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Impacto pronóstico de la adherencia secundaria a betabloqueantes tras infarto de miocardio con elevación del segmento ST sin disfunción ventricular
Secondary adherence to beta-blockers after ST-elevation myocardial infarction without ventricular dysfunction
Ana Padilla Lópeza,
Autor para correspondencia
apadillafar@gmail.com

Autor para correspondencia.
, Manuel Alós-Almiñanab, José E. Perisc
a Servicio de Farmacia de Área, Departamento de Salud de Gandía, Gandía, Valencia, España
b Servicio de Farmacia, Hospital Clínico Universitario, Valencia, España
c Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Valencia, Valencia, España
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como su duraci&#243;n en los pacientes sin insuficiencia cardiaca o con una fracci&#243;n de eyecci&#243;n de ventr&#237;culo izquierdo &#40;FEVI&#41; &#8805; 40&#37;&#46; Los estudios observacionales disponibles para el IAMCEST&#44; con una duraci&#243;n entre uno y 5<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; presentan resultados dispares a nivel del impacto en la morbimortalidad<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">6-11</span></a>&#46; Esta falta de evidencias concluyentes provoca discrepancias en la duraci&#243;n m&#237;nima del tratamiento recomendada por las principales gu&#237;as de pr&#225;ctica cl&#237;nica de referencia<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">12-14</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Entre los principales factores que limitan la efectividad de un tratamiento se encuentra la toma correcta de la medicaci&#243;n a largo plazo&#44; definida como adherencia secundaria&#46; Un problema alarmante en la actualidad es que aproximadamente el 50&#37; de los pacientes no son adherentes al tratamiento prescrito<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&#44; con un claro impacto en el pron&#243;stico<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a>&#46; En este sentido&#44; son escasos los trabajos dedicados a la adherencia a largo plazo a betabloqueantes y su influencia en la evoluci&#243;n de los pacientes con enfermedad coronaria<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17-21</span></a>&#44; especialmente en los pacientes de bajo riesgo<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo principal del presente trabajo ha sido determinar el impacto de la prescripci&#243;n y la adherencia secundaria a betabloqueantes en la morbimortalidad cardiovascular a medio y largo plazo&#44; en una cohorte de pacientes diagnosticados de un primer episodio de IAMCEST tipo 1 sin insuficiencia cardiaca o con FEVI &#8805; 40&#37;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Poblaci&#243;n del estudio</span><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio&#44; de tipo observacional y retrospectivo&#44; se llev&#243; a cabo en el Hospital Cl&#237;nico Universitario de Valencia sobre una poblaci&#243;n de pacientes mayores de 18 a&#241;os que presentaron&#44; entre enero del 2008 y diciembre del 2013&#44; un primer episodio de IAMCEST tipo 1 asociado a la presencia de aterosclerosis como diagn&#243;stico principal de ingreso hospitalario &#40;c&#243;digos de la Clasificaci&#243;n Internacional de Enfermedades 9&#46;&#170; edici&#243;n &#91;CIE-9&#93; 410&#46;0-410&#46;9&#41;&#44; sin insuficiencia cardiaca o con FEVI &#8805; 40&#37; y que fueron dados de alta con vida&#46; Se excluy&#243; a los pacientes en situaci&#243;n terminal al alta hospitalaria&#44; los que no alcanzaron los 30 d&#237;as de seguimiento&#44; los no pertenecientes a ese departamento&#44; los residentes en otras comunidades aut&#243;nomas o pa&#237;ses&#44; y aquellos con una prestaci&#243;n farmac&#233;utica no cubierta por el Sistema Nacional de Salud o sin cobertura sanitaria&#46; El estudio fue aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica del Hospital Cl&#237;nico Universitario de Valencia&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Se efectu&#243; el seguimiento de los pacientes hasta el fallecimiento o hasta la fecha de finalizaci&#243;n del estudio&#44; 1 de enero del 2015&#44; de modo que todos ellos fueron evaluados durante al menos un a&#241;o post-IAMCEST&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables analizadas</span><p id="par0030" class="elsevierStylePara elsevierViewall">Para la identificaci&#243;n de los pacientes a incluir en el estudio y la obtenci&#243;n de datos relacionados con los episodios de hospitalizaci&#243;n&#44; se utiliz&#243; la informaci&#243;n disponible en los informes de alta hospitalaria gestionados por la Unidad de Documentaci&#243;n&#46; Se registraron la t&#233;cnica de revascularizaci&#243;n coronaria y determinados hallazgos cl&#237;nicos que pudieran condicionar la prescripci&#243;n de betabloqueantes&#58; bradicardia&#44; bloqueo aur&#237;culo-ventricular y fibrilaci&#243;n auricular&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">A trav&#233;s del Sistema de Informaci&#243;n Poblacional de la Conselleria de Sanitat de la Generalitat Valenciana&#44; se identificaron los datos demogr&#225;ficos individuales&#58; sexo&#44; fecha de nacimiento&#44; pa&#237;s de nacimiento y modalidad de acreditaci&#243;n de la prestaci&#243;n farmac&#233;utica&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A partir de los episodios registrados antes del ingreso en la historia cl&#237;nica ambulatoria electr&#243;nica&#44; se identificaron los factores de riesgo cardiovascular&#44; definidos por los diagn&#243;sticos&#58; diabetes mellitus &#40;c&#243;digo CIE-9 250&#41;&#44; dislipidemia &#40;c&#243;digo CIE-9 272&#41;&#44; hipertensi&#243;n arterial &#40;c&#243;digos CIE-9 401-405&#41;&#44; obesidad &#40;c&#243;digo CIE-9 278&#41; y tabaquismo &#40;c&#243;digos CIE-9 989&#46;84&#44; 305&#46;1&#44; V15&#46;82&#41;&#59; los antecedentes cardiovasculares&#44; definidos por los diagn&#243;sticos&#58; otros s&#237;ndromes coronarios agudos &#40;c&#243;digos CIE-9 410-412&#41;&#44; angina