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inicial &#40;HR&#58; 1&#44;80 para mortalidad total y HR&#58; 2&#44;32 para MCV&#41;&#44; como en aquellas con existencia de ECV &#40;HR&#58; 1&#44;65 para mortalidad total y HR&#58; 1&#44;89 para MCV&#41;&#46; Datos del UK Biobank<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a> han demostrado que&#44; en ausencia de ECV prevalente&#44; los pacientes con DM&#44; en an&#225;lisis ajustado para otros factores de riesgo&#44; tienen un incremento del 50&#37; en el riesgo de mortalidad respecto a la poblaci&#243;n sin DM&#59; no obstante&#44; este riesgo se multiplica por un factor de 3&#44;6 a 4&#44;9 ante la presencia simult&#225;nea de diabetes y de diferentes manifestaciones de ECV&#46; Un reciente an&#225;lisis combinado del <span class="elsevierStyleItalic">Emerging Risk Factors Collaboration</span> y del UK Biobank<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a> ha comprobado que cada d&#233;cada de diagn&#243;stico m&#225;s precoz de la DM incrementa un 14&#37; el riesgo de mortalidad total y un 19&#37; el riesgo de MCV&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Espec&#237;ficamente en la DM tipo<span class="elsevierStyleHsp" style=""></span>2 &#40;DM2&#41;&#44; la aplicaci&#243;n en la pr&#225;ctica cl&#237;nica de los resultados de ensayos que han demostrado la eficacia del control gluc&#233;mico<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a>&#44; del control de la presi&#243;n arterial &#40;PA&#41;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">5</span></a>&#44; del control lip&#237;dico<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a> y del abordaje simult&#225;neo de todos los factores de riesgo vascular<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">7</span></a>&#44; deber&#237;a haberse traducido en una mejora del pron&#243;stico de los pacientes<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a>&#46; Datos del Registro de Diabetes Nacional Sueco confirman una reducci&#243;n de mortalidad total del 21&#37; y de MCV del 46&#37; en pacientes con DM2 entre 1998 y 2014&#44; aunque este descenso es menor que en la poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Es necesario recopilar datos actualizados sobre la mortalidad de los pacientes con diabetes&#44; dada la reciente disponibilidad de f&#225;rmacos hipoglucemiantes &#40;inhibidores de SGLT2 &#91;i-SGLT2&#93; y agonistas del receptor de GLP1 &#91;AR-GLP1&#93;&#41; con capacidad de modificar el pron&#243;stico de la ECV<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a>&#46; Aunque es ampliamente conocido que la presencia de enfermedad cardiovascular ateroscler&#243;tica &#40;ECVA&#41;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> y de insuficiencia cardiaca<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a> incrementa el riesgo de mortalidad total y de MCV&#44; es preciso cuantificar el incremento de riesgo conferido por cada una de estas complicaciones para estratificar eficazmente el riesgo de los pacientes&#46; Es prioritario identificar los grupos de pacientes con DM2 con mayor riesgo de fallecer&#44; ya que&#44; en ellos&#44; a igualdad de reducci&#243;n de riesgo relativo&#44; se producir&#225; una mayor reducci&#243;n de riesgo absoluto&#59; este hecho se ha comprobado en un metaan&#225;lisis de ensayos de i-SGLT2 y AR-GLP1&#44; con tasas de MCV en los grupos placebo que variaron entre 7 y 125 por cada 1&#46;000 pacientes-a&#241;o<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Nuestra hip&#243;tesis fue que&#44; en el momento actual&#44; el riesgo de mortalidad de los pacientes con DM2 seguir&#237;a siendo muy variable en dependencia de sus caracter&#237;sticas iniciales&#46; Mediante el seguimiento prospectivo de una cohorte de pacientes con DM2&#44; procedente de las consultas externas de distintos hospitales de nuestro pa&#237;s&#44; nuestro objetivo fue evaluar el riesgo de mortalidad en dependencia de la presencia y del tipo de ECV inicial&#46; Asimismo&#44; analizamos la prevalencia de uso y la eficacia cl&#237;nica sobre la reducci&#243;n de mortalidad del empleo de i-SGLT2 y AR-GLP1&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o</span><p id="par0025" class="elsevierStylePara elsevierViewall">El estudio DIABET-IC fue planificado como un estudio multic&#233;ntrico&#44; observacional&#44; prospectivo y anal&#237;tico promovido conjuntamente por la Sociedad Espa&#241;ola de Diabetes y la Sociedad Espa&#241;ola de Cardiolog&#237;a&#46; Fue llevado a cabo en 58 hospitales del territorio nacional espa&#241;ol&#44; con el objetivo de evaluar la prevalencia y la incidencia de insuficiencia card&#237;aca&#44; as&#237; como el pron&#243;stico vital en dependencia de la presencia y del tipo de ECV&#46; Los datos de incidencia de insuficiencia cardiaca se presentar&#225;n en art&#237;culos adicionales&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El dise&#241;o planteado fue observacional y pragm&#225;tico&#44; con seguimiento de los pacientes en una situaci&#243;n de pr&#225;ctica cl&#237;nica rutinaria&#44; sin indicaciones espec&#237;ficas de prescripci&#243;n terap&#233;utica&#46; El protocolo inicial contemplaba una visita inicial y tres visitas de seguimiento&#46; No obstante&#44; debido a la situaci&#243;n de pandemia por COVID-19&#44; el protocolo fue modificado para intentar alcanzar en el mayor n&#250;mero posible de pacientes al menos la visita de cierre del estudio&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">El trabajo se realiz&#243; siguiendo las normas de la Declaraci&#243;n de Helsinki y fue aprobado por el Comit&#233; &#201;tico del Complejo Hospitalario de Toledo el 28 de marzo de 2018 &#40;c&#243;digo de identificaci&#243;n 243&#41;&#46; Todos los pacientes firmaron el consentimiento informado para la participaci&#243;n en el estudio&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Criterios de inclusi&#243;n y exclusi&#243;n</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se incluyeron pacientes con una edad igual o superior a 18<span class="elsevierStyleHsp" style=""></span>a&#241;os y con un diagn&#243;stico de DM2 seg&#250;n criterios de la <span class="elsevierStyleItalic">American Diabetes Association</span><a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a> desde al menos 1<span class="elsevierStyleHsp" style=""></span>a&#241;o antes de la visita de inclusi&#243;n&#46; Pod&#237;an reclutarse pacientes con y sin ECV&#46; Los criterios de exclusi&#243;n fueron un diagn&#243;stico de DM tipo<span class="elsevierStyleHsp" style=""></span>1&#44; la participaci&#243;n concomitante en alg&#250;n ensayo cl&#237;nico&#44; la incapacidad para otorgar consentimiento informado&#44; la presencia de enfermedad renal cr&#243;nica estadio<span class="elsevierStyleHsp" style=""></span>5 y una esperanza de vida estimada inferior a 3<span class="elsevierStyleHsp" style=""></span>a&#241;os por patolog&#237;as acompa&#241;antes&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">El reclutamiento de pacientes se complet&#243; de forma consecutiva y balanceada entre consultas externas hospitalarias de endocrinolog&#237;a y cardiolog&#237;a&#46; En cada centro participante un endocrin&#243;logo y un cardi&#243;logo realizaban de forma conjunta la evaluaci&#243;n de los pacientes&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">El tama&#241;o muestral calculado inicialmente fue de 2&#46;400 pacientes&#44; para conseguir una estimaci&#243;n de la prevalencia de insuficiencia cardiaca con una precisi&#243;n de &#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&#37;&#44; con un nivel de confianza del 95&#37;&#46; Para ello originalmente se ofreci&#243; la participaci&#243;n a 60 hospitales&#44; con selecci&#243;n de los primeros 40 pacientes en cada hospital que cumpliesen los criterios de inclusi&#243;n &#40;20 procedentes de consultas externas de endocrinolog&#237;a y 20 procedentes de consultas externas de cardiolog&#237;a&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Variable dependiente &#40;punto final cl&#237;nico&#41;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Cada investigador document&#243;&#44; en caso de producirse&#44; mediante consulta de la historia cl&#237;nica&#44; la fecha de mortalidad y si la muerte era o no de causa cardiovascular&#46; Se consider&#243; MCV la debida a s&#237;ndrome coronario agudo&#44; insuficiencia cardiaca&#44; muerte