhages in the group in which antiplatelet drugs were withdrawn&#44; it is possible that this was due to the use&#44; not indicated in general&#44; of bridging therapy with heparins&#44; which was done in a not insignificant percentage of cases&#44; or of an intravenous antiplatelet&#44; such as cangrelor&#44; which was done in 2 cases&#46; However&#44; most of the bleeding complications occurred in patients in whom antiplatelet therapy was not interrupted&#44; either inappropriately or because it was correctly indicated&#44; as it was a procedure with a high or moderate ischemic risk&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">These findings are noteworthy considering the large number of patients on antiplatelet therapy who require surgery at some point in their lives&#46; After IPTW adjustment&#44; inadequate use of antiplatelet therapy was a strong independent risk factor for any type of event occurring during the first 30 days after surgery&#47;procedure&#44; including overall mortality and serious bleeding&#46; This finding reinforces the importance of proper adherence to recommendations&#44; and not only in high-risk patients&#44; to reduce the incidence of adverse events&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Limitations</span><p id="par0090" class="elsevierStylePara elsevierViewall">This study has several limitations&#44; the main one being its observational and non-experimental randomized design&#44; so the results on the incidence of adverse events and the implication of stopping or maintaining treatment must be taken with caution&#46; On the other hand&#44; since the study was conducted during the COVID-19 pandemic&#44; there were sometimes difficulties in obtaining all patient data and variables as well as 30-day follow-up &#40;although this was achieved in 97&#46;2&#37; of the included patients&#41;&#46; Another limitation is that it has not been possible to analyze separately the different causes of inappropriate management of the antiplatelet therapy&#44; due to the sample size and the low number of events&#44; that makes unfeasible to perform a separate statistical analysis of each specific situation&#46; This is common in real-life studies and is one of the limitations of this type of study&#46; Despite these limitations&#44; the results of the study are reinforced by the fact that it is a multicenter registry&#44; in which professionals from multiple specialties have contributed to patient recruitment&#44; and that data collection was prospective and systematic&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusions</span><p id="par0095" class="elsevierStylePara elsevierViewall">The results of the REQXAA registry demonstrate that&#44; despite the recommendations of the different scientific societies for perioperative antiplatelet therapy&#44; implementation in the &#8220;real world&#8221; is scarce&#46; Moreover&#44; inappropriate use in this context is associated with an increased incidence of adverse events&#44; both ischemic and hemorrhagic&#46; It is essential to insist on the correct use of antiplatelet agents&#44; developing local protocols&#44; to reduce perioperative complications&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Ethical considerations</span><p id="par0100" class="elsevierStylePara elsevierViewall">The study was conducted in accordance with the Declaration of Helsinki&#44; was approved by the Ethics Committee of the Hospital Cl&#237;nico San Carlos de Madrid and was authorized by the other participating centers&#46; All patients agreed to participate in writing by signing the informed consent form for participation in the study&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0105" class="elsevierStylePara elsevierViewall">This work was not supported by any funding source&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Authorship contribution</span><p id="par0110" class="elsevierStylePara elsevierViewall">M&#46; Anguita-G&#225;mez and D&#46; Vivas contributed equally to the manuscript&#46; All authors fulfill the following requirements&#58; &#40;a&#41; contributed substantially to the conception and design of the study&#44; acquisition of data or their analysis and interpretation&#59; &#40;b&#41; drafted the article and&#47;or critically reviewed its intellectual content&#59; &#40;c&#41; gave final approval to the version to be published&#59; and &#40;d&#41; agreed to take responsibility for all aspects of the article and to investigate and resolve any issues related to the accuracy and veracity of any part of the paper&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflict of interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">D&#46; Vivas&#58; honoraria for papers from Daiichi Sankyo&#44; AstraZeneca&#44; Bayer&#44; Pfizer&#44; Abbott&#44; Boehringer Ingelheim&#44; Bristol-Myers-Squibb and Ferrer&#46; R&#46; Ferrandis&#58; speaking fees from LFB&#44; CSL Behring and Octapharma&#46; M&#46; Anguita&#58; speaking fees for Eli Lilly &#38; Co&#44; Daiichi Sankyo&#44; AstraZeneca&#44; Bayer&#44; Pfizer&#44; Boehringer Ingelheim&#44; Bristol-Myers-Squibb and Novartis&#59; consultancy work for Eli Lilly &#38; Co&#44; Daiichi Sankyo&#44; AstraZeneca&#44; Bayer&#44; Pfizer&#44; Boehringer Ingelheim&#44; Bristol-Myers-Squibb and Novartis&#46; I&#46; Egocheaga&#58; speaking fees from Boehringer Ingelheim&#44; AstraZeneca&#59; consultancy work for AstraZeneca&#59; support for conference attendance from Novartis&#46; A&#46; Abad-Motos&#58; support for attendance at Vifor&#44; Edwards congresses&#46; E&#46; Figuero&#58; speaking fees from Oral-B&#44; Colgate&#44; Johnsson &#38; Johnsson&#44; Spanish Society of Periodontology &#40;SEPA&#41;&#44; Irish Society of Periodontology&#44; Ukrainian Association of Periodontology&#44; French Dental Association of Periodontology&#59; research grants from Dentaid&#44; Lacer&#44; University of Bristol&#59; support for conference attendance from SEPA&#44; European Federation of Periodontology&#44; Irish Society of Periodontology and French