estable &#40;c&#243;digos CIE-9 413-414&#41;&#44; ictus &#40;c&#243;digos CIE-9 430-434&#44; 436-438&#41;&#44; accidente isqu&#233;mico transitorio &#40;c&#243;digo CIE-9 435&#41; y enfermedad vascular perif&#233;rica &#40;c&#243;digos CIE-9 443-445&#41;&#44; y la presencia de otras enfermedades cr&#243;nicas relevantes&#44; definidas por los diagn&#243;sticos&#58; insuficiencia hep&#225;tica &#40;c&#243;digo CIE-9 571&#41;&#44; insuficiencia renal &#40;c&#243;digos CIE-9 583&#44; 585&#41;&#44; antecedentes neopl&#225;sicos &#40;c&#243;digos CIE-9 140-239&#41;&#44; antecedentes neuropsiqui&#225;tricos &#40;c&#243;digos CIE-9 290-319&#44; 331&#44; 332&#41; y antecedentes respiratorios &#40;c&#243;digos CIE-9 490-496&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Durante el periodo de seguimiento se registraron las prescripciones &#40;posolog&#237;a diaria&#44; fecha de inicio y fecha de fin&#41; y las dispensaciones ambulatorias &#40;presentaci&#243;n farmac&#233;utica dispensada con el n&#250;mero de unidades por caja y fechas de dispensaci&#243;n&#41; del grupo C07 de la clasificaci&#243;n ATC de la Organizaci&#243;n Mundial de la Salud&#44; disponibles en el Gestor de la Prestaci&#243;n Farmac&#233;utica de la Conselleria de Sanitat de la Generalitat Valenciana&#46; Se estim&#243; la adherencia secundaria mediante la proporci&#243;n de d&#237;as cubiertos&#44; que equivale al porcentaje de d&#237;as que el paciente dispone de un medicamento con relaci&#243;n a todo el periodo de estudio<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a>&#44; a trav&#233;s de la siguiente f&#243;rmula&#58;<elsevierMultimedia ident="eq0005"></elsevierMultimedia></p><p id="par0050" class="elsevierStylePara elsevierViewall">Se estableci&#243; una proporci&#243;n de d&#237;as cubiertos igual o superior al 80&#37; como punto de corte para considerar a un paciente como adherente<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para la evaluaci&#243;n de resultados en salud tras el alta hospitalaria&#44; se recogieron las siguientes variables&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Aparici&#243;n de un nuevo evento cardiovascular &#40;que incluye la aparici&#243;n de infarto de miocardio o angina inestable&#44; accidente cerebrovascular&#44; arteriopat&#237;a perif&#233;rica&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Muerte por un nuevo evento cardiovascular &#40;que incluye muerte por infarto de miocardio&#44; por accidente cerebrovascular o por arteriopat&#237;a perif&#233;rica&#41;&#46; El fallecimiento por causa desconocida se asumi&#243; como muerte de origen cardiovascular&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Fallecimiento por otra causa&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0075" class="elsevierStylePara elsevierViewall">P&#233;rdida de seguimiento&#46;</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">An&#225;lisis estad&#237;stico</span><p id="par0080" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis estad&#237;stico descriptivo inicial de las variables seleccionadas&#46; La selecci&#243;n de los factores potenciales con influencia en la adherencia secundaria a betabloqueantes durante el primer a&#241;o de seguimiento se realiz&#243; mediante el test &#967;<span class="elsevierStyleSup">2</span>&#46; En las variables con significaci&#243;n estad&#237;stica&#44; se estim&#243; la correspondiente <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; y su intervalo de confianza del 95&#37; &#40;IC del 95&#37;&#41; mediante un an&#225;lisis de regresi&#243;n log&#237;stica&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">La relaci&#243;n entre betabloqueantes y morbimortalidad cardiovascular se estudi&#243; mediante el an&#225;lisis de incidencia acumulativa&#46; Se consider&#243; evento competitivo la mortalidad por causa distinta de la cardiovascular<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a>&#46; La incidencia acumulativa se expres&#243; como la probabilidad &#40;&#37;&#41; de que se produjera el evento cardiovascular&#59; las comparaciones se efectuaron mediante el test univariante de Gray<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a>&#44; calculando la <span class="elsevierStyleItalic">hazard ratio</span> &#40;HR&#41; y su IC del 95&#37;&#46; Posteriormente&#44; se realiz&#243; un an&#225;lisis multivariante de Fine-Gray<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> en caso de una HR significativa&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Para evaluar el impacto en la morbimortalidad&#44; se compararon 3<span class="elsevierStyleHsp" style=""></span>poblaciones diferentes durante el primer a&#241;o y en todo el periodo de seguimiento&#46; En la primera de estas poblaciones&#44; se incluye a los pacientes sin prescripci&#243;n de betabloqueantes&#46; El grupo de comparaci&#243;n lo constituyen los pacientes con prescripci&#243;n de betabloqueantes&#46; La segunda poblaci&#243;n de an&#225;lisis est&#225; formada por aquellos pacientes a los que se prescribieron betabloqueantes&#44; pero no fueron adherentes al tratamiento&#46; El grupo de comparaci&#243;n lo constituyen los pacientes con prescripci&#243;n de betabloqueantes y adherencia adecuada al tratamiento&#46; La tercera de las poblaciones queda constituida por el conjunto de pacientes que no recibieron un tratamiento betabloqueante adecuado&#44; bien por ausencia de prescripci&#243;n&#44; bien por falta de adherencia&#46; El grupo de comparaci&#243;n lo constituye el resto de los pacientes de la poblaci&#243;n total seleccionada que no cumpl&#237;an las respectivas condiciones&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico descriptivo y el an&#225;lisis de regresi&#243;n log&#237;stica se realizaron mediante el paquete estad&#237;stico para Windows&#174; SPSS&#174; versi&#243;n 17&#46; El an&#225;lisis de la incidencia acumulativa y de Fine-Gray se realiz&#243; usando el lenguaje y entorno de programaci&#243;n R versi&#243;n 