arr&#237;tmica o muerte s&#250;bita&#44; rotura de aneurisma arterial o ictus&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables recogidas en la visita inicial</span><p id="par0060" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Variables demogr&#225;ficas&#58; edad y g&#233;nero&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Comorbilidades y factores de riesgo vascular&#58;</p></li></ul></p><p id="par0075" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall">Tabaquismo clasificado en fumador actual&#44; exfumador y no fumador &#40;con agrupamiento posterior en fumador actual o no fumador actual&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0085" class="elsevierStylePara elsevierViewall">Hipertensi&#243;n arterial &#40;HTA&#41;&#44; definida como presi&#243;n arterial sist&#243;lica &#40;PAS&#41; confirmada &#8805;<span class="elsevierStyleHsp" style=""></span>140<span class="elsevierStyleHsp" style=""></span>mmHg&#44; presi&#243;n arterial diast&#243;lica &#40;PAD&#41; confirmada &#8805;<span class="elsevierStyleHsp" style=""></span>90<span class="elsevierStyleHsp" style=""></span>mmHg o toma de antihipertensivos&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0090" class="elsevierStylePara elsevierViewall">Dislipemia&#44; definida como toma de hipolipemiantes o cifras de colesterol total &#62;<span class="elsevierStyleHsp" style=""></span>240<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y&#47;o colesterol LDL &#62;<span class="elsevierStyleHsp" style=""></span>160<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y&#47;o triglic&#233;ridos &#62;<span class="elsevierStyleHsp" style=""></span>200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y&#47;o colesterol HDL &#60;<span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en varones o &#60;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en mujeres&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0095" class="elsevierStylePara elsevierViewall">Diagn&#243;stico de c&#225;ncer&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0100" class="elsevierStylePara elsevierViewall">&#205;ndice de comorbilidad de Charlson&#46;</p></li></ul></p><p id="par0105" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">3&#46;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Presencia inicial de ECV&#44; definida como la constataci&#243;n de una o m&#225;s de las siguientes patolog&#237;as&#58;</p></li></ul></p><p id="par0115" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0120" class="elsevierStylePara elsevierViewall">Insuficiencia cardiaca seg&#250;n criterios diagn&#243;sticos de la Sociedad Europea de Cardiolog&#237;a<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a> y clasificada como insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n reducida &#40;ICFEr&#41;&#44; intermedia &#40;ICFEm&#41; o preservada &#40;ICFEp&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">-</span><p id="par0125" class="elsevierStylePara elsevierViewall">Enfermedad cardiovascular ateroscler&#243;tica &#40;ECVA&#41;&#58; presencia de enfermedad arterial coronaria y&#47;o enfermedad cerebrovascular y&#47;o enfermedad arterial perif&#233;rica&#46; Se gener&#243; adicionalmente una variable ordinal con tres categor&#237;as&#58; no afectaci&#243;n&#44; afectaci&#243;n de 1<span class="elsevierStyleHsp" style=""></span>territorio y afectaci&#243;n de &#62;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>territorio vascular&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">-</span><p id="par0130" class="elsevierStylePara elsevierViewall">Enfermedad arterial coronaria &#40;EACo&#41;&#58; documentaci&#243;n de infarto agudo de miocardio&#44; s&#237;ndrome coronario agudo&#44; revascularizaci&#243;n coronaria o estenosis coronaria &#62;<span class="elsevierStyleHsp" style=""></span>50&#37;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">-</span><p id="par0135" class="elsevierStylePara elsevierViewall">Enfermedad arterial cerebrovascular &#40;EACe&#41;&#58; documentaci&#243;n de ictus isqu&#233;mico o hemorr&#225;gico o estenosis carot&#237;dea &#62;<span class="elsevierStyleHsp" style=""></span>50&#37;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">-</span><p id="par0140" class="elsevierStylePara elsevierViewall">Enfermedad arterial perif&#233;rica &#40;EAPe&#41;&#58; documentaci&#243;n de arteriopat&#237;a de miembros inferiores&#46;</p></li></ul></p><p id="par0145" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">4&#46;</span><p id="par0150" class="elsevierStylePara elsevierViewall">Antecedentes relacionados con la DM&#58; duraci&#243;n de la enfermedad&#44; presencia de retinopat&#237;a&#44; presencia de enfermedad renal cr&#243;nica &#40;ERC&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">5&#46;</span><p id="par0155" class="elsevierStylePara elsevierViewall">Exploraci&#243;n f&#237;sica&#58; PAS&#44; PAD&#44; peso &#40;kg&#41;&#44; talla &#40;metros&#41;&#44; &#237;ndice de masa corporal &#40;IMC&#41; expresado en kg&#47;m<span class="elsevierStyleSup">2</span>&#44; per&#237;metro de la cintura &#40;cm&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">6&#46;</span><p id="par0160" class="elsevierStylePara elsevierViewall">Datos de laboratorio &#40;obtenidos en cada hospital mediante m&#233;todos rutinarios&#41;&#58; glucemia &#40;mg&#47;dl&#41;&#44; HbA1c &#40;&#37;&#41;&#44; perfil lip&#237;dico con colesterol&#44; triglic&#233;ridos&#44; cLDL&#44; cHDL y colesterol no-HDL &#40;colesterol total &#8722;<span class="elsevierStyleHsp" style=""></span>cHDL&#41; expresados en mg&#47;dl&#44; tasa de filtraci&#243;n glomerular estimada &#40;TFGe&#41; mediante f&#243;rmula CKD-EPI en ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; excreci&#243;n de alb&#250;mina urinaria &#40;EAU&#41; en mg&#47;g de creatinina&#44; hemoglobina &#40;g&#47;dl&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">7&#46;</span><p id="par0165" class="elsevierStylePara elsevierViewall">Electrocardiograma&#44; con constataci&#243;n de la presencia de fibrilaci&#243;n auricular &#40;FA&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">8&#46;</span><p id="par0170" class="elsevierStylePara elsevierViewall">NT-proBNP y ecocardiograma&#44; con c&#225;lculo de la fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo &#40;FEVI&#41;&#44; para determinar la presencia y la clasificaci&#243;n de insuficiencia cardiaca<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a>&#46; Posteriormente se agruparon los pacientes con insuficiencia cardiaca en dependencia de que la FEVI fuese &#60;<span class="elsevierStyleHsp" style=""></span>40&#37; o &#8805;<span class="elsevierStyleHsp" style=""></span>40&#37;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">9&#46;</span><p id="par0175" class="elsevierStylePara elsevierViewall">Medicaci&#243;n administrada en el momento de la finalizaci&#243;n de la visita inicial&#46;</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">M&#233;todos estad&#237;sticos</span><p id="par0180" class="elsevierStylePara elsevierViewall">Se realiz&#243; la descripci&#243;n de las variables cuantitativas mediante la media y la desviaci&#243;n est&#225;ndar &#40;DE&#41; o mediante la mediana y el rango intercuart&#237;lico&#46; Las variables cualitativas se describen con su distribuci&#243;n de frecuencias &#40;&#37;&#41;&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Para la comparaci&#243;n de variables cuantitativas se utiliz&#243; la t de Student de muestras independientes o ANOVA&#44; con aplicaci&#243;n de pruebas no param&#233;tricas en el caso de que no se cumpliesen los supuestos de normalidad&#46; La comparaci&#243;n de variables cualitativas fue realizada con test de chi-cuadrado o test de Fisher&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Se realiz&#243; seguimiento de los pacientes hasta su fallecimiento&#44; abandono del estudio o visita final programada de cierre del estudio en junio de 2022&#46; Las tasas de incidencia &#40;TI&#41; de mortalidad se expresan por cada 1&#46;000 pacientes-a&#241;o&#46; Se realizaron curvas de supervivencia de Kaplan-Meier y comparaci&#243;n de las tasas de mortalidad seg&#250;n caracter&#237;sticas iniciales de los pacientes mediante log-rank-test&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">El incremento del riesgo de mortalidad total y de MCV seg&#250;n presencia inicial&#44; tipo de ECV y n&#250;mero de territorios