Dental Association of Periodontology&#46; N&#46; Bouz&#243;-Molina&#58; support for attendance at MSD congresses&#46; J&#46; Torres&#58; fees for presentations from Amgen&#44; AstraZeneca&#44; Bayer&#44; Boehringer Ingelheim&#44; Daiichi Sankyo&#44; Eli Lilly &#38; Co&#44; Novartis&#44; Pfizer and Rovi&#46; M&#46;J&#46; Descalzo&#58; speaking fees from GlaxoSmithKline&#59; support for conference attendance from Daiichi Sankyo&#46; E&#46; Mart&#237;n-Rioboo&#58; speaking fees from Servier&#44; Ferrer&#44; Boehringer Ingelheim&#46; F&#46; Mar&#237;n&#58; speaking fees from AstraZeneca and Boehringer Ingelheim&#59; consultancy work for Boehringer Ingelheim&#59; research grants from AstraZeneca&#44; Ferrer and BMS&#59; support for conference attendance from Esteve and Novo Nordisk&#59; participation in advisory committees or safety data monitoring from AFNET&#46; The other authors declare no conflicts of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2023-12-14"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and aims</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">There is little evidence on the impact of current recommendations on the use of antiplatelet therapy during the perioperative and periprocedural period in our setting&#46; The aim of this study was to analyze the incidence and clinical impact of inappropriate use of antiplatelet therapy in a population of patients undergoing surgery or a diagnostic or therapeutic procedure in &#8220;real life&#8221; in Spain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective multicenter observational study of patients treated with antiplatelet agents requiring intervention was conducted&#46; The incidence of thrombotic and hemorrhagic events at 30 days was analyzed according to peri-intervention management of antiplatelet therapy&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We included 643 patients &#40;31&#46;9&#37; women&#44; 39&#46;0&#37; over 75 years of age&#41;&#44; most of them &#40;87&#46;7&#37;&#41; receiving aspirin as antiplatelet therapy at a dose of 100<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#46; Indications for antiplatelet therapy were ischemic heart disease &#40;44&#46;9&#37;&#41;&#44; cerebrovascular disease &#40;21&#46;7&#37;&#41;&#44; and peripheral vascular disease &#40;23&#46;0&#37;&#41;&#46; Ischemic risk was low in 74&#46;3&#37;&#44; while 51&#46;6&#37; had a low bleeding risk of the intervention&#46; Periprocedural management was considered appropriate in 61&#46;7&#37; of cases&#46; 30-day incidence of the combined primary endpoint of thrombotic events and major bleeding &#40;12&#46;1&#37; versus 5&#46;0&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; and 30-day mortality &#40;5&#46;2&#37; versus 1&#46;5&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; were significantly higher in patients with inappropriate periprocedural management of antiplatelet agents&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Despite current recommendations for the use of antiplatelet drugs in the perioperative&#47;periprocedural period&#44; their implementation in the &#8220;real world&#8221; remains low&#46; Inappropriate use is associated with an increased incidence of adverse events&#44; both thrombotic and hemorrhagic&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Existe poca evidencia sobre el impacto de las recomendaciones actuales sobre el uso de la terapia antiplaquetaria durante el periodo perioperatorio y periprocedimiento en nuestro medio&#46; El objetivo de este estudio fue analizar la incidencia y el impacto cl&#237;nico del uso inapropiado de la terapia antiplaquetaria en una poblaci&#243;n de pacientes sometidos a cirug&#237;a o a un procedimiento diagn&#243;stico o terap&#233;utico en la &#171;vida real&#187; en Espa&#241;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio observacional multic&#233;ntrico prospectivo de pacientes tratados con antiagregantes plaquetarios que requer&#237;an intervenci&#243;n&#46; Se analiz&#243; la incidencia de eventos tromb&#243;ticos y hemorr&#225;gicos a los 30 d&#237;as seg&#250;n el manejo peri-intervenci&#243;n del tratamiento antiplaquetario&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 643 pacientes &#40;31&#44;9&#37; mujeres&#44; 39&#44;0&#37; mayores de 75 a&#241;os&#41;&#44; la mayor&#237;a de ellos &#40;87&#44;7&#37;&#41; recib&#237;an aspirina como tratamiento antiplaquetario a dosis de 100<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#46; Las indicaciones del tratamiento antiagregante plaquetario fueron cardiopat&#237;a isqu&#233;mica &#40;44&#44;9&#37;&#41;&#44; enfermedad cerebrovascular &#40;21&#44;7&#37;&#41; y enfermedad vascular perif&#233;rica &#40;23&#44;0&#37;&#41;&#46; El riesgo isqu&#233;mico era bajo en el 74&#44;3&#37;&#44; mientras que en el 51&#44;6&#37; el riesgo hemorr&#225;gico de la intervenci&#243;n era bajo&#46; El tratamiento periprocedimiento se consider&#243; adecuado en el 61&#44;7&#37; de los casos&#46; La incidencia a 30 d&#237;as de la variable principal combinada de eventos tromb&#243;ticos y hemorragia grave &#40;12&#44;1 frente al 5&#44;0&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; y la mortalidad a 30 d&#237;as &#40;5&#44;2 frente al 1&#44;5&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41; fueron significativamente mayores en los pacientes con un manejo inadecuado de los antiagregantes plaquetarios durante el procedimiento&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A pesar de las recomendaciones actuales para el uso de antiagregantes plaquetarios en el periodo perioperatorio&#47;periprocedimiento&#44; su implementaci&#243;n en el &#171;mundo real&#187; sigue siendo baja&#46; El uso inadecuado se asocia a una mayor incidencia de acontecimientos adversos&#44; tanto tromb&#243;ticos como hemorr&#225;gicos&#46;</p></span>"