3&#46;4&#46;0<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Se consideraron estad&#237;sticamente significativos los resultados cuando el valor de p fue menor de 0&#44;05&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Resultados</span><p id="par0105" class="elsevierStylePara elsevierViewall">Se revis&#243; retrospectivamente a 487 pacientes dados de alta tras un primer episodio de IAMCEST tipo 1&#44; sin insuficiencia cardiaca o con una FEVI &#8805; 40&#37;&#46; Se excluy&#243; a 27 &#40;5&#44;5&#37;&#41; pacientes&#58; 9<span class="elsevierStyleHsp" style=""></span>procedentes de otra comunidad aut&#243;noma&#44; 6<span class="elsevierStyleHsp" style=""></span>por estar censados en otro departamento de salud de la Comunidad Valenciana&#44; 5<span class="elsevierStyleHsp" style=""></span>por prestaci&#243;n farmac&#233;utica no cubierta por el Sistema Nacional de Salud&#44; 4<span class="elsevierStyleHsp" style=""></span>por residir en el extranjero y 3<span class="elsevierStyleHsp" style=""></span>por situaci&#243;n terminal al alta&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se recogen las caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas de los 460 pacientes finalmente incluidos en el estudio&#46; La edad media de los pacientes seleccionados fue de 63&#44;8 &#177; 13&#44;8 a&#241;os&#44; con un 47&#44;2&#37; de pacientes mayores de 65 a&#241;os&#46; El 75&#44;7&#37; fueron hombres&#46; El 98&#37; de los pacientes presentaba alg&#250;n factor de riesgo cardiovascular&#44; siendo el tabaquismo y la hipertensi&#243;n arterial los m&#225;s frecuentes&#46; El 65&#44;8&#37; present&#243; comorbilidad asociada&#46; Los antecedentes neuropsiqui&#225;tricos &#40;33&#44;7&#37;&#41; junto con los cardiovasculares &#40;29&#44;1&#37;&#41; fueron los m&#225;s frecuentes&#46; En cuanto a los hallazgos cl&#237;nicos que pudieran condicionar la prescripci&#243;n de betabloqueantes&#44; fue m&#225;s frecuente el bloqueo aur&#237;culo-ventricular &#40;5&#37;&#41;&#46; En el 93&#44;5&#37; de los episodios se realiz&#243; una intervenci&#243;n coronaria percut&#225;nea&#44; principalmente con colocaci&#243;n de un <span class="elsevierStyleItalic">stent</span>&#46; La mediana de seguimiento fue de 46&#44;7 meses &#40;rango intercuart&#237;lico&#59; 30&#44;8-65&#44;4&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Prescripci&#243;n farmacol&#243;gica y factores condicionantes</span><p id="par0110" class="elsevierStylePara elsevierViewall">En 417 pacientes &#40;90&#44;7&#37;&#41; se prescribieron betabloqueantes durante el primer a&#241;o tras el alta &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#59; la proporci&#243;n de prescripciones fue significativamente menor en los pacientes a partir de 65 a&#241;os &#40;OR &#61; 0&#44;491&#59; IC del 95&#37;&#44; 0&#44;260-0&#44;948&#59; p &#61; 0&#44;034&#41;&#44; en los pacientes con antecedentes respiratorios &#40;OR &#61; 0&#44;254&#59; IC del 95&#37;&#44; 0&#44;127-0&#44;509&#59; p &#60; 0&#44;001&#41; y en los pacientes con bradicardia &#40;OR &#61; 0&#44;055&#59; IC del 95&#37; &#61; 0&#44;013-0&#44;239&#59; p &#60; 0&#44;001&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Adherencia farmacol&#243;gica secundaria y factores condicionantes</span><p id="par0115" class="elsevierStylePara elsevierViewall">Durante el primer a&#241;o de seguimiento fueron adherentes 356 &#40;85&#44;4&#37;&#41; del total de pacientes con prescripci&#243;n de betabloqueantes&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se ampl&#237;a esta informaci&#243;n&#44; con base en las diferentes variables analizadas&#46; As&#237;&#44; la adherencia fue significativamente menor en los pacientes extranjeros &#40;OR &#61; 0&#44;312&#59; IC del 95&#37;&#44; 0&#44;127-0&#44;764&#59; p &#61; 0&#44;011&#41;&#44; en los pacientes con historia de tabaquismo &#40;OR &#61; 0&#44;477&#59; IC del 95&#37;&#44; 0&#44;249-0&#44;913&#59; p &#61; 0&#44;025&#41;&#44; con antecedentes cardiovasculares &#40;OR &#61; 0&#44;539&#59; IC del 95&#37;&#44; 0&#44;308-0&#44;945&#59; p &#61; 0&#44;031&#41; o con bloqueo aur&#237;culo-ventricular &#40;OR &#61; 0&#44;347&#59; IC del 95&#37;&#44; 0&#44;127-0&#44;952&#41;&#59; por el contrario&#44; fue mayor en los pensionistas &#40;OR &#61; 1&#44;920&#59; IC del 95&#37;&#44; 1&#44;110-3&#44;322&#59; p &#61; 0&#44;020&#41;&#44; en pacientes con hipertensi&#243;n arterial &#40;OR &#61; 2&#44;058&#59; IC del 95&#37;&#44; 1&#44;190-3&#44;560&#59; p &#61; 0&#44;010&#41; y en los que fueron tratados mediante intervencionismo coronario percut&#225;neo &#40;OR &#61; 3&#44;167&#59; IC del 95&#37;&#44; 1&#44;223-8&#44;201&#59; p &#61; 0&#44;018&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">En conjunto&#44; se identific&#243; como adherentes&#44; durante todo el periodo de seguimiento&#44; a un total de 321 pacientes &#40;69&#44;8&#37;&#41;&#59; no siguieron adecuadamente el tratamiento recomendado por las gu&#237;as cl&#237;nicas 139 pacientes &#40;30&#44;2&#37;&#41;&#44; una proporci&#243;n aparentemente elevada&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados en salud durante el primer a&#241;o de seguimiento</span><p id="par0125" class="elsevierStylePara elsevierViewall">Un total de 32 de los pacientes &#40;7&#37;&#41; presentaron un nuevo evento cardiovascular durante los primeros 12 meses&#44; de los que 7<span class="elsevierStyleHsp" style=""></span> &#40;1&#44;5&#37;&#41; fallecieron &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#44; uno de ellos &#40;0&#44;2&#37;&#41; por causa desconocida&#46; Tres pacientes &#40;0&#44;6&#37;&#41; fallecieron por causa no cardiovascular y uno &#40;0&#44;2&#37;&#41; se perdi&#243; durante el seguimiento&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">En la poblaci&#243;n globalmente analizada&#44; la prescripci&#243;n de betabloqueantes &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41; no tuvo impacto en la incidencia de un nuevo evento cardiovascular sin fallecimiento&#44; el 5&#44;5&#37; frente al 4&#44;7&#37; &#40;HR &#61; 1&#44;190&#59; IC