vasculares afectados &#40;codificado como ninguno&#44; uno o m&#225;s de uno&#41; se evalu&#243; mediante modelos de regresi&#243;n de Cox uni y multivariante&#46; Se presentan las hazards ratio &#40;HR&#41; con sus correspondientes intervalos de confianza &#40;IC&#41; del 95&#37;&#46; Para el an&#225;lisis estad&#237;stico se agruparon las categor&#237;as de ICFEm e ICFEp debido al limitado n&#250;mero de sujetos&#46; El ajuste multivariante se realiz&#243; mediante criterios estad&#237;sticos &#40;significaci&#243;n de las variables en an&#225;lisis univariante&#41; y su sentido cl&#237;nico&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Se consideraron significativas las asociaciones con p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Resultados</span><p id="par0205" class="elsevierStylePara elsevierViewall">Entre mayo de 2018 y marzo de 2020 se evaluaron 1&#46;543 pacientes&#44; con participaci&#243;n de 110 investigadores de 58 hospitales con representaci&#243;n de todo el territorio nacional espa&#241;ol&#46; En el presente an&#225;lisis se incluyen los 1&#46;246 pacientes en los cuales se pudo obtener informaci&#243;n sobre mortalidad en la visita de cierre del estudio&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">La edad media de los participantes fue de 67&#44;3 &#40;DE&#58; 9&#44;9&#41; a&#241;os&#44; con un porcentaje de mujeres del 31&#44;6&#37;&#46; La prevalencia inicial de ECV total fue del 59&#44;3&#37;&#44; con la siguiente distribuci&#243;n de entidades&#58; insuficiencia cardiaca 39&#44;4&#37; &#40;ICFEr 17&#44;3&#37;&#44; ICFEm 8&#44;1&#37; y ICFEp 14&#37;&#41;&#44; ECVA 49&#44;9&#37; &#40;con 10&#44;9&#37; de los pacientes presentando m&#225;s de un territorio vascular afectado por patolog&#237;a ateroscler&#243;tica&#41;&#44; EACo 43&#44;1&#37;&#44; EACe 8&#44;2&#37; y EAPe 10&#44;8&#37;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se refleja el porcentaje de pacientes con un determinado tipo de ECV que tienen simult&#225;neamente otro tipo de ECV&#46; Es de destacar que&#44; entre los pacientes con EAPe&#44; casi el 70&#37; ten&#237;an EACo&#44; el 16&#37; EACe y el 55&#37; insuficiencia cardiaca&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0215" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas de los pacientes en su totalidad&#44; y en dependencia de que tuviesen o no alguna manifestaci&#243;n de ECV&#44; quedan plasmadas en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Como puede comprobarse&#44; los pacientes con ECV ten&#237;an mayor edad y puntuaci&#243;n de Charlson&#44; menor proporci&#243;n de mujeres&#44; menor IMC&#44; una TFGe m&#225;s reducida acompa&#241;ada de una EAU m&#225;s elevada&#44; y valores de NT-proBNP m&#225;s altos&#44; junto con una menor FEVI&#46; Los pacientes con ECV ten&#237;an mejor control de los factores de riesgo vascular&#44; con menor proporci&#243;n de fumadores activos y valores inferiores de PA y l&#237;pidos &#40;cLDL y colesterol no-HDL&#41;&#44; lo cual puede justificarse por la mayor utilizaci&#243;n de hipotensores e hipolipemiantes&#46; No obstante&#44; solo el 46&#44;3&#37; de los sujetos con ECV ten&#237;an una HbA1c &#60;<span class="elsevierStyleHsp" style=""></span>7&#37;&#44; el 43&#44;8&#37; ten&#237;an una PAS &#60;<span class="elsevierStyleHsp" style=""></span>130<span class="elsevierStyleHsp" style=""></span>mmHg y el 30&#44;8&#37; ten&#237;an un colesterol no-HDL &#60;<span class="elsevierStyleHsp" style=""></span>85<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; En pacientes con ECV hab&#237;a una elevada utilizaci&#243;n de estatinas &#40;90&#44;3&#37;&#41;&#44; pero el uso de ezetimiba &#40;22&#44;3&#37;&#41; y de i-PCSK9 &#40;1&#44;3&#37;&#41; era bajo&#44; a pesar de una proporci&#243;n elevada de pacientes que no cumpl&#237;an los objetivos terap&#233;uticos lip&#237;dicos&#46; Respecto al tratamiento hipoglucemiante&#44; el 39&#44;4&#37; de los pacientes con ECV estaban tratados con i-SGLT2 y el 12&#37; con AR-GLP1&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0220" class="elsevierStylePara elsevierViewall">Durante una media de 2&#44;6 a&#241;os de seguimiento se produjeron 122 fallecimientos&#44; de los cuales 46 fueron por causa cardiovascular&#46; Las caracter&#237;sticas de los participantes clasificados en aquellos que fallecieron o no y clasificados en aquellos que murieron o no por causa cardiovascular quedan resumidas&#44; respectivamente&#44; en las <a class="elsevierStyleCrossRefs" href="#tbl0015">tablas 3 y 4</a>&#46; Los pacientes que fallecieron ten&#237;an mayor edad y puntuaci&#243;n de Charlson&#44; una prevalencia m&#225;s alta de diagn&#243;stico de c&#225;ncer&#44; valores m&#225;s altos de EAU y valores m&#225;s bajos de PA&#44; IMC&#44; cHDL&#44; hemoglobina&#44; TFGe y FEVI&#44; as&#237; como mayores prevalencias de complicaciones micro y macrovasculares&#46; El patr&#243;n era similar en aquellos en los que la causa de la muerte fue de origen cardiovascular&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0225" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a> se describen las TI de mortalidad total y cardiovascular en dependencia del tipo de ECV inicial&#44; y en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se presentan las curvas de supervivencia&#46; Como comparaci&#243;n&#44; se incluye tambi&#233;n la TI de mortalidad de los pacientes diagnosticados con c&#225;ncer&#46; Los pacientes sin ECV ten&#237;an una TI de mortalidad de 19&#47;1&#46;000 y de MCV de 4&#44;5&#47;1&#46;000&#46; Puede comprobarse&#44; como era de esperar&#44; que cualquier manifestaci&#243;n de ECV incrementaba las tasas de mortalidad total y de MCV&#46; Espec&#237;ficamente&#44; las TI m&#225;s elevadas de mortalidad total y de MCV se produjeron en los pacientes con EAPe &#40;85&#44;6&#47;1&#46;000 y 33&#44;6&#47;1&#46;000 pacientes-a&#241;o&#44; respectivamente&#41;&#44; ante la afectaci&#243;n de m&#225;s de un territorio vascular &#40;79&#44;1&#47;1&#46;000 y 27&#44;4&#47;1&#46;000&#44; respectivamente&#41; y en aquellos diagnosticados de insuficiencia cardiaca &#40;72&#44;9&#47;1&#46;000 y 28&#44;7&#47;1&#46;000&#44; respectivamente&#41;&#46; Hay que resaltar que la TI m&#225;s alta de MCV se observ&#243; en los pacientes con ICFEr &#40;36&#44;5&#47;1&#46;000&#41;&#46; Las TI fueron inferiores en los sujetos con EACo &#40;47&#44;6&#47;10&#46;00 y 18&#44;1&#47;1&#46;000 para mortalidad total y MCV&#44; respectivamente&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0230" class="elsevierStylePara elsevierViewall">En an&#225;lisis univariante&#44; las patolog&#237;as cardiovasculares que m&#225;s incrementaron el riesgo de mortalidad &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; fueron la insuficiencia cardiaca &#40;HR&#58; 4&#44;4&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y la EAPe &#40;HR&#58; 2&#44;6&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Es de destacar que los pacientes tratados con i-SGLT2 &#40;HR&#58; 0&#44;47&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; o con AR-GLP1 &#40;HR&#58; 0&#44;18&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; ten&#237;an menos riesgo de mortalidad&#46; Respecto a MCV&#44; el riesgo aument&#243; significativamente con la existencia de insuficiencia cardiaca &#40;HR&#58; 5&#44;3&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y EAPe &#40;HR&#58; 2&#44;8&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; mientras que fue inferior en los tratados con i-SGLT2 &#40;HR&#58; 0&#44;28&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; o con AR-GLP1 &#40;HR&#58; 0&#44;24&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;046&#41;&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante del modelo final elegido para mortalidad total&#44; con inclusi&#243;n simult&#225;nea de todos los territorios vasculares afectados y ajustado para el resto de las variables asociadas con mortalidad&#44; la &#250;nica manifestaci&#243;n de ECV que permaneci&#243; estad&#237;sticamente significativa fue la insuficiencia cardiaca &#40;HR&#58; 1&#44;63&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;03-2&#44;58&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41;&#46; Otros factores que aumentaron el riesgo de mortalidad fueron la edad &#40;HR<span class="elsevierStyleInf">1a&#241;o</span>&#58; 1&#44;07&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;04-1&#44;10&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y