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            "apendice" => "<p id="par0125" class="elsevierStylePara elsevierViewall">Hospital Cl&#237;nico San Carlos&#44; Madrid&#46; David Vivas &#40;Principal Investigator&#44; PI&#41;&#44; Mar&#237;a Anguita-G&#225;mez&#44; Juan Carlos G&#243;mez-Polo&#44; Julia Play&#225;n&#44; Amaya Calbet&#44; Blanca Torres&#44; Andrea Gallardo&#44; Roc&#237;o P&#225;rraga&#44; In&#233;s Ramos&#44; Manuel Carnero-Alc&#225;zar&#46; Hospital Universitari i Polit&#232;cnic La Fe&#44; Valencia&#46; Raquel Ferrandis &#40;PI&#41;&#44; Marysol Echeverri&#44; Jes&#250;s Igualada Sevilla&#44; Mar&#237;a Salom&#233; Matoses Ja&#233;n&#44; Mar&#237;a Mart&#237; Monferrer&#44; Juan Manuel Sanch&#237;s Garc&#237;a&#44; Azucena Pajares Moncho&#44; Mar&#237;a Isabel Molina Monle&#243;n&#44; Jorge Tadeo Puchol Castillo&#44; Virginia Vilar Bianchi&#44; Rosa Bernabeu Santisteban&#44; Roc&#237;o Cejudo Armero&#44; Mar&#237;a Jos&#233; Alberola Estelles&#44; Elena D&#237;az Such&#44; Natalia Garc&#237;a Claudio&#46; Hospital Cl&#237;nico Universitario Virgen de la Arrixaca&#44; Murcia&#46; Francisco Mar&#237;n &#40;PI&#41;&#44; Mar&#237;a Asunci&#243;n Esteve-Pastor&#44; Jos&#233; Miguel Rivera-Caravaca&#44; Antonio Tello-Montoliu&#46; Hospital Universitario Infanta Leonor&#44; Vallecas&#44; Madrid&#46; BeatrizNozal-Mateo &#40;co-PI&#41;&#44; Ane Abad-Motos &#40;co-PI&#41;&#44; Ana Nieto-Moreno&#44; B&#225;rbara Algar-Y&#225;&#241;ez&#44; Berenice Guti&#233;rrez-Tonal&#44; Blanca Escontrela&#44; Mar&#237;a Laura Pelegrina-L&#243;pez&#44; David Stolle-Due&#241;as&#44; Elena Lucena de Pablo&#44; Elena Nieto-Moreno&#44; Eugenio Mart&#237;nez-Hurtado&#44; Javier Ripoll&#233;s-Melchor&#44; Marina de Retes-Sanz&#44; Nerea G&#243;mez-P&#233;rez&#44; Norma Aracil-Escoda&#44; Olga de la Varga-Mart&#237;nez&#44; Rosa Sanz-Gonz&#225;lez&#44; Sandra Gad&#237;n-L&#243;pez&#44; Sem Briongos &#40;co-PI&#44; Kateri Chao-Novo&#44; Alfredo Abad-Gurumeta&#46; Facultad de Odontolog&#237;a&#44; Universidad Complutense&#44; Madrid&#46; Elena Figuero &#40;IPPI&#41;&#44; Mar&#237;a Gonz&#225;lez Zamora&#44; Nagore Ambrosio&#44; Ana Molina&#44; David Herrera&#44; Mariano Sanz&#46; Facultad de Odontolog&#237;a&#44; Universidad Rey Juan Carlos&#44; Madrid&#46; Rafael G&#243;mez de Diego&#44; Mar&#237;a Gonz&#225;lez-Zamora&#46; Hospital Universitario Reina Sof&#237;a&#44; C&#243;rdoba&#46; Manuel Anguita &#40;PI&#41;&#44; Paula Anguita-G&#225;mez&#46; Hospital Universitario 12 de octubre&#44; Madrid&#46; Nuria Bouz&#243; &#40;PI&#41;&#44; Rosana Sanz-Pe&#241;uelas&#44; &#193;lvaro Ramiro-Ruiz&#44; Susana Reca-Gonz&#225;lez&#44; Roc&#237;o G&#243;mez-Margarida&#44; Sara Arlanz&#243;n de Quevedo&#44; Mar&#237;a Guerrero-D&#237;ez&#44; Raquel Jim&#233;nez-Garc&#237;a&#44; Rafael Arboleda-Salazar&#44; Pablo Garc&#237;a-Pimentel&#44; Agar C&#225;ndida Carrero-Cabo&#46; Hospital Doctor Balmis&#44; Alicante&#46; Teresa Lozano &#40;PI&#41;&#44; Laura Fuertes-Kenneally&#44; Ana Mar&#237;a Garc&#237;a Barrios&#44; Andrea Lloret-Rubio&#44; Carlos L&#243;pez-Menchero&#46; Hospital Universitario La Paz&#44; Madrid&#46; Carlos &#193;lvarez &#40;PI&#41;&#46; Hospital Universitario Ja&#233;n&#46; Javier Torres &#40;PI&#41;&#44; Mar&#237;a Eugenia Zambrano&#46; Hospital Costa del Sol&#44; Marbella&#44; M&#225;laga&#46; Mar&#237;a Jos&#233; Descalzo-Pulido &#40;PI&#41;&#44; Azahara del Milagro V&#225;zquez&#44; Azahara S&#225;ez-Mu&#241;oz&#44; Nansi Vidal-Lorenzo&#46; Hospital General Universitario&#44; Valencia&#46; Juan Carlos Catal&#225; &#40;P&#206;&#41;&#44; Francisco Ridocci &#40;PI&#41;&#44; Marta Jimenez Fenell&#243;s&#46; Unidad de Gesti&#243;n Cl&#237;nica de Atenci&#243;n Primaria Poniente&#44; C&#243;rdoba&#46; Enrique Mart&#237;n-Rioboo &#40;PI&#41;&#44; Emilio Garc&#237;a-Criado&#44; Mar&#237;a &#193;ngeles Ortega-Osuna&#44; Julia Mar&#237;a Herv&#225;s-Jerez&#46; Centro de Salud Isla de Oza&#44; Madrid&#46; Isabel Egocheaga &#40;PI&#41;&#44; Laura Utrilla&#44; Yasmin Drak Hern&#225;ndez&#46; Centro de Salud Palma Norte&#44; Madrid&#46; Francisco Javier Torres-Mart&#237;nez &#40;PI&#41;&#46; Hospital Marina Baixa&#44; Villajoyosa&#44; Alicante&#46; Alejandra Molines-Cant&#243; &#40;PI&#41;&#44; Gracia Barber-Ballester&#46; Hospital Torrec&#225;rdenas&#44; Almer&#237;a&#46; Roc&#237;o Rodr&#237;guez-Contreras &#40;IP&#41;&#44; Regina Bernal-Basurto&#46; Hospital Universitario La Zarzuela&#44; Madrid&#46; Juan Jos&#233; S&#225;nchez-Palomo &#40;PI&#41;&#46;</p> <p id="par0130" class="elsevierStylePara elsevierViewall">PI&#58; principal investigator&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Overall series<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>643&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">Appropriate management<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>397 &#40;61&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">Inappropriate management<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>246 &#40;38&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#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">70&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;3&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">70&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;2&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">71&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;7&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;425&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>75 years&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">251 &#40;39&#46;0&#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">147 &#40;37&#46;0&#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">104 &#40;42&#46;3&#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">0&#46;190&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female sex&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">205 &#40;31&#46;9&#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">115 &#40;28&#46;9&#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">90 &#40;36&#46;6&#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">0&#46;073&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypertension&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">494 &#40;76&#46;8&#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">290 &#40;73&#46;0&#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">204 &#40;82&#46;9&#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">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes mellitus&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">292 &#40;43&#46;8&#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">171 &#40;43&#46;1&#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">111 &#40;45&#46;1&#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">0&#46;202&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Active smoker&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">160 &#40;24&#46;9&#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">103 &#40;25&#46;9&#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">57 &#40;23&#46;1&#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">0&#46;091&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dyslipidemia&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">475 &#40;73&#46;8&#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">298 &#40;75&#46;1&#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">177 &#40;71&#46;9&#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">0&#46;189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stroke&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;21&#46;7&#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">75 &#40;18&#46;9&#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">65 &#40;26&#46;4&#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">0&#46;038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ischemic heart disease&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">289 &#40;44&#46;9&#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">186 &#40;46&#46;8&#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">103 &#40;41&#46;8&#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">0&#46;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pulmonary embolism&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 &#40;1&#46;5&#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">7 &#40;1&#46;8&#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">3 &#40;1&#46;2&#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">0&#46;172&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peripheral vascular disease&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 &#40;23&#46;0&#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">83 &#40;20&#46;9&#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">63 &#40;25&#46;6&#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">0&#46;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart failure&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">84 &#40;13&#46;1&#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">40 &#40;10&#46;1&#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">44 &#40;17&#46;9&#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">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atrial fibrillation&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">97 &#40;15&#46;1&#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">51 &#40;12&#46;8&#37;&#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</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic kidney disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \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
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cancer&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">135 &#40;20&#46;9&#37;&#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">79 &#40;19&#46;9&#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">56 &#40;22&#46;8&#37;&#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\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">COPD&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</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;383&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Deep venous thrombosis&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 &#40;4&#46;8&#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">21 &#40;5&#46;2&#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
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                  \t\t\t\t">0&#46;316&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia&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">90 &#40;13&#46;9&#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">47 &#40;11&#46;8&#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">43 &#40;17&#46;5&#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">0&#46;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous bleeding&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">39 &#40;6&#46;1&#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">20 &#40;5&#46;0&#37;&#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">19 &#40;7&#46;7&#37;&#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;116&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Liver disease&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">35 &#40;5&#46;4&#37;&#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">19 &#40;7&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">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="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Appropriate management<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>397 &#40;62&#46;7&#37;&#41;&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" scope="col" style="border-bottom: 2px solid black">Inappropriate management<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>246 &#40;38&#46;3&#37;&#41;&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