del 95&#37;&#44; 0&#44;281-5&#44;070&#59; p &#61; 0&#44;810&#41;&#44; ni en la mortalidad durante el primer a&#241;o post-IAMCEST&#44; el 1&#44;4&#37; frente al 2&#44;3&#37; &#40;HR &#61; 0&#44;624&#59; IC del 95&#37;&#44; 0&#44;076-5&#44;060&#59; p &#61; 0&#44;660&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Sin embargo &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; cuando se analiz&#243; la subpoblaci&#243;n con prescripci&#243;n de betabloqueantes&#44; los pacientes adherentes presentaron una incidencia de mortalidad cardiovascular significativamente menor&#44; el 0&#44;6&#37; frente al 6&#44;6&#37; &#40;HR &#61; 0&#44;083&#59; IC del 95&#37;&#44; 0&#44;015-0&#44;488&#59; p &#61; 0&#44;003&#41;&#46; Por otra parte&#44; esta circunstancia no condicion&#243; significativamente la aparici&#243;n de un nuevo evento cardiovascular sin fallecimiento&#44; el 5&#44;1&#37; frente al 8&#44;2&#37; &#40;HR &#61; 0&#44;570&#59; IC del 95&#37;&#44; 0&#44;211-1&#44;540&#59; p &#61; 0&#44;270&#41;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">El an&#225;lisis multivariante de Fine-Gray mostr&#243; que&#44; en la aparici&#243;n de mortalidad cardiovascular&#44; la adherencia al tratamiento junto con la edad del paciente eran factores significativos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">Los pacientes adherentes al tratamiento betabloqueante mostraron un mejor pron&#243;stico respecto a los que no recibieron el tratamiento por ausencia de prescripci&#243;n o por falta de adherencia &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#58; la incidencia de mortalidad fue del 0&#44;6&#37; frente al 4&#44;8&#37; &#40;HR &#61; 0&#44;115&#59; IC del 95&#37;&#44; 0&#44;022-0&#44;587&#59; p &#61; 0&#44;009&#41;&#46; Por el contrario&#44; no se objetiv&#243; diferencia en la aparici&#243;n de un nuevo evento vascular sin fallecimiento&#44; el 5&#44;3&#37; frente al 5&#44;8&#37; &#40;HR &#61;0&#44;716&#59; IC del 95&#37;&#44; 0&#44;298-1&#44;720&#59; p &#61; 0&#44;456&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante de Fine-Gray &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#44; la adherencia secundaria y la edad condicionaron independientemente la mortalidad cardiovascular&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Resultados en salud durante todo el periodo de seguimiento</span><p id="par0155" class="elsevierStylePara elsevierViewall">Durante todo el periodo de seguimiento &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#44; se produjeron 85 &#40;18&#44;5&#37;&#41; nuevos eventos cardiovasculares&#44; de los que 29 &#40;6&#44;3&#37;&#41; fallecieron&#44; 5<span class="elsevierStyleHsp" style=""></span>de ellos &#40;1&#44;1&#37;&#41; por causa desconocida&#59; 21 pacientes &#40;4&#44;6&#37;&#41; fallecieron por causas no cardiovasculares y 7<span class="elsevierStyleHsp" style=""></span> &#40;1&#44;5&#37;&#41; fueron p&#233;rdida de seguimiento&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">Cuando se analiz&#243; el impacto de la prescripci&#243;n y de la adherencia a betabloqueantes en la evoluci&#243;n cl&#237;nica durante este periodo &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#44; no se objetiv&#243; significaci&#243;n estad&#237;stica alguna en todos los &#237;tems analizados&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0165" class="elsevierStylePara elsevierViewall">En el presente estudio&#44; la prescripci&#243;n de betabloqueantes no condiciona los resultados en la morbimortalidad durante el primer a&#241;o tras un IAMCEST con funci&#243;n sist&#243;lica ventricular izquierda conservada&#46; Por el contrario&#44; la incidencia de mortalidad cardiovascular en los pacientes adherentes a betabloqueantes fue significativamente menor con respecto a los no adherentes o al total de pacientes que no recibieron el tratamiento con betabloqueantes&#46; Sin embargo&#44; estos resultados no se objetivaron cuando el periodo de observaci&#243;n fue mayor&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Sin duda&#44; el tratamiento farmacol&#243;gico actual y la implementaci&#243;n del intervencionismo coronario percut&#225;neo han mejorado el pron&#243;stico del IAMCEST&#46; La evidencia cient&#237;fica en la que se basa la prescripci&#243;n de betabloqueantes se soporta en ensayos cl&#237;nicos previos a la era de la tromb&#243;lisis y de la reperfusi&#243;n&#44; con un mayor riesgo de da&#241;o mioc&#225;rdico&#44; por lo que en la actualidad se cuestiona su prescripci&#243;n en determinados pacientes<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#44;3&#44;28</span></a>&#46; Los estudios en poblaci&#243;n sin disfunci&#243;n del ventr&#237;culo izquierdo tras un IAMCEST y un a&#241;o de seguimiento no encuentran relaci&#243;n entre la prescripci&#243;n de betabloqueantes y la reducci&#243;n de la mortalidad total<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; Los trabajos a m&#225;s largo plazo&#44; a partir de 3<span class="elsevierStyleHsp" style=""></span>a&#241;os de seguimiento&#44; no muestran una reducci&#243;n de la mortalidad cardiovascular<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">6&#44;9</span></a>&#44; a excepci&#243;n de Konishi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a>&#46; La morbilidad cardiovascular y la mortalidad total&#44; en consonancia con nuestros resultados&#44; tampoco disminuyen de manera significativa en ninguno de los estudios consultados<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">6&#44;9-11</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Con relaci&#243;n a la adherencia&#44; Puymirat et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a>&#44; en una amplia serie de pacientes&#44; no evidenciaron una mejor evoluci&#243;n a los 5<span class="elsevierStyleHsp" style=""></span>a&#241;os de seguimiento en aquellos pacientes con infarto de miocardio que fueron persistentes al tratamiento betabloqueante durante el primer a&#241;o de seguimiento&#46; Sin embargo&#44; este