el &#237;ndice de Charlson &#40;HR<span class="elsevierStyleInf">1punto</span>&#58; 1&#44;77&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;46-2&#44;16&#41;&#59; por el contrario&#44; fueron factores asociados con menor riesgo la TFGe &#40;HR<span class="elsevierStyleInf">1ml&#47;min</span>&#58; 0&#44;990&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;980-0&#44;999&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; tener un diagn&#243;stico de c&#225;ncer &#40;HR&#58; 0&#44;52&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;28-0&#44;98&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#41; y ser tratado con AR-GLP1 &#40;HR&#58; 0&#44;29&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;10-0&#44;78&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41;&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante del modelo final elegido para MCV&#44; con inclusi&#243;n simult&#225;nea de todos los territorios vasculares afectados y ajustado para el resto de las variables asociadas con MCV&#44; la &#250;nica manifestaci&#243;n de ECV que permaneci&#243; estad&#237;sticamente significativa fue tambi&#233;n la insuficiencia cardiaca &#40;HR&#58; 3&#44;41&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;68-6&#44;93&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Otro factor que increment&#243; el riesgo de MCV fue la edad &#40;HR<span class="elsevierStyleInf">1a&#241;o</span>&#58; 1&#44;04&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;00-1&#44;08&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;033&#41;&#59; por el contrario&#44; fueron factores protectores la TFGe &#40;HR<span class="elsevierStyleInf">1ml&#47;min</span>&#58; 0&#44;98&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;96-0&#44;99&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41;&#44; y en el l&#237;mite de la significaci&#243;n estad&#237;stica el g&#233;nero femenino &#40;HR&#58; 0&#44;50&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;25-1&#44;01&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;053&#41; y ser tratado con i-SGLT2 &#40;HR&#58; 0&#44;44&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;19-1&#44;01&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;052&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105"><span class="elsevierStyleBold">Discusi&#243;n</span></span><p id="par0245" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; mediante el seguimiento prospectivo durante 2&#44;6<span class="elsevierStyleHsp" style=""></span>a&#241;os de una cohorte de pacientes con DM2 reclutados en el medio hospitalario&#44; y con una elevada prevalencia de ECV&#44; hemos comprobado c&#243;mo las TI de mortalidad total y de MCV var&#237;an en dependencia del tipo de ECV inicial&#46; Las TI m&#225;s elevadas&#44; y el mayor incremento de riesgo&#44; se produjeron en pacientes con insuficiencia cardiaca&#44; EAPe y ante la afectaci&#243;n ateroscler&#243;tica de m&#225;s de un territorio vascular&#46; En an&#225;lisis ajustado para potenciales factores de confusi&#243;n&#44; la &#250;nica ECV que increment&#243; el riesgo de forma estad&#237;sticamente significativa fue la insuficiencia cardiaca&#46; Cabe resaltar que todas las TI de mortalidad&#44; excepto las asociadas a EACo&#44; fueron superiores a las de tener un diagn&#243;stico de c&#225;ncer&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">El riesgo de mortalidad total&#44; y en concreto el de MCV&#44; es variable en el paciente con DM&#44; por lo que las gu&#237;as de pr&#225;ctica cl&#237;nica<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">15&#44;16</span></a> recomiendan realizar una estratificaci&#243;n cuidadosa del riesgo vascular en cada paciente&#44; para fijar el tipo de tratamiento y la intensidad de los objetivos terap&#233;uticos&#46; Hay pocos datos en la literatura que comparen el riesgo de mortalidad de las distintas manifestaciones de ECV&#46; En un estudio retrospectivo basado en bases de datos de atenci&#243;n primaria en el Reino Unido<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a> el riesgo de MCV fue mayor en los pacientes con m&#250;ltiples comorbilidades cardiovasculares&#46; En un estudio poblacional dan&#233;s reciente<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a>&#44; con m&#225;s de 150&#46;000 personas con DM2 analizadas en un seguimiento de casi 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; el mayor riesgo de mortalidad estaba asociado al desarrollo de insuficiencia cardiaca &#40;RR&#58; 3&#41;&#44; un riesgo intermedio estaba asociado a EAPe y EACe &#40;RR&#58; 2&#44;3 y 2&#44;2&#44; respectivamente&#41; y un riesgo m&#225;s bajo aparec&#237;a ante la presencia de EACo &#40;RR&#58; 1&#44;3&#41;&#59; no obstante&#44; no dispusieron de informaci&#243;n sobre otros factores de riesgo ni de la existencia de afectaci&#243;n microvascular&#46; Estos datos son totalmente superponibles a los encontrados en nuestro estudio en el an&#225;lisis univariante de mortalidad&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">El reconocimiento de la insuficiencia cardiaca como una complicaci&#243;n asociada a la DM&#44; debido al efecto perjudicial de la hiperglucemia y de la resistencia insul&#237;nica&#44; se ha incrementado en los &#250;ltimos a&#241;os&#44; y ha sido objeto de revisiones<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a> y de documentos de consenso<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a>&#46; La DM2 puede favorecer el desarrollo tanto de ICFEp &#40;m&#225;s frecuente en estadios iniciales de la enfermedad&#41; como de ICFEr &#40;m&#225;s frecuente en pacientes con EACo&#41;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a>&#46; El riesgo de mortalidad parece ser m&#225;s elevado en los pacientes con ICFEr<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a>&#44; proporcionalmente al grado de descenso de la FEVI&#46; En nuestro estudio comprobamos que aunque las TI de mortalidad total eran similares&#44; las de MCV eran superiores en los pacientes con insuficiencia cardiaca si la FEVI era &#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">La presencia de EAPe incrementa notablemente la probabilidad de presentar otras manifestaciones de ECVA&#44; as&#237; como de insuficiencia cardiaca&#44; por lo que puede considerase un marcador de enfermedad polivascular<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a>&#46; Un amplio estudio epidemiol&#243;gico comprob&#243; la asociaci&#243;n de EAPe con otras formas de ECVA y con insuficiencia cardiaca&#44; as&#237; como el aumento significativo del riesgo de MCV &#40;HR&#58; 1&#44;86&#41;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">22</span></a>&#46; Nuestro trabajo confirm&#243; que los pacientes con EAPe ten&#237;an una elevada prevalencia de otras manifestaciones de ECVA&#44; as&#237; como de insuficiencia cardiaca&#44; lo que justificaba que desarrollasen las TI m&#225;s elevadas de mortalidad total y una de las TI m&#225;s elevadas de MCV&#44; solo superadas por los pacientes con ICFEr&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">El mayor riesgo conferido por la presencia de insuficiencia cardiaca y EAPe viene asociado al hecho de que pueden ser en el momento actual las entidades iniciales m&#225;s frecuentes de ECV&#44; adem&#225;s de ser la EAPe la enfermedad ateroscler&#243;tica m&#225;s estrechamente asociada a la DM<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a>&#46; De hecho&#44; en las &#250;ltimas d&#233;cadas la forma de ECVA que mayor reducci&#243;n ha experimentado en sus TI ha sido la EACo&#59; esta reducci&#243;n ha ido acompa&#241;ada tambi&#233;n de una disminuci&#243;n del n&#250;mero absoluto de casos&#44; algo que no se ha conseguido ni para la EAPe ni para la EACe<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a>&#46; Por ello las gu&#237;as recientes recomiendan tener un alto &#237;ndice de sospecha para realizar cribado de insuficiencia cardiaca<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">16&#44;25</span></a> y de EAPe<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Los &#250;ltimos datos epidemiol&#243;gicos demuestran en nuestro pa&#237;s<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a> una tendencia favorable de reducci&#243;n de mortalidad en pacientes con DM2&#46; La tendencia global hacia una reducci&#243;n en las tasas de MCV puede deberse a mejores estrategias preventivas y terap&#233;uticas<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">8&#44;27</span></a>&#46; La demostraci&#243;n del beneficio espec&#237;fico de i-SGLT2 y AR-GLP1<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a> hace que sean un&#225;nimemente recomendados ante la presencia de ECV en los pacientes con DM2<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; En nuestro estudio&#44; aunque no espec&#237;ficamente dise&#241;ado para ello&#44; vimos c&#243;mo mejoraba el pron&#243;stico de los pacientes tratados con estos grupos terap&#233;uticos&#46; Adem&#225;s&#44; identificamos una oportunidad de mejora&#44; ya que apenas el 39&#37; de los pacientes con ECV eran tratados con un i-SGLT2 y el 12&#37; con AR-GLP1&#46; Estos resultados pueden servir para impulsar la utilizaci&#243;n de f&#225;rmacos cardioprotectores&#44; con el objetivo de que ning&#250;n paciente que pueda beneficiarse de ellos sea privado de su prescripci&#243;n<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">28</span></a>&#46; Hay que tener en cuenta&#44; adem&#225;s&#44; el beneficio aditivo de la utilizaci&#243;n simult&#225;nea de varios grupos terap&#233;uticos<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a>&#46; Por otra parte&#44; tambi&#233;n constatamos en nuestro trabajo que era necesario intensificar el tratamiento hipolipemiante hasta alcanzar los objetivos marcados por las gu&#237;as<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">El presente estudio tiene como ventaja el contar con una muestra de pacientes con DM2 con elevada prevalencia de ECV&#44; reclutados en hospitales representativos de todo el territorio nacional&#46; Se dispuso de datos epidemiol&#243;gicos&#44; cl&#237;nicos y anal&#237;ticos&#46; Adem&#225;s&#44; los pacientes hab&#237;an sido evaluados conjuntamente en consultas de cardiolog&#237;a y endocrinolog&#237;a&#44; por lo que se dispon&#237;a de datos ecocardiogr&#225;ficos en casi el 90&#37; de la cohorte&#46; Por ello puede considerarse que las TI descritas en las distintas situaciones son exactas&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">No obstante&#44; hay limitaciones importantes que deben ser tenidas en cuenta&#46; En primer lugar&#44; la muestra y el seguimiento fueron inferiores a los inicialmente proyectados&#44; debido a las restricciones impuestas por la pandemia de COVID-19&#59; por ello la potencia estad&#237;stica puede ser limitada para la realizaci&#243;n de modelos de regresi&#243;n multivariable y an&#225;lisis de subgrupos&#44; y los resultados deben ser interpretados con precauci&#243;n&#46; A modo de ejemplo&#44; el incremento de riesgo de mortalidad conferido por la presencia de c&#225;ncer en an&#225;lisis univariante se revirti&#243; en el an&#225;lisis multivariante&#44; lo que podr&#237;a justificarse por la inclusi&#243;n simult&#225;nea en los modelos del &#237;ndice de Charlson y por el riesgo competitivo de la MCV&#46; En segundo lugar&#44; los pacientes fueron recogidos en medio hospitalario&#44; por lo que las prevalencias de ECV no son representativas de la poblaci&#243;n total de pacientes con DM2&#46; Finalmente&#44; el tratamiento prescrito fue a discreci&#243;n del m&#233;dico responsable&#44; por lo que los datos de eficacia respecto a reducci&#243;n de riesgo de mortalidad de algunos f&#225;rmacos pueden estar parcialmente sesgados &#40;sesgo de indicaci&#243;n&#41; y deben ser considerados como generadores de hip&#243;tesis y no definitivos&#46;</p><p id="par0285" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; el riesgo residual de mortalidad total y MCV de los pacientes con DM2 y ECV puede ser muy elevado&#46; Esto es especialmente manifiesto en los sujetos con insuficiencia cardiaca&#44; EAPe y ante la afectaci&#243;n ateroscler&#243;tica de m&#250;ltiples territorios vasculares&#46; La existencia de insuficiencia cardiaca triplica&#44; de modo independiente&#44; el riesgo de MCV&#44; mientras que el incremento de riesgo asociado a la EAPe puede explicarse por su frecuente asociaci&#243;n con insuficiencia cardiaca y afectaci&#243;n polivascular&#46; Por ello consideramos que es necesario detectar en los pacientes con DM2 la presencia de estas patolog&#237;as para optimizar el manejo de los factores de riesgo vascular y para ampliar la utilizaci&#243;n de f&#225;rmacos hipoglucemiantes con el potencial de mejorar el pron&#243;stico de la enfermedad&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Financiaci&#243;n</span><p id="par0290" class="elsevierStylePara elsevierViewall">El presente trabajo ha sido financiado con la ayuda de una beca&#44; concedida a la Sociedad Espa&#241;ola de Diabetes y a la Sociedad Espa&#241;ola de Cardiolog&#237;a&#44; de Boehringer Ingelheim&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicto de intereses</span><p id="par0295" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Resumen"
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            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introducci&#243;n"
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            1 => array:2 [
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              "titulo" => "Materiales y m&#233;todos"
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            2 => array:2 [
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              "titulo" => "Resultados"
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            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusiones"
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              "titulo" => "Criterios de inclusi&#243;n y exclusi&#243;n"
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              "titulo" => "Variable dependiente &#40;punto final cl&#237;nico&#41;"
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              "titulo" => "Variables recogidas en la visita inicial"
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    "fechaRecibido" => "2024-03-03"
    "fechaAceptado" => "2024-03-25"
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            0 => "Diabetes tipo 2"
            1 => "Mortalidad"
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          "clase" => "keyword"
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            0 => "Type 2 diabetes"
            1 => "Mortality"
            2 => "Cardiovascular disease"
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    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El riesgo de mortalidad total y de mortalidad cardiovascular &#40;MCV&#41; de los pacientes con diabetes tipo<span class="elsevierStyleHsp" style=""></span>2 &#40;DM2&#41; puede ser muy elevado ante la existencia de enfermedad cardiovascular &#40;ECV&#41;&#46; Nuestro objetivo fue cuantificar este riesgo considerando las diferentes manifestaciones de ECV&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materiales y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El estudio DIABET-IC es un estudio multic&#233;ntrico&#44; observacional&#44; prospectivo y anal&#237;tico&#44; con reclutamiento consecutivo de pacientes con DM2 procedentes de consultas externas hospitalarias&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se recogieron variables cl&#237;nicas&#44; anal&#237;ticas y ecocardiogr&#225;ficas&#44; con clasificaci&#243;n de los pacientes en dependencia de la presencia y tipo de ECV&#58; insuficiencia cardiaca&#44; enfermedad arterial coronaria &#40;EACo&#41;&#44; enfermedad arterial cerebrovascular &#40;EACe&#41; y enfermedad arterial perif&#233;rica &#40;EAPe&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las variables dependientes analizadas fueron mortalidad total y MCV&#46; Se calcularon las tasas por cada 1&#46;000 pacientes-a&#241;o y se realizaron modelos de Cox para determinar el riesgo de mortalidad asociado a cada tipo de ECV&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 1&#46;246 pacientes de 67&#44;3 &#40;DE&#58; 9&#44;9&#41; a&#241;os&#44; 31&#44;6&#37; mujeres y con prevalencia inicial de ECV del 59&#44;3&#37;&#46; Durante un seguimiento de 2&#44;6<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; hubo 122 fallecimientos &#40;46 cardiovasculares&#41;&#46; Las tasas asociadas a existencia de EAPe &#40;85&#44;6&#47;1&#46;000 mortalidad total y 33&#44;6&#47;1&#46;000 MCV&#41; e insuficiencia cardiaca &#40;72&#44;9&#47;1&#46;000 mortalidad total y 28&#44;7&#47;1&#46;000 MCV&#41; fueron las m&#225;s elevadas&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En an&#225;lisis multivariante&#44; la insuficiencia cardiaca aument&#243; el riesgo de mortalidad total &#40;HR&#58; 1&#44;63&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;03-2&#44;58&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41; y MCV &#40;HR&#58; 3&#44;41&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;68-6&#44;93&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La mortalidad de los pacientes con DM2 est&#225; incrementada&#44; especialmente ante la existencia de insuficiencia cardiaca y EAPe&#44; lo que justifica su cribado para intensificar las medidas terap&#233;uticas&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materiales y m&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">All-cause mortality and cardiovascular mortality &#40;CVM&#41; risk can be very high in adults with type<span class="elsevierStyleHsp" style=""></span>2 diabetes mellitus &#40;DM2&#41; with previous cardiovascular disease &#40;CVD&#41;&#46; Our objective was to determine this risk among the different clinical spectrum of CVD&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The DIABET-IC trial is a multicenter&#44; prospective&#44; observational&#44; and analytical study&#46; Consecutive subjects with DM2 attending our outpatients&#8217; clinics were recruited&#46; Data on clinical features&#44; lab test results&#44; and echocardiographic measures were collected&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Patients were categorized depending on the presence and type of CVD&#58; heart failure &#40;HF&#41;&#44; coronary artery disease &#40;CAD&#41;&#44; cerebrovascular disease &#40;CVD&#41; and peripheral artery disease &#40;PAD&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">All-cause mortality and CVM were the dependent variables analyzed&#46; Mortality rate was expressed as deaths per 1000 patients-year&#46; Cox proportional hazards regressions models were used to establish the mortality risk associated with every type of CVD&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">We studied a total of 1246 patients &#40;mean age&#44; 6&#46;3 &#40;SD&#58; 9&#46;9&#41; years&#59; 31&#46;6&#37;&#44; female&#41; with an initial prevalence of CVD of 59&#46;3&#37;&#46; A total of 122 deaths &#40;46 due to CVD&#41; occurred at the 2&#46;6-year follow-up&#46; All-cause and CVM rates associated with the presence of PAD &#40;85&#46;6&#47;1000 and 33&#46;6&#47;1000&#44; respectively&#41; and HF &#40;72&#46;9&#47;1000 and 28&#46;7&#47;1000 respectively&#41; were the most elevated of all&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">In multivariate analysis&#44; HF increased all-cause mortality risk &#40;HR&#58; 1&#46;63&#59; 95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#58; 1&#46;03-2&#46;58&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;037&#41; and the risk of CVM &#40;HR&#58; 3&#46;41&#59; 95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#58; 1&#46;68-6&#46;93&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Mortality among DM2 patients is highly increased in the presence of HF and PAD&#46; This justifies the screening of these conditions to intensify therapeutic strategies&#46;</p></span>"
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            "apendice" => "<p id="par0305" class="elsevierStylePara elsevierViewall">Listado de los investigadores de DIABET-IC<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">EACe&#58; enfermedad arterial cerebrovascular&#59; EACo&#58; enfermedad arterial coronaria&#59; EAPe&#58; enfermedad arterial perif&#233;rica&#59; FE&#58; fracci&#243;n de eyecci&#243;n&#59; IC&#58; insuficiencia cardiaca&#59; &#37;&#58; porcentaje de pacientes con un determinado tipo de ECV que tienen simult&#225;neamente otro tipo de ECV&#46;</p>"
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                  \t\t\t\t">IC con FE&#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24&#44;77&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Afectaci&#243;n cardiovascular cruzada entre territorios vasculares</p>"
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      2 => array:8 [
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">EAU&#58; excreci&#243;n de alb&#250;mina urinaria&#59; ERC&#58; enfermedad renal cr&#243;nica&#59; FEVI&#58; fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo&#59; IMC&#58; &#237;ndice de masa corporal&#59; PAD&#58; presi&#243;n arterial diast&#243;lica&#59; PAS&#58; presi&#243;n arterial sist&#243;lica&#59; TFGe&#58; tasa de filtraci&#243;n glomerular estimada&#46;</p>"
          "tablatextoimagen" => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No ECV</th><th class="td" title="\n
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                  \t\t\t\t" scope="col">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables cuantitativas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&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" scope="col" style="border-bottom: 2px solid black">Media&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" scope="col" style="border-bottom: 2px solid black">DE&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" scope="col" style="border-bottom: 2px solid black">n&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">Media&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">DE&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" scope="col" style="border-bottom: 2px solid black">n&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" scope="col" style="border-bottom: 2px solid black">Media&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">DE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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
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                  \t\t\t\t">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;246&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">67&#44;35&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">507&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;18&nbsp;\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</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Colesterol no-HDL &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Duraci&#243;n de la diabetes &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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            1 => array:2 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables cualitativas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo &#40;&#37; mujer&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">217&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">177&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">HbA1c &#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">7&#37; &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">45&#44;23&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">219&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio 1 &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>90&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio 2 &#40;60-89&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio 3 &#40;30-59&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio 5 &#40;&#60;15&#41;&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">PAS &#40;mmHg&#41;&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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;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
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">PAD &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Per&#237;metro cintura sobre cresta il&#237;aca &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Valores FEVI basales &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">118&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">48&#44;79&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15&#44;2&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">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;76&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">cHDL &#40;mg&#47;dl&#41;&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">Colesterol no-HDL &#40;total &#8722; HDL&#41; &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">108&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33&#44;72&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">118&nbsp;\t\t\t\t\t\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">103&#44;22&nbsp;\t\t\t\t\t\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">31&#44;25&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;105&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">0&#44;995&nbsp;\t\t\t\t\t\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&#44;990&nbsp;\t\t\t\t\t\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&#44;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="left" valign="\n
                  \t\t\t\t\ttop\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">Glucemia basal &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">140&#44;14&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">146&#44;36&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">HbA1c &#40;&#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\ttable-entry\n
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                  \t\t\t\t\ttable-entry\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">Duraci&#243;n de la diabetes &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3604581.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
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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-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" scope="col">Mortalidad total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>122&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No</th><th class="td" title="\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&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
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                  \t\t\t\t" scope="col">HR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC 95&#37;</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables cualitativas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&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" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\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\ttable-head\n
                  \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\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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"><span class="elsevierStyleItalic">Sexo &#40;&#37; mujer&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">349&nbsp;\t\t\t\t\t\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">31&#44;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">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">28&#44;69&nbsp;\t\t\t\t\t\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&#44;465&nbsp;\t\t\t\t\t\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&#44;893&nbsp;\t\t\t\t\t\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&#44;603&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;322&nbsp;\t\t\t\t\t\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&#44;572&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Enfermedad arterial cerebrovascular &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
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                  \t\t\t\t">1 &#40;Referencia&#41;</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="elsevierStyleHsp" style=""></span>Estadio 2 &#40;60-89&#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">7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10&#44;77&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio 3 &#40;30-59&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;315&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="elsevierStyleHsp" style=""></span>Estadio 4 &#40;15-29&#41;&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\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio 5 &#40;&#60; 15&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">EAU &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t">1 &#40;Referencia&#41;</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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EAU<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;30&#44;300&#41;&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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EAU<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>300&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;391&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3604583.png"
              ]
            ]
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                  \t\t\t\t" scope="col">Mortalidad cardiovascular &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;ndice de Charlson &#40;puntos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Per&#237;metro cintura sobre cresta il&#237;aca &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Valores FEVI basales &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">EAU &#40;mg&#47;g de creatinina&#41;&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">cLDL &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">79&#44;78&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;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">Triglic&#233;ridos &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" 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  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;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">0&#44;213&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">cHDL &#40;mg&#47;dl&#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">1&#46;137&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;19&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="left" valign="\n
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                  \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  " align="left" 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  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;97&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="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;021&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">Colesterol no-HDL &#40;mg&#47;dl&#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">1&#46;136&nbsp;\t\t\t\t\t\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">108&#44;7&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;4&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="left" 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  " align="left" valign="\n
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                  \t\t\t\t">100&#44;9&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="left" valign="\n
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                  \t\t\t\t">34&#44;5&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;075&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="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;00&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;147&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">Glucemia basal &#40;mg&#47;dl&#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
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                  \t\t\t\t">1&#46;162&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="left" valign="\n
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                  \t\t\t\t">139&#44;97&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  " align="left" valign="\n
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                  \t\t\t\t">161&#44;09&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">64&#44;11&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</td><td class="td" title="\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
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                  \t\t\t\t">HbA1c &#40;&#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">1&#44;35&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</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</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  " align="left" valign="\n
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                  \t\t\t\t">0&#44;431&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">Duraci&#243;n de la diabetes &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;163&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  """
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                0 => "xTab3604586.png"
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            1 => array:2 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables cualitativas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">HTA &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estadio 5 &#40;&#60; 15&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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 &#40;Referencia&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EAU<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;30&#44;300&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">230&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t  " align="left" valign="\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="left" valign="\n
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                  \t\t\t\t">7&#44;51&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">0&#44;075&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3604580.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas iniciales de los pacientes en dependencia de que falleciesen o no por causa cardiovascular con an&#225;lisis de Cox univariante para cada variable</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Tabla 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at5"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">Muertes totales &#40;n&#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">TI mortalidad&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">p &#40;log rank test&#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">Muertes vasculares &#40;n&#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">TI mortalidad cardiovascular&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">p&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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">C&#225;ncer</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">No&nbsp;\t\t\t\t\t\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">105&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="left" valign="\n
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                  \t\t\t\t">35&#44;38&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">13&#44;48&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">0&#44;161&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">S&#237;&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">17&nbsp;\t\t\t\t\t\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">71&#44;03&nbsp;\t\t\t\t\t\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\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">25&#44;07&nbsp;\t\t\t\t\t\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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad cardiovascular</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">No&nbsp;\t\t\t\t\t\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">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;98&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\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">4&#44;56&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;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">S&#237;&nbsp;\t\t\t\t\t\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">97&nbsp;\t\t\t\t\t\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">51&#44;46&nbsp;\t\t\t\t\t\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\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">21&#44;22&nbsp;\t\t\t\t\t\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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia card&#237;aca seg&#250;n FE</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">No&nbsp;\t\t\t\t\t\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">33&nbsp;\t\t\t\t\t\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">16&#44;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">Referencia&nbsp;\t\t\t\t\t\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">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;54&nbsp;\t\t\t\t\t\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">Referencia&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">FE &#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&nbsp;\t\t\t\t\t\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">39&nbsp;\t\t\t\t\t\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">71&#44;17&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\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">36&#44;50&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;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">FE &#8805;<span class="elsevierStyleHsp" style=""></span>40&#37;&nbsp;\t\t\t\t\t\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">50&nbsp;\t\t\t\t\t\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">74&#44;33&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">22&#44;30&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia card&#237;aca</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">No&nbsp;\t\t\t\t\t\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">33&nbsp;\t\t\t\t\t\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">16&#44;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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;54&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;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">S&#237;&nbsp;\t\t\t\t\t\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">89&nbsp;\t\t\t\t\t\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">72&#44;91&nbsp;\t\t\t\t\t\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">28&#44;67&nbsp;\t\t\t\t\t\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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad arterial cerebrovascular</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">No&nbsp;\t\t\t\t\t\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">104&nbsp;\t\t\t\t\t\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">35&#44;21&nbsp;\t\t\t\t\t\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&#44;004&nbsp;\t\t\t\t\t\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">39&nbsp;\t\t\t\t\t\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">13&#44;20&nbsp;\t\t\t\t\t\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&#44;06&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">S&#237;&nbsp;\t\t\t\t\t\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">18&nbsp;\t\t\t\t\t\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">71&#44;64&nbsp;\t\t\t\t\t\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;86&nbsp;\t\t\t\t\t\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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad arterial perif&#233;rica</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">No&nbsp;\t\t\t\t\t\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">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;67&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">12&#44;16&nbsp;\t\t\t\t\t\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&#44;002&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">S&#237;&nbsp;\t\t\t\t\t\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">28&nbsp;\t\t\t\t\t\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">85&#44;55&nbsp;\t\t\t\t\t\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;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="" 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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad arterial coronaria</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">No&nbsp;\t\t\t\t\t\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">56&nbsp;\t\t\t\t\t\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">30&#44;82&nbsp;\t\t\t\t\t\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&#44;017&nbsp;\t\t\t\t\t\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">21&nbsp;\t\t\t\t\t\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">11&#44;56&nbsp;\t\t\t\t\t\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&#44;133&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">S&#237;&nbsp;\t\t\t\t\t\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">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;65&nbsp;\t\t\t\t\t\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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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
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