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">200 &#40;81&#46;3&#37;&#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">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Clopidogrel</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">131 &#40;20&#46;3&#37;&#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</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;31&#46;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Prasugrel</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">2 &#40;0&#46;3&#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">1 &#40;0&#46;2&#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">1 &#40;0&#46;4&#37;&#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="left" valign="\n
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                  \t\t\t\t">1&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Ticagrelor</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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;4&#46;0&#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">18 &#40;4&#46;4&#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">7 &#40;2&#46;8&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;296&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Double antiplatelet therapy</span>&nbsp;\t\t\t\t\t\t\n
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                  \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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&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&#46;36&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;98&#44; 1&#46;90&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;068&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&#46;45&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;01&#44; 2&#46;06&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;041&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypertension&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&#46;93&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;31&#44; 2&#46;90&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;001&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&#46;58&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;05&#44; 2&#46;42&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;031&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes mellitus&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&#46;15&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;84&#44; 1&#46;57&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;397&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="" 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-entry\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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smoking&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;83&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;57&#44; 1&#46;19&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;303&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="" valign="\n
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                  \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-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dyslipidemia&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;88&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;62&#44; 1&#46;25&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;472&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="" valign="\n
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                  \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-entry\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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prior stroke&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&#46;59&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;09&#44; 2&#46;31&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;015&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&#46;79&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;20&#44; 2&#46;66&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;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ischemic heart disease&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;76&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;55&#44; 1&#46;04&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;089&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="" valign="\n
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                  \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-entry\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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peripheral artery disease&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&#46;35&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;94&#44; 1&#46;94&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;106&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="" 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-entry\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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pulmonay embolism&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;61&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;13&#44; 2&#46;11&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;461&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="" 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-entry\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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Deep venous thrombosis&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;77&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;34&#44; 1&#46;61&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;495&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="" 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-entry\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-entry\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></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart failure&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">2&#46;00&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;28&#44; 3&#46;14&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;002&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;64&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;01&#44; 2&#46;65&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;045&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atrial fibrillation&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">1&#46;58&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">1&#46;03&#44; 2&#46;42&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;035&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic renal disease&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">0&#46;54&#44; 1&#46;28&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;416&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">History of cancer&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">1&#46;19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;81&#44; 1&#46;74&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;359&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">COPD&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">1&#46;00&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;64&#44; 1&#46;54&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;986&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia&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">1&#46;57&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;02&#44; 2&#46;42&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;041&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</td><td class="td" title="\n
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                  \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-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prior bleeding&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">1&#46;45&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">0&#46;77&#44; 2&#46;70&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">0&#46;241&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</td><td class="td" title="\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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Liver disease&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">1&#46;88&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">0&#46;96&#44; 3&#46;73&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;066&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</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DAPT&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">1&#46;74&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;14&#44; 2&#46;66&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;010&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">1&#46;74&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">1&#46;11&#44; 2&#46;73&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;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>VASC&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">1&#46;20&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;09&#44; 1&#46;33&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;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HASBLED&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">1&#46;28&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;10&#44; 1&#46;50&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;002&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">High hemorrhagic risk&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;63 &#40;0&#46;19&#8211;13&#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  " align="char" valign="\n
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                  \t\t\t\t">0&#46;626&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">1&#46;74 &#40;0&#46;16&#8211;20&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">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="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Intracranial bleeding&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;0&#46;4&#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  " align="char" valign="\n
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                  \t\t\t\t">0&#46;996&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">2&#46;74 &#40;0&#46;67&#8211;13&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;169&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;42 &#40;0&#46;73&#8211;8&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;155&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Bleeding needing transfusion&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">10 &#40;4&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;2&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;84 &#40;0&#46;73&#8211;4&#46;69&#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">0&#46;191&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">1&#46;87 &#40;0&#8211;81-4&#46;38&#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">0&#46;143&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Bleeding needing admission&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">9 &#40;3&#46;6&#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">6 &#40;1&#46;5&#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">2&#46;49 &#40;0&#46;89&#8211;7&#46;51&#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">0&#46;087&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;84 &#40;1&#46;07&#8211;8&#46;17&#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">0&#46;040&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Bleeding needing stop antiplatelets&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;2&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;97 &#40;0&#46;59&#8211;6&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;266&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;19 &#40;0&#46;76&#8211;6&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Procedure&#47;surgery delayed&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;63 &#40;0&#46;30&#8211;8&#46;88&#41;&nbsp;\t\t\t\t\t\t\n
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