estudio<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> no permite conocer si el paciente ha tomado de manera correcta la medicaci&#243;n durante todo el periodo de estudio&#44; tan solo si la ha interrumpido definitivamente&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">La falta de adherencia secundaria al tratamiento prescrito es un serio problema en la enfermedad cardiovascular<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&#46; En este sentido&#44; es importante recordar la estrecha relaci&#243;n entre la no adherencia terap&#233;utica y el aumento de la morbimortalidad posterior al infarto de miocardio<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&#46; Pese a ello&#44; no se han encontrado trabajos donde se valore el impacto de la adherencia secundaria a betabloqueantes tras un IAMCEST en pacientes de bajo riesgo y es escasa la informaci&#243;n disponible tras un infarto de miocardio sin diferenciar el riesgo<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17-21</span></a>&#46; Dos de los estudios&#44; con un seguimiento de 2&#44;8 y 4&#44;1 a&#241;os&#44; comprobaron una incidencia significativamente menor de mortalidad global&#44; mortalidad cardiovascular o revascularizaci&#243;n coronaria en los pacientes adherentes a betabloqueantes<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#44;21</span></a>&#46; Por el contrario&#44; otros 2<span class="elsevierStyleHsp" style=""></span>trabajos con una duraci&#243;n de 15 meses y 4&#44;5 a&#241;os no objetivaron una menor incidencia de mortalidad y de nuevo evento cardiovascular en los pacientes adherentes<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">19&#44;20</span></a>&#46; Sin embargo&#44; los datos son dif&#237;cilmente extrapolables por no conocerse la tasa de pacientes con bajo y alto riesgo en las poblaciones incluidas&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">En el presente trabajo&#44; junto a la edad avanzada&#44; la adherencia a betabloqueantes durante el primer a&#241;o tras el alta condiciona de manera independiente la mortalidad&#44; no as&#237; a m&#225;s largo plazo&#46; En este sentido&#44; se posicionan las recomendaciones recogidas por el National Institute for Health and Care Excellence<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> y la American College of Cardiology Foundation<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> que&#44; tras una duraci&#243;n m&#237;nima de uno a 3<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; establecen la necesidad de reevaluaci&#243;n individual&#44; teniendo en cuenta el balance riesgo-beneficio con relaci&#243;n a la extensi&#243;n de la enfermedad y la presencia de otras comorbilidades o de efectos adversos&#46; Sin embargo&#44; la Sociedad Europea de Cardiolog&#237;a&#44; ante la ausencia de estudios m&#225;s concluyentes&#44; indica la imposibilidad de establecer una recomendaci&#243;n espec&#237;fica<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Como es l&#243;gico&#44; entre los factores que condicionan la prescripci&#243;n y la adherencia secundaria se encuentran algunos relacionados con la aparici&#243;n de efectos adversos a los betabloqueantes&#46; En nuestra experiencia&#44; la presencia de bradicardia&#44; bloqueo aur&#237;culo-ventricular&#44; tabaquismo o enfermedades pulmonares limitan el tratamiento a betabloqueantes&#44; al igual que ocurre en parte de la bibliograf&#237;a consultada<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;17&#44;18</span></a>&#46; Por tanto&#44; es muy importante la correcta selecci&#243;n de pacientes que se pueden beneficiar del tratamiento&#44; dado que sufren efectos secundarios y esto limita el correcto cumplimiento&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Este trabajo no est&#225; exento de limitaciones&#46; La ausencia de disfunci&#243;n del ventr&#237;culo izquierdo se determina en el momento del alta y su aparici&#243;n posterior no queda recogida&#44; as&#237; como su impacto en los resultados&#46; Adem&#225;s&#44; el c&#225;lculo de la adherencia se ha realizado a partir de ficheros de dispensaci&#243;n de las oficinas de farmacia y no con base en la toma real de medicamentos&#46; Sin embargo&#44; se ha observado previamente una buena correlaci&#243;n con otros tipos de medidas como el recuento de comprimidos o los registros electr&#243;nicos<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">A modo de conclusi&#243;n&#44; nuestros resultados confirman que la prescripci&#243;n de betabloqueantes durante el primer a&#241;o tras un IAMCEST no modifica la evoluci&#243;n de los pacientes con funci&#243;n ventricular izquierda conservada&#46; Sin embargo&#44; la adherencia secundaria a los mismos s&#237; que mejora el pron&#243;stico&#46; Por ello&#44; creemos de inter&#233;s se&#241;alar la necesidad de llevar a cabo amplios estudios para determinar el impacto de los betabloqueantes en la evoluci&#243;n de este grupo de pacientes&#44; pero desde la perspectiva de la adherencia farmacol&#243;gica secundaria&#46; Un ejemplo de ello es el ensayo cl&#237;nico BETAMI&#44; actualmente en desarrollo y cuyos resultados esperamos que aporten la evidencia cient&#237;fica suficiente con respecto al papel de los betabloqueantes en este grupo de pacientes<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a>&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Financiaci&#243;n</span><p id="par0210" class="elsevierStylePara elsevierViewall">La presente investigaci&#243;n no ha recibido ayudas espec&#237;ficas provenientes de agencias del sector p&#250;blico&#44; sector comercial ni entidades sin &#225;nimo de lucro&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicto de intereses</span><p id="par0205" class="elsevierStylePara elsevierViewall">Ninguno&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "titulo" => "Adherencia farmacol&#243;gica secundaria y factores condicionantes"
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              "titulo" => "Resultados en salud durante el primer a&#241;o de seguimiento"
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              "titulo" => "Resultados en salud durante todo el periodo de seguimiento"
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    "fechaRecibido" => "2019-07-27"
    "fechaAceptado" => "2019-11-28"
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            0 => "Infarto del miocardio con elevaci&#243;n del ST"
            1 => "Adherencia al tratamiento"
            2 => "Prevenci&#243;n secundaria"
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    "resumen" => array:2 [
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n y objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La toma correcta de medicaci&#243;n condiciona la efectividad de un tratamiento&#46; El objetivo del presente trabajo ha sido determinar el impacto de la prescripci&#243;n y la adherencia secundaria a betabloqueantes en la morbimortalidad cardiovascular a medio y largo plazo&#44; tras un primer episodio de infarto de miocardio con elevaci&#243;n del segmento ST &#40;IAMCEST&#41; tipo 1 sin insuficiencia cardiaca o con fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo &#8805; 40&#37;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional y retrospectivo en una cohorte de pacientes ingresados entre 2008 y 2013 en el Hospital Cl&#237;nico Universitario de Valencia&#46; El an&#225;lisis de incidencia acumulativa estableci&#243; la relaci&#243;n entre la mortalidad cardiovascular o la aparici&#243;n de un nuevo evento vascular con la prescripci&#243;n de betabloqueantes y la adherencia secundaria&#44; definida como proporci&#243;n de d&#237;as cubiertos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Durante el primer a&#241;o tras el alta&#44; la prescripci&#243;n de betabloqueantes no influy&#243; significativamente sobre los resultados en salud de los 460 pacientes incluidos&#46; Sin embargo&#44; la mortalidad cardiovascular fue menor en los pacientes adherentes respecto a los no adherentes&#44; el 0&#44;6&#37; frente al 6&#44;6&#37; &#40;HR &#61; 0&#44;083&#59; IC del 95&#37;&#44; 0&#44;015-0&#44;448&#59; p &#61; 0&#44;003&#41;&#44; y en los pacientes adherentes respecto a los que no recibieron el tratamiento por ausencia de prescripci&#243;n o por falta de adherencia&#44; el 0&#44;6&#37; frente al 4&#44;8&#37; &#40;HR &#61; 0&#44;115&#59; IC del 95&#37;&#44; 0&#44;022-0&#44;587&#59; p &#61; 0&#44;009&#41;&#46; Estos resultados no se objetivaron cuando se analiz&#243; todo el periodo de seguimiento &#40;mediana 46&#44;7 meses&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La adherencia secundaria a betabloqueantes mejora el pron&#243;stico durante el primer a&#241;o tras un IAMCEST con funci&#243;n ventricular izquierda conservada&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction and objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Adequate medication intake affects treatment effectiveness&#46; The aim of this study was to establish the impact of prescription and secondary adherence to beta-blockers on medium- and long-term and long-term cardiovascular outcomes&#44; after a first type 1 ST-elevation myocardial infarction &#40;STEMI&#41; episode without heart failure or left ventricular ejection fraction &#8805; 40&#37;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A retrospective observational study was conducted in a cohort of patients admitted from 2008 to 2013 to the University Clinical Hospital in Valencia&#46; Competing risk analysis assessed the relationship between cardiovascular mortality or new vascular event with beta-blocker prescription and secondary adherence&#44; defined as a proportion of days covered&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">During after the first year following discharge&#44; beta-blocker prescription was not significantly associated with better health outcomes in the 460 patients included&#46; However&#44; cardiovascular mortality was lower in adherent patients compared to non-adherent patients&#44; at 0&#46;6&#37; vs&#46; 6&#46;6&#37; &#40;HR &#61; 0&#46;083&#59; 95&#37; CI&#44; 0&#46;015-0&#46;448&#59; p &#61; 0&#46;003&#41;&#44; and in adherent patients compared to those who did not receive the treatment due to lack of prescription or lack of adherence&#44; with 0&#46;6&#37; vs&#46; 4&#46;8&#37; &#40;HR &#61; 0&#46;115&#59; 95&#37; CI&#44; 0&#46;022-0&#46;587&#59; p &#61; 0&#46;009&#41;&#46; These results were not observed when the complete follow-up period was analysed &#40;median 46&#46;7 months&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Secondary adherence to beta-blockers improves 1-year prognosis after STEMI with preserved left ventricular function&#46;</p></span>"
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                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prescripci&#243;n de betabloqueantes</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Adherencia a betabloqueantes</th></tr><tr title="table-row"><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">Pacientes&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#61; 460&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">S&#237;n &#61; 417&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
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No n &#61; 43&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
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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
                  \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
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">S&#237;n &#61; 356&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
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No n &#61; 61&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
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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
                  \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  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sociodemogr&#225;ficas</span></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>&#8805; 65 a&#241;os&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">217 &#40;47&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">190 &#40;45&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27 &#40;62&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;031&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">167 &#40;46&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;37&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;182&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>Mujeres&nbsp;\t\t\t\t\t\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">112 &#40;24&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;24&#41;&nbsp;\t\t\t\t\t\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 &#40;27&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;568&nbsp;\t\t\t\t\t\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 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">15 &#40;24&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;904&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>Nacionalidad espa&#241;ola&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">433 &#40;94&#44;1&#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">393 &#40;94&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;93&#41;&nbsp;\t\t\t\t\t\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;746&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">340 &#40;95&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;86&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;014&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>Pensionistas&nbsp;\t\t\t\t\t\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">272 &#40;59&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">242 &#40;58&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">30 &#40;69&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;138&nbsp;\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">215 &#40;60&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27 &#40;44&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Factores de riesgo cardiovascular</span></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>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">146 &#40;31&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">132 &#40;31&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;32&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;904&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">119 &#40;33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">13 &#40;21&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;060&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>Dislipidemia&nbsp;\t\t\t\t\t\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">287 &#40;62&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">261 &#40;62&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">26 &#40;60&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;784&nbsp;\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">227 &#40;63&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">34 &#40;55&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;231&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>Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\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">294 &#40;63&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">267 &#40;64&#41;&nbsp;\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">27 &#40;62&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;872&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">237 &#40;66&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">30 &#40;49&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;009&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes cl&#237;nicos</span></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>Cardiovasculares&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Insuficiencia hep&#225;tica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Insuficiencia renal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neopl&#225;sicos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neuropsiqui&#225;tricos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratorios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Hallazgos cl&#237;nicos</span></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>Bradicardia&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">8 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 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">2 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;379&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>Bloqueo aur&#237;culo-ventricular&nbsp;\t\t\t\t\t\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">23 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;9&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;256&nbsp;\t\t\t\t\t\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 &#40;3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;9&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;044&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>Fibrilaci&#243;n auricular&nbsp;\t\t\t\t\t\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 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;633&nbsp;\t\t\t\t\t\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">14 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;9&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Procedimiento de revascularizaci&#243;n coronaria</span></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>Intervenci&#243;n coronaria percut&#225;nea&nbsp;\t\t\t\t\t\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">435 &#40;94&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">396 &#40;95&#41;&nbsp;\t\t\t\t\t\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 &#40;90&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;277&nbsp;\t\t\t\t\t\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">342 &#40;96&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;88&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;022&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas de la poblaci&#243;n total&#44; de la poblaci&#243;n con prescripci&#243;n activa y de la poblaci&#243;n con adherencia secundaria &#40;proporci&#243;n de d&#237;as cubiertos &#8805; 80&#37;&#41; durante el primer a&#241;o posterior al alta hospitalaria</p>"
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                  <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">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</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">Poblaci&#243;n total&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">Pacientes&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#61; 460&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">S&#237; n &#61; 417&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">No n &#61; 43&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">S&#237; n &#61; 356&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">No n &#61; 61&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">S&#237; n &#61; 356&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">No n &#61; 104&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nuevo evento vascular&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">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">23 &#40;5&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;4&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;8&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;5&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;5&#44;8&#41;&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
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                  \t\t\t\t">Mortalidad cardiovascular&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">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">6 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;6&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Resultados en salud durante el primer a&#241;o</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Variable&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">&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  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Univariante</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Multivariante</th></tr><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">Incidencia acumulativa &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&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">HR &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Prescripci&#243;n de betabloqueantes &#40;n &#61; 417&#41;</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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mujer</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">0&#44;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  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;013</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" 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">Edad &#8805; 65 a&#241;os</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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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">0&#44;007</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;319 &#40;1&#44;037-1&#44;235&#41;&nbsp;\t\t\t\t\t\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;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">3&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" 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">Pensionista</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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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">0&#44;036</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" 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">Fibrilaci&#243;nAuricular</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">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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">&#60; 0&#44;001</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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">10&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" 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">Adherencia betabloqueantes</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">6&#44;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  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001</td><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">0&#44;079 &#40;0&#44;014-0&#44;434&#41;</td><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">0&#44;003</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">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2378889.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Poblaci&#243;n total &#40;n &#61; 460&#41;</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">Edad &#8805; 65 a&#241;os</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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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">0&#44;004</td><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">1&#44;101 &#40;1&#44;041-1&#44;164&#41;</td><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">&#60; 0&#44;001</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">3&#44;2&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">Adherencia betabloqueantes</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">4&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><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">0&#44;001</td><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">0&#44;145 &#40;0&#44;026-0&#44;809&#41;</td><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">0&#44;028</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
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 00257753
Idioma original: Español
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos