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Diferencias en el manejo de los pacientes con fibrilación auricular según inicie el tratamiento con anticoagulantes orales de acción directa el médico de atención primaria o el especialista. Estudios SILVER-AP y BRONCE-AP
Differences in the management of patients with atrial fibrillation according to whether primary care or the specialist initiates treatment with direct oral anticoagulants. The SILVER-AP and BRONCE-AP studies
M. de la Figueraa, M.A. Prietob, N. Marínc,
Autor para correspondencia
nuria.marinmontanes@bayer.com

Autor para correspondencia.
, I. Egocheagad, S. Cinzae, en nombre de los investigadores del estudio SILVER BRONCE-AP 1
a CAP Sardenya, Barcelona, España
b C.S. Vallobín-La Florida, Oviedo, España
c Departamento Médico, Bayer Hispania S.L., Sant Joan Despí, Barcelona, España
d Centro Salud Isla de Oza, Madrid, España
e C.S. Porto do Son, Santiago de Compostela, La Coruña, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La anticoagulaci&#243;n constituye la piedra angular en el tratamiento de los pacientes con fibrilaci&#243;n auricular &#40;FA&#41; para disminuir el riesgo de presentar complicaciones tromboemb&#243;licas<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">1</span></a>&#46; Durante d&#233;cadas se han empleado los antagonistas de la vitamina<span class="elsevierStyleHsp" style=""></span>K &#40;AVK&#41; como tratamiento antitromb&#243;tico en los sujetos con FA<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">2&#44;3</span></a>&#46; Sin embargo&#44; a pesar de que la mayor&#237;a de los pacientes con FA tienen un elevado riesgo de presentar ictus<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a>&#44; existe una proporci&#243;n importante de pacientes&#44; que puede llegar hasta el 40&#37; de los casos seg&#250;n las series&#44; que aun teniendo FA e indicaci&#243;n de anticoagulaci&#243;n no la reciben&#44; a pesar de no haber una contraindicaci&#243;n clara para ella<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">2&#44;5</span></a>&#46; Aunque la infraestimaci&#243;n del riesgo de ictus podr&#237;a explicar en parte esta situaci&#243;n&#44; el miedo al sangrado asociado a la anticoagulaci&#243;n&#44; y sobre todo las limitaciones relacionadas con el tratamiento con AVK&#44; podr&#237;an subyacer como las causas principales<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">2&#44;6</span></a>&#46; Adem&#225;s&#44; aproximadamente el 40&#37; de los pacientes anticoagulados con AVK tienen habitualmente un mal control de la relaci&#243;n normalizada internacional &#40;<span class="elsevierStyleItalic">internacional normalizad ratio</span> &#91;INR&#93;&#41;&#44; lo que aumenta de manera innecesaria tanto el riesgo de ictus como el de sangrados<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">7&#8211;11</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Globalmente&#44; en comparaci&#243;n con los AVK&#44; los anticoagulantes orales de acci&#243;n directa &#40;ACOD&#41; reducen el riesgo de ictus o embolismo sist&#233;mico y tienen un menor riesgo de hemorragias&#44; sobre todo intracraneales y mortales<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a>&#46; Adem&#225;s&#44; se pueden administrar a dosis fijas&#44; no necesitan controles peri&#243;dicos de la anticoagulaci&#243;n y tienen escasas interacciones con otros f&#225;rmacos y ninguna con los alimentos<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">13&#44;14</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Aunque en la actualidad en Espa&#241;a el tratamiento anticoagulante m&#225;s frecuentemente prescrito siguen siendo los AVK&#44; cada vez son m&#225;s pacientes los que reciben tratamiento anticoagulante con ACOD<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a>&#46; En el a&#241;o 2013&#44; la Agencia Espa&#241;ola de Medicamentos y Productos Sanitarios public&#243; un informe de posicionamiento terap&#233;utico &#40;IPT&#41; realizando una serie de recomendaciones sobre el uso de ACOD en el paciente con FA no valvular &#40;FANV&#41;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a>&#44; indicando&#44; entre otras cosas&#44; en qu&#233; pacientes&#47;situaciones se deber&#237;an emplear los ACOD de manera preferencial&#46; Sin embargo&#44; cada comunidad aut&#243;noma ha realizado sus propias recomendaciones&#44; y no en todas las comunidades aut&#243;nomas el m&#233;dico de atenci&#243;n primaria &#40;AP&#41; puede prescribir directamente ACOD&#44; sino que en algunas el m&#233;dico de AP se ve obligado a derivar al especialista para que sea este el que lo haga&#46; Recientemente se ha publicado una nueva versi&#243;n del IPT&#44; si bien los cambios no han sido muy sustanciales con respecto a la edici&#243;n previa<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Actualmente existe muy poca informaci&#243;n en nuestro pa&#237;s acerca de en qu&#233; pacientes se est&#225;n empleando ACOD&#44; c&#243;mo se est&#225; realizando el manejo de ACOD en la pr&#225;ctica cl&#237;nica&#44; y si el hecho de que el m&#233;dico de AP pueda prescribir directamente o no un ACOD tiene alg&#250;n impacto<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#44;18-20</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El objetivo principal de este estudio fue describir las caracter&#237;sticas sociodemogr&#225;ficas y cl&#237;nicas de los pacientes diagnosticados de FANV con riesgo de ictus o embolia sist&#233;mica en tratamiento anticoagulante que hubiesen modificado su pauta terap&#233;utica hac&#237;a al menos 3 meses por cualquier situaci&#243;n cl&#237;nica&#44; y que actualmente se encontrasen en tratamiento con un ACOD&#46; Como objetivos secundarios se analizaron el cumplimiento terap&#233;utico de los pacientes con FANV con respecto a su tratamiento cr&#243;nico anticoagulante en el momento de ser reclutados&#44; la satisfacci&#243;n de los pacientes con el tratamiento anticoagulante&#44; as&#237; como los motivos que hubiesen determinado el cambio de tratamiento anticoagulante&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Para contestar a estas cuestiones&#44; el presente trabajo ha analizado la informaci&#243;n proveniente de dos estudios&#58; el SILVER-AP y el BRONCE-AP<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">21&#44;22</span></a>&#46; La metodolog&#237;a de ambos estudios ha sido publicada previamente<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">21&#44;22</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">En resumen&#44; SILVER-AP fue un estudio observacional de corte transversal&#44; nacional y multic&#233;ntrico&#44; realizado en las 9 comunidades aut&#243;nomas en las que el m&#233;dico de AP pod&#237;a establecer la indicaci&#243;n y la prescripci&#243;n de un ACOD en el momento del reclutamiento de los pacientes &#40;Galicia&#44; Madrid&#44; Pa&#237;s Vasco&#44; Navarra&#44; Arag&#243;n&#44; Andaluc&#237;a&#44; Catalu&#241;a&#44; Valencia y Baleares&#41;&#44; mientras que el estudio BRONCE-AP fue un estudio observacional&#44; transversal&#44; nacional y multic&#233;ntrico realizado en las 8 comunidades aut&#243;nomas donde el m&#233;dico de AP no pod&#237;a prescribir un ACOD directamente y ten&#237;a que derivar al paciente al especialista para que este lo hiciese&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para ello se incluy&#243; a pacientes &#8805;<span class="elsevierStyleHsp" style=""></span>18 a&#241;os diagnosticados de FANV con riesgo de ictus o embolia sist&#233;mica atendidos en consultas de AP&#44; que estuviesen en tratamiento cr&#243;nico con anticoagulantes&#44; que hubiesen modificado su pauta terap&#233;utica por cualquier situaci&#243;n cl&#237;nica y que actualmente estuviesen en tratamiento con un ACOD durante al menos 3<span class="elsevierStyleHsp" style=""></span>meses antes de ser reclutados&#44; cuya indicaci&#243;n del ACOD hubiese sido establecida por el m&#233;dico de AP &#40;SILVER-AP&#41; o cuya primera prescripci&#243;n del ACOD tuviese que ser realizada por el especialista &#40;BRONCE-AP&#41; y que hubiesen firmado el consentimiento informado&#46; Se excluy&#243; a los pacientes que hubiesen modificado su tratamiento anticoagulante en un periodo inferior a 3<span class="elsevierStyleHsp" style=""></span>meses antes de la firma del consentimiento informado&#44; que presentasen un deterioro cognitivo que impidiese la comprensi&#243;n de lo redactado en la hoja de informaci&#243;n para el paciente&#44; el consentimiento informado o la realizaci&#243;n de cuestionarios autoadministrados o cuyo inicio del tratamiento anticoagulante para FANV fuese un ACOD&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">El estudio SILVER-AP fue aprobado por el comit&#233; &#233;tico de investigaci&#243;n cl&#237;nica de referencia &#40;IDIAP&#44; Fundaci&#243;n Jordi Gol&#41; y por los comit&#233;s &#233;ticos de investigaci&#243;n cl&#237;nica locales de los diferentes centros participantes&#46; El reclutamiento se inici&#243; en mayo de 2015 y finaliz&#243; en diciembre de 2015&#46; El estudio BRONCE-AP fue aprobado por el comit&#233; &#233;tico de investigaci&#243;n cl&#237;nica de referencia &#40;Principado de Asturias&#41; y por los comit&#233;s &#233;ticos de investigaci&#243;n cl&#237;nica locales de los diferentes centros participantes&#46; El reclutamiento se realiz&#243; entre septiembre y diciembre de 2015&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En cada uno de los dos estudios todos los datos se obtuvieron en una &#250;nica entrevista al paciente y a trav&#233;s de dos fuentes de informaci&#243;n&#58; la historia cl&#237;nica del paciente y el cuestionario de satisfacci&#243;n con el tratamiento anticoagulante <span class="elsevierStyleItalic">Anti-Clot Treatment Scale</span> &#40;ACTS&#41;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a>&#46; Los datos se recogieron en un cuaderno de recogida de datos electr&#243;nico dise&#241;ado espec&#237;ficamente para cada uno de los estudios y que dispon&#237;a de un sistema de validaci&#243;n interna&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se recogieron variables sociodemogr&#225;ficas &#40;edad&#44; sexo&#44; raza&#44; situaci&#243;n laboral&#44; situaci&#243;n familiar&#44; grado de autonom&#237;a&#44; nivel de estudios&#41;&#44; datos referentes a la FA &#40;tipo de FA&#44; tiempo desde el diagn&#243;stico&#41;&#44; exploraci&#243;n f&#237;sica &#40;peso&#44; talla&#44; presi&#243;n arterial y frecuencia cardiaca&#41;&#44; factores de riesgo cardiovascular &#40;hipertensi&#243;n arterial&#44; dislipemia&#44; diabetes&#44; h&#225;bito tab&#225;quico&#41;&#44; enfermedades cardiovasculares asociadas &#40;cardiopat&#237;a isqu&#233;mica&#44; incluyendo antecedentes de infarto de miocardio&#44; insuficiencia cardiaca congestiva y&#47;o disfunci&#243;n del ventr&#237;culo izquierdo&#44; historia de ictus&#44; ataque isqu&#233;mico transitorio o embolismo sist&#233;mico&#44; enfermedad arterial perif&#233;rica&#44; insuficiencia renal &#91;filtrado glomerular estimado &#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#93;&#44; placa de ateroma&#41;&#44; antecedentes de sangrado&#44; anemia o predisposici&#243;n al sangrado&#44; antecedentes de INR l&#225;bil &#40;tiempo en rango terap&#233;utico &#60;<span class="elsevierStyleHsp" style=""></span>60&#37; por el m&#233;todo directo o &#60;<span class="elsevierStyleHsp" style=""></span>65&#37; por el de Rosendaal<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a>&#41;&#44; polimedicaci&#243;n &#40;toma &#8805;<span class="elsevierStyleHsp" style=""></span>5 principios activos de forma habitual en el momento de la visita&#41;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">21&#44;22</span></a>&#44; EPOC&#44; depresi&#243;n y c&#225;ncer activo&#46; Se estratific&#243; el riesgo tromboemb&#243;lico mediante las escalas CHADS<span class="elsevierStyleInf">2</span> y CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc y el riesgo de sangrado mediante la escala HAS-BLED<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">24&#44;25</span></a>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se analiz&#243; el tratamiento anticoagulante previo &#40;tipo&#44; duraci&#243;n y&#44; en caso de AVK&#44; qu&#233; m&#233;dico y d&#243;nde se realizaba el control de la anticoagulaci&#243;n&#44; as&#237; como los motivos del cambio del tratamiento previo anticoagulante a ACOD seg&#250;n se siguiera el IPT<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a>&#41;&#46; Con respecto a los ACOD&#44; se analiz&#243; el tipo de ACOD prescrito y su posolog&#237;a&#46; Tambi&#233;n se analiz&#243; el cumplimiento terap&#233;utico referido a los ACOD mediante el test de Haynes-Sackett y el grado de satisfacci&#243;n con los ACOD a trav&#233;s del cuestionario ACTS<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">23&#44;26</span></a>&#46; En el test de Haynes-Sackett se define buen cumplimiento cuando el paciente declara haber tomado una cantidad de comprimidos &#62;<span class="elsevierStyleHsp" style=""></span>80&#37; y &#60;<span class="elsevierStyleHsp" style=""></span>110&#37; de los prescritos<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a>&#46; El cuestionario ACTS mide la satisfacci&#243;n con el tratamiento anticoagulante&#44; teniendo en cuenta su experiencia con el tratamiento en las 4 semanas anteriores&#46; Incluye 13 &#237;tems sobre la carga que supone el tratamiento&#44; mediante una escala de 12 &#237;tems &#40;escala Carga <span class="elsevierStyleItalic">&#91;Burden Scale&#93;</span>&#41; y una pregunta global sobre dicha carga&#44; y 4 &#237;tems sobre los beneficios de dicho tratamiento&#44; incluyendo una escala de 3 &#237;tems sobre los beneficios &#40;escala Beneficios <span class="elsevierStyleItalic">&#91;Benefit Scale&#93;</span>&#41; y una pregunta de car&#225;cter general&#46; En ambas escalas&#44; cuanto mayor sea la puntuaci&#243;n&#44; la satisfacci&#243;n con el tratamiento ser&#225; mayor&#46; La puntuaci&#243;n de la escala Carga oscila entre 12 y 60 puntos&#44; y la de la escala Beneficio&#44; entre 3 y 15 puntos<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a>&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lisis estad&#237;stico</span><p id="par0065" class="elsevierStylePara elsevierViewall">Las variables categ&#243;ricas se describieron mediante frecuencias absolutas y relativas&#46; Para la descripci&#243;n de las variables continuas se emplearon la media y la desviaci&#243;n t&#237;pica&#46; Los datos de ambos estudios se analizaron de manera conjunta&#44; incluyendo a todos los pacientes valorables de ambos estudios y tambi&#233;n cada uno de los 2 estudios de forma independiente&#44; pudiendo as&#237; analizar diferencias estad&#237;sticamente significativas entre ambos estudios&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Para las comparaciones de subgrupos de pacientes en las variables cuantitativas se utilizaron pruebas param&#233;tricas &#40;t de Student&#41; o no param&#233;tricas &#40;U de Mann-Whitney&#41;&#44; seg&#250;n las caracter&#237;sticas propias de las variables en estudio &#40;normalidad de las variables&#41;&#46; Para las variables cualitativas se realiz&#243; la prueba chi-cuadrado o el test exacto de Fisher&#46; En todas las pruebas estad&#237;sticas se aplic&#243; un nivel de significaci&#243;n estad&#237;stica bilateral &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">El tratamiento estad&#237;stico de los datos se realiz&#243; con el soporte del paquete estad&#237;stico SAS versi&#243;n 9&#46;4 &#40;SAS Institute Inc&#46;&#44; Cary&#44; NC&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0080" class="elsevierStylePara elsevierViewall">En el conjunto de estudios SILVER-AP y BRONCE AP participaron un total de 138 investigadores de toda Espa&#241;a &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46; La edad media de los investigadores fue de 51&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;5<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; el 52&#44;9&#37; varones&#44; y la mayor&#237;a proven&#237;an principalmente del &#225;mbito urbano &#40;75&#44;4&#37;&#41;&#44; sobre todo en el estudio SILVER-AP&#46; Todos los investigadores ten&#237;an una amplia experiencia &#40;tiempo trabajado 24&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;7<span class="elsevierStyleHsp" style=""></span>a&#241;os&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">En el SILVER-AP y en el BRONCE-AP&#44; de los 792 y 247 pacientes incluidos&#44; respectivamente&#44; 790 &#40;99&#44;7&#37;&#41; y 246 &#40;99&#44;6&#37;&#41; resultaron valorables para el an&#225;lisis final del estudio&#46; De esta forma&#44; en el presente estudio se incluyeron un total de 1&#46;036 pacientes &#40;790 provenientes del estudio SILVER-AP y 246 del BRONCE-AP&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a> se resumen las principales caracter&#237;sticas cl&#237;nicas de los pacientes incluidos&#44; divididos seg&#250;n el estudio de origen&#46; Globalmente&#44; los pacientes ten&#237;an una edad avanzada &#40;edad media 78&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;6<span class="elsevierStyleHsp" style=""></span>a&#241;os&#41;&#44; la mayor&#237;a estaban jubilados &#40;83&#44;1&#37;&#41;&#44; viv&#237;an acompa&#241;ados &#40;87&#44;2&#37;&#41; y eran independientes &#40;78&#44;9&#37;&#41;&#46; La mayor&#237;a de los pacientes ten&#237;a FA permanente &#40;59&#44;3&#37;&#41;&#44; con un tiempo medio de evoluci&#243;n de 5&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;4<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; El 85&#44;0&#37; de los pacientes eran hipertensos&#44; el 26&#44;9&#37; ten&#237;an insuficiencia cardiaca&#44; el 20&#44;3&#37; presentaban antecedentes de ictus&#44; ataque isqu&#233;mico transitorio o embolismo sist&#233;mico&#44; y el 18&#44;1&#37;&#44; insuficiencia renal&#46; Los pacientes del estudio tomaban una media de 7&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;1 principios activos de forma habitual&#44; incluyendo el tratamiento anticoagulante &#40;el 82&#44;1&#37; de los pacientes se encontraba polimedicado&#41;&#46; En el estudio SILVER-AP&#44; en comparaci&#243;n con el estudio BRONCE-AP&#44; los pacientes eran m&#225;s ancianos &#40;78&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;4 vs&#46; 76&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;0&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; era m&#225;s frecuente la FA permanente &#40;64&#44;6&#37; vs&#46; 42&#44;3&#37;&#59; p <span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ten&#237;an m&#225;s hipertensi&#243;n arterial &#40;86&#44;3&#37; vs&#46; 80&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41;&#44; diabetes &#40;32&#44;4&#37; vs&#46; 24&#44;0&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#41;&#44; insuficiencia cardiaca &#40;29&#44;4&#37; vs&#46; 19&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; e insuficiencia renal &#40;20&#44;0&#37; vs&#46; 11&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46; La polimedicaci&#243;n tambi&#233;n fue m&#225;s frecuente en el estudio SILVER-AP &#40;83&#44;6&#37; vs&#46; 77&#44;2&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;023&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Los pacientes ten&#237;an un elevado riesgo tromboemb&#243;lico &#40;79&#44;1&#37; de los pacientes ten&#237;an un CHADS<span class="elsevierStyleInf">2</span> &#8805;<span class="elsevierStyleHsp" style=""></span>2&#44; y el 96&#44;4&#37; un CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc &#8805;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; siendo mayor en el estudio SILVER-AP que en el BRONCE-AP &#40;CHADS<span class="elsevierStyleInf">2</span> medio 2&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;2 vs&#46; 2&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;3&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc medio 4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;6 vs&#46; 3&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Por el contrario&#44; solo el 26&#44;1&#37; de los pacientes ten&#237;a un elevado riesgo de sangrado&#44; que tambi&#233;n fue mayor en el estudio SILVER-AP &#40;HAS-BLED 2&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8 vs&#46; 1&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Con respecto al tratamiento anticoagulante previo al cambio a un ACOD&#44; el 94&#44;9&#37; de los pacientes tomaba AVK antes del cambio al ACOD &#40;95&#44;9&#37; en el estudio SILVER-AP vs&#46; 91&#44;5&#37; en el estudio BRONCE-AP&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#44; con una duraci&#243;n media de tratamiento de 42&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&#44;2<span class="elsevierStyleHsp" style=""></span>meses &#40;43&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&#44;1 vs&#46; 37&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&#44;1&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; En el 72&#44;2&#37; de los pacientes el control de la anticoagulaci&#243;n previo al cambio de tratamiento a un ACOD se realizaba solo desde AP &#40;78&#44;1&#37; vs&#46; 53&#44;3&#37;&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; seguido de hematolog&#237;a &#40;16&#44;0&#37; de los pacientes&#59; 12&#44;2&#37; vs&#46; 28&#44;1&#37;&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los motivos del cambio a ACOD seg&#250;n se siguiesen los criterios del IPT se resumen en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 4</a>&#46; En el 59&#37; de los casos de la muestra total el cambio de tratamiento se hizo siguiendo los criterios indicados en el IPT&#44; siendo el motivo m&#225;s frecuente del cambio el mal control de INR&#44; independientemente de si se siguiesen los criterios del IPT&#46; Cuando se siguieron los criterios del IPT no hubo diferencias significativas en cuanto al motivo del cambio a ACOD entre ambos estudios&#46; En cambio&#44; cuando no se siguieron los criterios del IPT&#44; mientras que el motivo principal del cambio en el estudio SILVER-AP fue el mal control de INR&#44; en el estudio BRONCE-AP fue la prescripci&#243;n seg&#250;n la ficha t&#233;cnica&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">En cuanto al tratamiento con ACOD&#44; la duraci&#243;n media del tratamiento fue de 15&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;4<span class="elsevierStyleHsp" style=""></span>meses&#44; sin diferencias significativas entre ambos estudios&#46; El cumplimiento terap&#233;utico fue elevado&#46; El 91&#44;9&#37; de los pacientes afirmaron no tener dificultad para tomar todos los comprimidos&#44; sin que se observaran diferencias estad&#237;sticamente significativas en funci&#243;n del estudio&#46; Igualmente&#44; la satisfacci&#243;n con el tratamiento anticoagulante fue elevada&#44; siendo mayor la satisfacci&#243;n en el estudio BRONCE-AP que en el estudio SILVER-AP &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">El ACOD m&#225;s frecuentemente prescrito fue rivaroxab&#225;n &#40;56&#44;9&#37;&#41;&#44; seguido de dabigatr&#225;n &#40;23&#44;5&#37;&#41; y apixab&#225;n &#40;19&#44;6&#37;&#41;&#44; sin diferencias significativas entre los estudios&#46; En cuanto a la posolog&#237;a&#44; las dosis bajas de ACOD se emplearon en el 29&#44;9&#37; de los pacientes tratados con rivaroxab&#225;n&#44; en el 38&#44;4&#37; de los pacientes tratados con apixab&#225;n y en el 60&#44;1&#37; de los pacientes tratados con dabigatr&#225;n &#40;<a class="elsevierStyleCrossRef" href="#tbl0035">tabla 6</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0035"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discusi&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">Los resultados principales de nuestro estudio muestran que los pacientes en los que el m&#233;dico de AP puede prescribir ACOD tienen un peor perfil cl&#237;nico&#44; con un mayor riesgo tromboemb&#243;lico y de hemorragias que aquellos casos en los que debe derivar al especialista&#46; Asimismo&#44; nuestro estudio mostr&#243; que el cumplimiento terap&#233;utico con ACOD fue elevado&#44; al igual que la satisfacci&#243;n con el tratamiento&#46; Finalmente&#44; las dosis bajas de ACOD se emplearon frecuentemente&#44; especialmente con dabigatr&#225;n&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">A pesar de que en los &#250;ltimos a&#241;os se est&#225;n publicando numerosos trabajos acerca de en qu&#233; pacientes se est&#225;n prescribiendo ACOD y c&#243;mo se est&#225; realizando el manejo de los mismo en la pr&#225;ctica cl&#237;nica en otros pa&#237;ses<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">27&#44;28</span></a>&#44; la informaci&#243;n disponible en Espa&#241;a a este respecto es muy limitada<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#44;18-20&#44;29</span></a>&#46; En este sentido&#44; la informaci&#243;n aportada por nuestro trabajo es relevante&#46; Asimismo&#44; como hecho diferencial con respecto a otros estudios realizados en nuestro pa&#237;s&#44; adem&#225;s del importante n&#250;mero de pacientes incluidos se encuentra el hecho de que se analizaron las diferencias en el perfil cl&#237;nico y en el manejo en funci&#243;n de si el m&#233;dico de AP era el que pod&#237;a prescribir de inicio el ACOD&#44; o deb&#237;a derivar al paciente al especialista para que fuese este el que iniciase el tratamiento con ACOD&#46; Es importante destacar el gran n&#250;mero de investigadores que participaron en el estudio&#44; as&#237; como la gran experiencia cl&#237;nica que ten&#237;an &#40;tiempo trabajado&#44; 24<span class="elsevierStyleHsp" style=""></span>a&#241;os&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Globalmente&#44; los pacientes incluidos en nuestro estudio ten&#237;an una edad avanzada&#44; un gran n&#250;mero de comorbilidades y un elevado riesgo tromboemb&#243;lico&#46; En el estudio FANTASIIA&#44; que incluy&#243; 296 pacientes en tratamiento con ACOD&#44; la edad media fue de 73<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; y tambi&#233;n el n&#250;mero de comorbilidades fue elevado&#46; El riesgo tromboemb&#243;lico fue elevado&#44; aunque algo menor que en nuestro estudio &#40;el 71&#37; ten&#237;a un CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc &#8805;<span class="elsevierStyleHsp" style=""></span>2&#41;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a>&#46; En comparaci&#243;n con estudios realizados en Espa&#241;a en pacientes tratados con AVK&#44; el perfil cl&#237;nico fue bastante similar&#46; As&#237;&#44; en el estudio PAULA la edad media fue de 77<span class="elsevierStyleHsp" style=""></span>a&#241;os y m&#225;s del 94&#37; de los pacientes ten&#237;an un CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc &#8805;<span class="elsevierStyleHsp" style=""></span>2<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Por otra parte&#44; es importante conocer si existen diferencias en el perfil cl&#237;nico de los pacientes de acuerdo a si el m&#233;dico de AP pod&#237;a prescribir directamente ACOD o ten&#237;a que derivar al especialista para que iniciara este tratamiento&#46; Los pacientes en los que el m&#233;dico de AP pod&#237;a prescribir ACOD directamente &#40;estudio SILVER-AP&#41; ten&#237;an un mayor n&#250;mero de comorbilidades&#44; as&#237; como un mayor riesgo tromboemb&#243;lico y de hemorragias&#46; Adem&#225;s&#44; la polimedicaci&#243;n fue m&#225;s frecuente en esta poblaci&#243;n&#46; Es decir&#44; los m&#233;dicos de AP son capaces de manejar perfectamente los ACOD en pacientes complejos&#46; En consecuencia&#44; la complejidad del paciente no deber&#237;a constituir una excusa para establecer la necesidad de que el m&#233;dico de AP deba derivar a los pacientes al especialista para iniciar el tratamiento con ACOD&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los pacientes previamente anticoagulados en los que se inici&#243; el tratamiento con ACOD estaban tomando anteriormente AVK&#46; En un reciente estudio que analiz&#243; la percepci&#243;n que tienen los m&#233;dicos sobre los factores que pueden influir a la hora de escoger entre los AVK y los ACOD en pacientes con FANV se objetiv&#243; que tener un riesgo tromboemb&#243;lico o de sangrado aumentados&#44; as&#237; como el fracaso previo en el tratamiento con dicumar&#237;nicos&#44; se asociaron a una mayor predisposici&#243;n al empleo de ACOD<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>&#46; Todas estas caracter&#237;sticas son f&#225;cilmente identificables por el m&#233;dico de AP&#46; Adem&#225;s&#44; teniendo en cuenta que en Espa&#241;a el control de la anticoagulaci&#243;n de los AVK se realiza principalmente en el &#225;mbito de la AP y que el motivo principal del cambio es un pobre control de INR&#44; situaci&#243;n que ocurre hasta en el 40&#37; de los pacientes<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">7-11</span></a>&#44; el m&#233;dico de AP es el profesional mejor posicionado para poder identificar a los pacientes que m&#225;s se van a beneficiar de la anticoagulaci&#243;n con ACOD&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Por otra parte&#44; aproximadamente en el 40&#37; de los casos de la muestra total de pacientes el cambio a ACOD no se realiz&#243; siguiendo los criterios indicados en el IPT&#46; En parte esto se debe a que en algunos casos las prescripciones se pueden realizar desde el &#225;mbito de la medicina privada&#46; Sin embargo&#44; parece m&#225;s relevante para esta importante falta de seguimiento del IPT que las diferentes comunidades aut&#243;nomas hayan establecido criterios propios a la hora de permitir la prescripci&#243;n de ACOD&#44; lo que sin duda conduce a que el acceso a estos f&#225;rmacos sea diferente dependiendo de la comunidad aut&#243;noma<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; la duraci&#243;n media del tratamiento con ACOD fue de pr&#225;cticamente 16<span class="elsevierStyleHsp" style=""></span>meses&#44; lo que implica que la experiencia en el manejo de estos f&#225;rmacos es ya importante&#46; Seg&#250;n el test de Haynes-Sackett el cumplimiento fue muy elevado&#44; incluso en los pacientes polimedicados&#46; Esta elevada adherencia al tratamiento con ACOD&#44; posiblemente mayor que con los AVK&#44; ya hab&#237;a sido reportada en otros estudios<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Por otra parte&#44; la satisfacci&#243;n con el tratamiento con ACOD fue globalmente muy elevada&#44; quiz&#225;s algo mayor en el estudio BRONCE-AP&#44; probablemente porque eran pacientes con un mejor perfil cl&#237;nico&#46; En cualquier caso&#44; los resultados de nuestro estudio confirman los reportados por otros autores en los que se objetiva un elevado grado de satisfacci&#243;n con el tratamiento con ACOD&#44; posiblemente mayor que con los AVK<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">A pesar de las ventajas evidentes que aportan los ACOD&#44; nuestro trabajo refleja un dato preocupante&#44; y es el elevado n&#250;mero de pacientes en los que se prescriben las dosis bajas de ACOD&#44; hecho que ocurri&#243; con los 3 ACOD&#44; pero especialmente con dabigatr&#225;n en ambos estudios y con apixab&#225;n en el caso del SILVER-AP&#46; Es posible que la mayor complejidad a la hora de ajustar la dosis con dabigatr&#225;n y apixab&#225;n en comparaci&#243;n con rivaroxab&#225;n pueda haber influido en estos resultados&#46; Por otra parte&#44; otros estudios han mostrado que en una proporci&#243;n relativamente importante de pacientes se est&#225;n prescribiendo las dosis bajas de ACOD&#44; y que en muchos casos estas dosis no se corresponden con lo que deber&#237;a por el perfil cl&#237;nico de los pacientes<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">33</span></a>&#44; lo que podr&#237;a tener importantes implicaciones cl&#237;nicas&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">El presente trabajo tiene las limitaciones propias de un dise&#241;o transversal&#44; como la falta de un grupo control y de una asignaci&#243;n aleatoria&#44; lo que no permite controlar todos los posibles factores de confusi&#243;n&#46; Por otra parte&#44; en el presente trabajo se comparan 2 muestras obtenidas de diferentes estudios&#44; con un diferente perfil de investigadores &#40;urbano vs&#46; rural&#41;&#46; Aunque es cierto que parte de las diferencias podr&#237;an deberse a un diferente m&#233;todo de selecci&#243;n de la muestra en ambos estudios&#44; as&#237; como al diferente perfil de investigadores&#44; hay que tener en cuenta que los dise&#241;os de ambos estudios fueron muy similares&#44; y el amplio tama&#241;o muestral&#44; el que los pacientes fueron incluidos de manera consecutiva y la meticulosidad con que los datos fueron recogidos de alguna manera reducen estas limitaciones en gran medida&#46; Adem&#225;s&#44; este es el primer trabajo que compara espec&#237;ficamente el perfil cl&#237;nico y el manejo de los pacientes tratados con ACOD de acuerdo a si el m&#233;dico de AP pod&#237;a prescribir directamente un ACOD o deb&#237;a derivar al especialista para que este lo iniciara&#44; lo que demuestra la relevancia de nuestros resultados&#46; Por otra parte&#44; hay que reconocer que es posible que los investigadores participantes en el presente estudio estuviesen especialmente sensibilizados con el manejo de la anticoagulaci&#243;n en pacientes con FA&#44; y en particular con el uso de ACOD&#44; lo que de alguna manera podr&#237;a no representar a todos los m&#233;dicos de AP y&#44; en consecuencia&#44; limitar de alguna manera la validez externa del estudio&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; los pacientes tratados con ACOD en Espa&#241;a tienen un elevado riesgo tromboemb&#243;lico&#46; Los pacientes en los que el m&#233;dico de AP puede prescribir ACOD directamente tienen un peor perfil de riesgo&#44; con un mayor riesgo tromboemb&#243;lico y de hemorragias que aquellos pacientes en los que el m&#233;dico de AP debe derivar al especialista para que inicie el tratamiento con ellos&#46; El cumplimiento terap&#233;utico con ACOD es elevado&#44; as&#237; como la satisfacci&#243;n con el tratamiento&#46; Sin embargo&#44; en un n&#250;mero significativo de pacientes se prescriben las dosis bajas de ACOD&#44; lo que podr&#237;a tener implicaciones cl&#237;nicas&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Responsabilidades &#233;ticas</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protecci&#243;n de personas y animales&#46;</span><p id="par0165" class="elsevierStylePara elsevierViewall">Los autores declaran que los procedimientos seguidos se conformaron a las normas &#233;ticas del comit&#233; de experimentaci&#243;n humana responsable y de acuerdo con la Asociaci&#243;n M&#233;dica Mundial y la Declaraci&#243;n de Helsinki&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Confidencialidad de los datos&#46;</span><p id="par0170" class="elsevierStylePara elsevierViewall">Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicaci&#243;n de datos de pacientes&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Derecho a la privacidad y consentimiento informado&#46;</span><p id="par0175" class="elsevierStylePara elsevierViewall">Los autores han obtenido el consentimiento informado de los pacientes y&#47;o sujetos referidos en el art&#237;culo&#46; Este documento obra en poder del autor de correspondencia&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicto de intereses</span><p id="par0180" class="elsevierStylePara elsevierViewall">Nuria Mar&#237;n es empleada de Bayer Hispania&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Los dem&#225;s autores declaran no tener ning&#250;n conflicto de intereses&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Content Ed Net &#40;Madrid&#41; proporcion&#243; asistencia editorial en la preparaci&#243;n de este art&#237;culo&#46;</p></span></span>"
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              "titulo" => "Protecci&#243;n de personas y animales&#46;"
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              "titulo" => "Confidencialidad de los datos&#46;"
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              "titulo" => "Derecho a la privacidad y consentimiento informado&#46;"
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    "fechaRecibido" => "2017-05-29"
    "fechaAceptado" => "2017-09-12"
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          "palabras" => array:4 [
            0 => "Anticoagulaci&#243;n"
            1 => "Anticoagulantes orales de acci&#243;n directa"
            2 => "Atenci&#243;n primaria"
            3 => "Fibrilaci&#243;n auricular no valvular"
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            0 => "Anticoagulation"
            1 => "Direct oral anticoagulants"
            2 => "Primary care"
            3 => "Non-valvular atrial fibrillation"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las caracter&#237;sticas cl&#237;nicas y el manejo de pacientes con fibrilaci&#243;n auricular no valvular &#40;FANV&#41; tratados con anticoagulantes orales de acci&#243;n directa &#40;ACOD&#41; de acuerdo a qui&#233;n inicia su prescripci&#243;n&#58; el m&#233;dico de atenci&#243;n primaria &#40;AP&#41; o el especialista&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se compararon 2 estudios observacionales&#44; transversales y multic&#233;ntricos&#46; El estudio SILVER-AP se realiz&#243; en aquellas comunidades aut&#243;nomas en las que el m&#233;dico de AP pod&#237;a prescribir ACOD y el estudio BRONCE-AP en aquellas comunidades aut&#243;nomas en las que el m&#233;dico de AP deb&#237;a derivar al especialista para tal fin&#46; Se incluyeron pacientes diagnosticados de FANV con riesgo de ictus o embolia sist&#233;mica que estuviesen en tratamiento cr&#243;nico con anticoagulantes&#44; que hubiesen modificado su pauta terap&#233;utica y que actualmente estuviesen en tratamiento con un ACOD durante al menos 3<span class="elsevierStyleHsp" style=""></span>meses&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron un total de 1&#46;036 pacientes &#40;790 provenientes del estudio SILVER-AP y 246 del BRONCE-AP&#41;&#46; En comparaci&#243;n con el estudio BRONCE-AP&#44; los pacientes incluidos en el SILVER-AP eran mayores&#44; ten&#237;an m&#225;s comorbilidades y el riesgo tromboemb&#243;lico y hemorr&#225;gico era m&#225;s elevado &#40;CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc 4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;1&#44;6 vs&#46; 3&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; HAS-BLED 2&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8 vs&#46; 1&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El cumplimiento terap&#233;utico fue elevado&#44; al igual que la satisfacci&#243;n con el tratamiento&#46; Las dosis bajas de ACOD se emplearon frecuentemente&#44; en especial con dabigatr&#225;n&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los pacientes en los que el m&#233;dico de AP puede prescribir ACOD tienen un peor perfil cl&#237;nico&#44; con un mayor riesgo tromboemb&#243;lico y de hemorragias que aquellos casos en los que debe derivar al especialista&#46;</p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the clinical characteristics and management of patients with non-valvular atrial fibrillation &#40;NVAF&#41; treated with direct oral anticoagulants &#40;DOAC&#41; according to who initiates their prescription&#44; the Primary Care &#40;PC&#41; physician or referring the patient to a specialist&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Two observational&#44; cross-sectional and multicentre studies were compared for this purpose&#46; The SILVER-AP study was performed in those autonomous communities in which the PC physician can prescribe DOAC directly&#44; and the BRONCE-AP study in those autonomous communities in which the PC physician has to refer the patient to the specialist to start treatment with DOAC&#46; Patients on chronic treatment with anticoagulants&#44; in whom therapy was changed&#44; and those that were on current treatment with DOAC for at least 3<span class="elsevierStyleHsp" style=""></span>months&#44; were included&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 1&#44;036 patients &#40;790 from SILVER-AP study and 246 from BRONCE-AP study&#41; were included&#46; Compared with the BRONCE-AP study&#44; those patients included in SILVER-AP were older and had more comorbidities&#44; as well as a higher thromboembolic and haemorrhagic risk &#40;CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc 4&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6 vs&#46; 3&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;1&#46;8&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#59; HAS-BLED 2&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8 vs&#46; 1&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;0&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Therapeutic adherence and satisfaction with treatment were high&#46; Low doses of DOAC were frequently prescribed&#44; particularly with dabigatran&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Those patients in whom the PC physician can prescribe DOAC directly have a worse clinical profile&#44; as well as a higher thromboembolic and haemorrhagic risk than those patients in whom the PC physician has to refer to the specialist&#46;</p></span>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Urbano&#58; &#62;<span class="elsevierStyleHsp" style=""></span>10&#46;000 habitantes&#59; Intermedio&#58; &#62;<span class="elsevierStyleHsp" style=""></span>2&#46;000 y &#8804;<span class="elsevierStyleHsp" style=""></span>10&#46;000 habitantes&#59; Rural&#58; &#8804;<span class="elsevierStyleHsp" style=""></span>2&#46;000 habitantes&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Para la comparaci&#243;n entre variables cuantitativas se emple&#243; la t de Student y para la comparaci&#243;n entre variables cualitativas&#44; la prueba chi-cuadrado&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;078&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">&#193;mbito de trabajo &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urbano&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">AIT&#58; ataque isqu&#233;mico transitorio&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; ES&#58; embolismo sist&#233;mico&#59; IC 95&#37;&#58; intervalo de confianza del 95&#37;&#59; <span class="elsevierStyleSmallCaps">VI</span>&#58; ventr&#237;culo izquierdo&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Para la comparaci&#243;n entre variables cuantitativas se emple&#243; la t de Student y para la comparaci&#243;n entre variables cualitativas&#44; la prueba chi-cuadrado&#46;</p>"
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                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Datos sociodemogr&#225;ficos</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Jubilado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Grado de autonom&#237;a &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Independiente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="middle">0&#44;283</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dependiente familiar&#47;cuidador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">M&#225;ximo nivel de estudios &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sin estudios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">&#60; 0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Secundarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Superiores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Caracter&#237;sticas de la FA</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Tipo de FA &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Parox&#237;stica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="middle">&#60; 0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Persistente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Permanente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tiempo desde el diagn&#243;stico de FA &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4 &#177; 4&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4 &#177; 4&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3 &#177; 5&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;067&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Exploraci&#243;n f&#237;sica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de masa corporal &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;0 &#177; 4&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;0 &#177; 4&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;0 &#177; 5&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;727&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Presi&#243;n arterial sist&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131&#44;5 &#177; 14&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130&#44;9 &#177; 14&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">133&#44;2 &#177; 14&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Presi&#243;n arterial diast&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#44;9 &#177; 9&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#44;5 &#177; 9&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#44;9 &#177; 9&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Frecuencia cardiaca &#40;lpm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;5 &#177; 12&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;9 &#177; 12&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;2 &#177; 12&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;065&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Factores de riesgo cardiovascular</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hipertensi&#243;n arterial &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#44;0 &#91;82&#44;9-87&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#44;3 &#91;83&#44;9-88&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#44;9 &#91;76&#44;0-85&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dislipemia &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#44;9 &#91;58&#44;9-64&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;8 &#91;60&#44;5-67&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#44;6 &#91;49&#44;3-61&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes mellitus &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;4 &#91;27&#44;6-33&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;4 &#91;29&#44;1-35&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;0 &#91;18&#44;7-29&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo &#40;&#37; &#91;IC95&#37;&#93;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fumador activo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;3 &#91;3&#44;9-6&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8 &#91;4&#44;2-7&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;7 &#91;1&#44;3-6&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="middle">0&#44;354</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ex fumador &#40;&#8805; 1 a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;3 &#91;30&#44;4-36&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;7 &#91;29&#44;4-35&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#44;3 &#91;29&#44;4-41&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nunca fumador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#44;4 &#91;58&#44;4-64&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#44;5 &#91;58&#44;1-64&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#44;0 &#91;54&#44;9-67&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Enfermedades cardiovasculares</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Insuficiencia cardiaca&#47;disfunci&#243;n sist&#243;lica</span><span class="elsevierStyleSmallCaps">VI</span><span class="elsevierStyleItalic">&#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;9 &#91;24&#44;2-29&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;4 &#91;26&#44;2-32&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;1 &#91;14&#44;2-24&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antecedentes de ictus&#44; AIT o ES &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;3 &#91;17&#44;8-22&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;8 &#91;17&#44;9-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;7 &#91;13&#44;8-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;483&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Insuficiencia renal &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;1 &#91;15&#44;7-20&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;0 &#91;17&#44;2-22&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;8 &#91;7&#44;8-15&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Enfermedad arterial perif&#233;rica &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;0 &#91;8&#44;2-11&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;7 &#91;7&#44;7-11&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;0 &#91;7&#44;1-14&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;576&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cardiopat&#237;a isqu&#233;mica &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;9 &#91;11&#44;9-16&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;1 &#91;12&#44;6-17&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;6 &#91;6&#44;7-14&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antecedentes de infarto de miocardio &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;1 &#91;5&#46;6-8&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;8 &#91;6&#46;0-9&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;9 &#91;2&#46;2-7&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;114&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Placa de ateroma en cualquier territorio &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;8 &#91;4&#44;4-7&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;3 &#91;4&#44;6-8&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;1 &#91;1&#44;6-6&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Factores que aumentan el riesgo de sangrado</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">INR l&#225;bil conocido &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;7 &#91;60&#44;3-67&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&#44;0 &#91;32&#44;9-45&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Historia de sangrado&#44; anemia o predisposici&#243;n al sangrado &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;0 &#91;8&#44;2-11&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;4 &#91;8&#44;3-12&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;9 &#91;5&#44;4-12&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;513&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Otras enfermedades&#47;situaciones de inter&#233;s</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Polimedicaci&#243;n &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82&#44;1 &#91;79&#44;8-84&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&#44;6 &#91;81&#44;0-86&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#44;2 &#91;72&#44;0-82&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Depresi&#243;n &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;3 &#91;14&#44;1-18&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;2 &#91;13&#44;6-18&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;7 &#91;12&#44;0-21&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;863&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">EPOC &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;3 &#91;15&#44;0-19&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;4 &#91;16&#44;6-22&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;6 &#91;6&#44;7-14&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;1 &#91;2&#44;0-4&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;1 &#91;3&#44;5-9&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;036&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Riesgo tromboemb&#243;lico</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Escala CHADS</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CHADS</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#8805; 2 &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&#44;1 &#91;76&#44;7-81&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#44;9 &#91;79&#44;0-84&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#44;4 &#91;64&#44;6-76&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Componentes escala CHADS</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;&#37; &#91;IC 95&#37;&#93;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Historia de insuficiencia card&#237;aca congestiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;9 &#91;24&#44;2-29&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;4 &#91;26&#44;2-32&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;1 &#91;14&#44;2-24&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#44;3 &#91;83&#44;9-88&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#44;9 &#91;76&#44;0-85&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad &#8805; 75 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#44;1 &#91;66&#44;3-71&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#44;1 &#91;68&#44;0-74&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#44;6 &#91;56&#44;6-68&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;4 &#91;27&#44;6-33&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;4 &#91;29&#44;1-35&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;0 &#91;18&#44;7-29&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Historia de ictus&#47;AIT&#47;embolia sist&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;3 &#91;17&#44;8-22&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;8 &#91;17&#44;9-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;7 &#91;13&#44;8-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;483&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Escala CHA</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">DS</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">-VASc</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CHA</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">DS</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">-VASc &#8805; 2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#44;4 &#91;95&#44;3-97&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&#44;1 &#91;97&#44;2-99&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&#44;1 &#91;87&#44;5-94&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Componentes escala CHA</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">DS</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">-VASc &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Historia de ICC&#47;disfunci&#243;n ventricular izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;9 &#91;24&#44;2-29&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;4 &#91;26&#44;2-32&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;1 &#91;14&#44;2-24&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#44;0 &#91;82&#44;9-87&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#44;3 &#91;83&#44;9-88&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#44;9 &#91;76&#44;0-85&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad &#8805; 75 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#44;1 &#91;66&#44;3-71&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#44;1 &#91;68&#44;0-74&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#44;6 &#91;56&#44;6-68&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;4 &#91;27&#44;6-33&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;4 &#91;29&#44;1-35&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;0 &#91;18&#44;7-29&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Accidente cerebrovascular&#47;AIT &#47; embolia sist&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;3 &#91;17&#44;8-22&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;8 &#91;17&#44;9-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;7 &#91;13&#44;8-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;483&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad vascular<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;0 &#91;24&#44;3-29&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;0 &#91;24&#44;9-31&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;0 &#91;18&#44;8-29&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;218&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad 65-74 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#44;7 &#91;21&#44;2-26&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#44;3 &#91;20&#44;3-26&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;2 &#91;19&#44;8-30&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;538&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sexo femenino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;3 &#91;46&#44;3-52&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;5 &#91;46&#44;0-53&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#44;8 &#91;42&#44;5-55&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Riesgo de sangrado</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Escala HAS-BLED</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">HAS-BLED &#8805;3 &#40;&#37; &#91;IC95&#37;&#93;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;1 &#91;23&#44;4-28&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;6 &#91;24&#44;5-30&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#44;1 &#91;16&#44;0-26&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Componentes escala HAS-BLED &#40;&#37; &#91;IC 95&#37;&#93;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n no controlada &#40;PAS<span class="elsevierStyleHsp" style=""></span>&#62;160 mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;6 &#91;2&#44;4-4&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;3 &#91;2&#44;1-4&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5 &#91;1&#44;9-7&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;384&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia renal<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;5 &#91;0&#44;0-0&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;6 &#91;0&#44;0-1&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0 &#91;0&#44;0-0&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;211&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia hep&#225;tica<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;6 &#91;0&#44;1-1&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;8 &#91;0&#44;2-1&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0 &#91;0&#44;0-0&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Historia previa de ictus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;3 &#91;17&#44;8-22&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;8 &#91;17&#44;9-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;7 &#91;13&#44;8-23&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;843&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Historia de sangrado&#44; anemia o predisposici&#243;n al sangrado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;0 &#91;8&#44;2-11&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;4 &#91;8&#44;3-12&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;9 &#91;5&#44;4-12&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;513&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tiempo en rango terap&#233;utico del INR &#60;<span class="elsevierStyleHsp" style=""></span>60&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;8 &#91;54&#44;8-60&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;7 &#91;60&#44;3-67&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&#44;0 &#91;32&#44;9-45&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad<span class="elsevierStyleHsp" style=""></span>&#62; 65 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&#44;5 &#91;89&#44;9-93&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93&#44;4 &#91;91&#44;7-95&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#44;4 &#91;81&#44;0-89&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medicamentos que afecten la hemostasia<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;3 &#91;11&#44;3-15&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;8 &#91;10&#44;5-15&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;0 &#91;10&#44;8-20&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;363&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ingesta de &#8805; 8 bebidas alcoh&#243;licas&#47;semana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2 &#91;2&#44;9-5&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2 &#91;2&#44;8-5&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;1 &#91;1&#44;6-6&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;939&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Enfermedad vascular incluye infarto de miocardio previo&#44; enfermedad arterial perif&#233;rica&#44; placa a&#243;rtica&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Insuficiencia renal&#58; di&#225;lisis cr&#243;nica&#44; trasplante renal o creatinina s&#233;rica &#8805;<span class="elsevierStyleHsp" style=""></span>2&#44;26<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Insuficiencia hep&#225;tica&#58; enfermedad hep&#225;tica cr&#243;nica &#40;ej&#46;&#44; cirrosis&#41; o datos bioqu&#237;micos indicativos de deterioro hep&#225;tico &#40;ej&#46;&#44; bilirrubina &#62;<span class="elsevierStyleHsp" style=""></span>2 veces el l&#237;mite superior normal&#44; AST&#47;ALT &#62;<span class="elsevierStyleHsp" style=""></span>3 veces el l&#237;mite superior normal&#44; etc&#46;&#41;&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Medicamentos que afecten la hemostasia&#58; ej&#46;&#44; antiinflamatorios no esteroideos y antiagregantes plaquetarios&#44; clopidogrel&#44; etc&#46;</p> <p class="elsevierStyleNotepara" id="npar0025">Para la comparaci&#243;n entre variables cuantitativas se emple&#243; la t de Student y para la comparaci&#243;n entre variables cualitativas&#44; la prueba chi-cuadrado&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Estratificaci&#243;n de riesgo tromboemb&#243;lico y hemorr&#225;gico</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ACOD&#58; anticoagulantes orales de acci&#243;n directa&#59; AVK&#58; antagonistas de la vitamina<span class="elsevierStyleHsp" style=""></span>K&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; intervalo de confianza del 95&#37;&#59; INR&#58; <span class="elsevierStyleItalic">internacional normalizad ratio</span>&#59; IPT&#58; informe de posicionamiento terap&#233;utico&#46;</p>"
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pacientes en los que el cambio de tratamiento a los nuevos ACOD se paut&#243; seg&#250;n los criterios IPT &#40;&#37;&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>538&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SILVER-AP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>467&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">BRONCE-AP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pacientes que han iniciado tratamiento con AVK en los que no es posible mantener un control de INR dentro de rango &#40;2-3&#41; a pesar de un buen cumplimiento terap&#233;utico &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&#44;0 &#91;75&#44;6-82&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#44;4 &#91;74&#44;6-82&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&#44;1 &#91;74&#44;4-91&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;362&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pacientes con hipersensibilidad conocida o con contraindicaci&#243;n espec&#237;fica al uso acenocumarol o warfarina &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;0 &#91;10&#44;2-15&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;5 &#91;10&#44;4-16&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;9 &#91;2&#44;9-16&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Imposibilidad de acceso al control de INR convencional &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;9 &#91;6&#44;5-11&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;6 &#91;7&#44;0-12&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;2 &#91;0&#44;9-11&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pacientes en tratamiento con AVK que sufren episodios tromboemb&#243;licos arteriales graves a pesar de un buen control de INR&#46; Entre otras opciones terap&#233;uticas&#44; los ACOD podr&#237;an representar una alternativa en estos pacientes &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;3 &#91;6&#44;8-11&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;2 &#91;6&#44;6-11&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;9 &#91;2&#44;9-16&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;860&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pacientes con ictus isqu&#233;mico que presenten criterios cl&#237;nicos y de neuroimagen de alto riesgo de hemorragia intracraneal&#44; definido como la combinaci&#243;n de HAS-BLED &#8805;<span class="elsevierStyleHsp" style=""></span>3 y al menos uno de los siguientes&#58; leucoaraiosis grado <span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">IV</span> y&#47;o microsangrados corticales m&#250;ltiples &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;1 &#91;4&#44;9-9&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;1 &#91;4&#44;7-9&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;0 &#91;1&#44;1-13&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;994&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pacientes con antecedentes de hemorragia intracraneal &#40;excepto durante la fase aguda&#41; en los que se valore que los beneficios de la anticoagulaci&#243;n superan el riesgo hemorr&#225;gico &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;3 &#91;2&#44;6-6&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5 &#91;2&#44;6-6&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;8 &#91;0&#44;0-6&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;515&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1804401.png"
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            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pacientes en los que el cambio de tratamiento a los nuevos ACOD no se paut&#243; seg&#250;n los criterios IPT &#40;&#37;&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>374&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SILVER-AP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>323&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">BRONCE-AP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paciente con INR no controlado durante el &#250;ltimo a&#241;o &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;9 &#91;59&#44;0-68&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#44;8 &#91;66&#44;9-76&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;7 &#91;4&#44;3-23&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prescrito seg&#250;n ficha t&#233;cnica &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;7 &#91;22&#44;3-31&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;8 &#91;15&#44;5-24&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#44;6 &#91;58&#44;1-83&#44;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paciente con hipersensibilidad conocida o con contraindicaci&#243;n espec&#237;fica al uso de acenocumarol o warfarina &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;7 &#91;1&#44;8-5&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;7 &#91;1&#44;7-5&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;9 &#91;0&#44;0-9&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;943&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paciente en tratamiento con AVK que sufre episodios tromboemb&#243;licos arteriales graves a pesar de un buen control del INR &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;7 &#91;1&#44;8-5&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;1 &#91;1&#44;2-4&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;8 &#91;0&#44;5-15&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Reacciones adversas graves asociadas al tratamiento con AVK o interacci&#243;n farmacol&#243;gica relevante de dif&#237;cil control a pesar del ajuste posol&#243;gico en funci&#243;n del INR &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1 &#91;0&#44;7-3&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;5 &#91;0&#44;8-4&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;0 &#91;0&#44;0-0&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paciente en tratamiento con AVK que ha presentado episodios hemorr&#225;gicos graves a pesar de un buen control del INR &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1 &#91;0&#44;7-3&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;2 &#91;0&#44;6-3&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;0 &#91;0&#44;0-5&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;925&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paciente con riesgo elevado de hemorragia intracraneal &#40;&#37; &#91;IC 95&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;6 &#91;0&#44;3-2&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;5 &#91;0&#44;2-2&#44;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;0 &#91;0&#44;0-6&#44;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;827&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            0 => array:3 [
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Un paciente pod&#237;a tener m&#225;s de un motivo&#46;</p> <p class="elsevierStyleNotepara" id="npar0035">Para la comparaci&#243;n de variables cualitativas se emple&#243; la prueba de chi cuadrado&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Motivos del cambio a ACOD seg&#250;n se siguiesen los criterios del IPT o no<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a></p>"
        ]
      ]
      4 => array:8 [
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        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
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            "detalle" => "Tabla "
            "rol" => "short"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">IC 95&#37;&#58; intervalo de confianza del 95&#37;&#46;</p><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Para la comparaci&#243;n entre variables cuantitativas se emple&#243; la t de Student&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;036&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SILVER-AP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>790&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">BRONCE-AP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>246&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Escala Carga&#59; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DT &#91;IC 95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;1 &#91;52&#44;1-53&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;2 &#91;51&#44;5-52&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;3 &#91;53&#44;4-55&#44;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Escala Beneficio&#59; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DT &#91;IC 95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2 &#91;12&#44;0-12&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2 &#91;12&#44;0-12&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;3 &#91;11&#44;8-12&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;912&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1804398.png"
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        "descripcion" => array:1 [
          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Puntuaci&#243;n del cuestionario ACTS</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0035"
        "etiqueta" => "Tabla 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at6"
            "detalle" => "Tabla "
            "rol" => "short"
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        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">bid&#58; dos veces al d&#237;a&#59; od&#58; una vez al d&#237;a&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SILVER-AP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">BRONCE-AP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Rivaroxab&#225;n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>mg od&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#44;1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>414&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#44;2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>321&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#44;9 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="middle">0&#44;994</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>mg od&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;9 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>176&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;8 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>136&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Dabigatr&#225;n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>150<span class="elsevierStyleHsp" style=""></span>mg bid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&#44;9 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#44;7 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;9 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="middle">0&#44;484</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>110<span class="elsevierStyleHsp" style=""></span>mg bid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#44;1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>146&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#44;3 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>109&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#44;1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Apixab&#225;n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mg bid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#44;6 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>125&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#44;2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#44;4 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="middle">0&#44;037</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&#44;5<span class="elsevierStyleHsp" style=""></span>mg bid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#44;4 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#44;8 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#44;6 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Dosis empleadas en el tratamiento con anticoagulantes orales de acci&#243;n directa &#40;ACOD&#41;</p>"
        ]
      ]
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        "identificador" => "tbl0005"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">&#42;Listado de investigadores</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alfonso Romero Furones &#40;<span class="elsevierStyleSmallCaps">C</span>&#46;S&#46; San Bernardo&#44; Salamanca &#8211;Salamanca&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ana Alayeto Sanchez &#40;C&#46;S&#46; Mar B&#225;ltico&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ana Isabel Perez Aragues &#40;CAP Manso&#44; Barcelona &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Andr&#233;s Mart&#237;nez Gonzalez &#40;C&#46;S Serantes&#44; Ferrol &#8211;La Coru&#241;a&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Angela Gutierrez Perez &#40;C&#46;S Calero&#44; Las Palmas &#8211;Las Palmas&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antonio Arroyo P&#233;rez &#40;C&#46; S&#46; Gregorio Mara&#241;&#243;n&#44; Alcorc&#243;n &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antonio Calvo Guerrero &#40;C&#46;S Noia&#44; La Coru&#241;a &#8211;La Coru&#241;a&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antonio de Torres Lopez &#40;C&#46;S Potosi&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antonio Jimenez Lopez &#40;C&#46;S&#46; T&#237;jola&#44; T&#237;jola -Almer&#237;a&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antonio Regueiro Martinez &#40;C&#46;S Vilanova de Arousa&#44; Vilanova de Arousa &#8211;Pontevedra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arantxa Gonzalez Osuna &#40;CAP Maragall&#44; Barcelona &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Beatriz Alvarez Alvarez &#40;C&#46;S Andres Mellado&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bego&#241;a Ruiz Aguirre &#40;Amb&#46;Markonzaga&#44; Sestao &#8211;Bizkaia&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Carlos Casado Alvaro &#40;C&#46;S&#46; General Ricardos&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clara Ordas Miguelez &#40;C&#46;S&#46; Benavides&#44; Benavides &#8211;Le&#243;n&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cristina Aguado Taberne &#40;C&#46;S&#46; Santa Rosa&#44; C&#243;rdoba &#8211;C&#243;rdoba&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cristina Ni&#241;o Azcarate &#40;C&#46;S Playa de los Cristianos&#44; Arona -Tenerife&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Delia Mestres &#40;CAP el Pla&#44; Sant Feliu Llobregat &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Eduardo Hevia Rodriguez &#40;CS Vallob&#237;n - Concinos&#44; Oviedo &#8211;Asturias&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Elena L&#243;pez de la Fuente &#40;C&#46;S Villaamil&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Emilio Aberasturi Ramirez &#40;C&#46;S&#46; Ntra Sra de Estibaliz&#44; Vitoria -&#193;lava&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enrique Mart&#237;n Riob&#243; &#40;C&#46;S&#46; Fuensanta&#44; C&#243;rdoba &#8211;C&#243;rdoba&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fco&#46; Javier Cecilio Montero &#40;C&#46;S de Porri&#241;o&#44; Porri&#241;o &#8211;Pontevedra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fernando Gallo Trevol &#40;C&#46;S&#46; Joaqu&#237;n Elizalde&#44; Logro&#241;o -La Rioja&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ferran Marco Cardona &#40;CAP Adri&#225;&#44; Barcelona &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gabriel Lliteras Fleixas &#40;C&#46;S&#46; Lluc Major&#44; Lluc Major - Mallorca &#8211;Islas Baleares&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Giusseppe Ruffo &#40;CAP Banyoles&#44; Banyoles &#8211;Girona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ignacio Brotons Garcia &#40;C&#46;S Legazpi&#44; Madrid -Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Inmaculada C&#46; Marin Cabrera &#40;C&#46;S&#46; Alvarez de la Riva&#44; Orihuela &#8211;Alicante&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Isabel Ortega Abarca &#40;CAP Pubilla Cases&#44; Esplugues de Llobregat &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jaime Ruiz Perez &#40;C&#46;S Tanos&#44; Tanos &#8211;Cantabria&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Javier Cejudo Palmero &#40;C&#46;S&#46; San Fermin&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Javier Velasco &#40;C&#46;S Las Rozas Abajon&#44; Las Rozas &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jes&#250;s de Juan Prego &#40;C&#46;S Fontela Maristany&#44; Ferrol &#8211;La Coru&#241;a&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Joan Lluis Frigola Marcet &#40;CAP San Pere&#44; Reus &#8211;Tarragona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jorge Abraldes Dopazo &#40;C&#46;S&#46; Landako&#44; Durango &#8211;Bizkaia&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jos&#233; Antonio Quindimil &#40;C&#46;S&#46; Kueto&#44; Sestao &#8211;Bizkaia&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jos&#233; Manuel Soto Gonzalez &#40;C&#46;S&#46; De Pintor Colmeiro&#44; Vigo &#8211;Pontevedra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jos&#233; Mar&#237;a Fern&#225;ndez Villaverde &#40;C&#46;S Ribeira&#44; Ribeira &#8211;La Coru&#241;a&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jose Porta Quintana &#40;C&#46;S&#46; Mu&#241;oz Fernandez Ruise&#241;ores&#44; Zaragoza&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jose Ram&#243;n Dom&#237;nguez Alonso &#40;C&#46;S&#46; San Jos&#233; Norte&#44; Zaragoza &#8211;Zaragoza&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Juan Jos&#233; Mu&#241;oz Gavil&#225;n &#40;C&#46;S&#46; Levante Norte&#44; C&#243;rdoba &#8211;C&#243;rdoba&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Judith Calpe &#40;CAP Terrassa Oest&#44; Terrassa &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Julio Vallina Blanco &#40;C&#46;S Llano Ponte&#44; Avil&#233;s &#8211;Asturias&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lidia Gonzalez Gil &#40;CAP Rambla&#44; Terrassa &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lucas Mengual Mart&#237;nez &#40;ABS Badia Vall&#233;s&#44; Badia del Vall&#232;s &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Luis Prieto Albino &#40;C&#46;S Nuevo C&#225;ceres&#44; C&#225;ceres &#8211;C&#225;ceres&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Luis Segovia Castro &#40;C&#46;S&#46; Casa Do Mar Marin&#44; Marin &#8211;Pontevedra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Luis Serrano Mallagray &#40;C&#46;S&#46; Cascante&#44; Cascante &#8211;Navarra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Luis Torres Buisan &#40;CS Yunquera de Henares&#44; Yunquera de Henares &#8211;Guadalajara&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Manuel Barral Castro &#40;C&#46;S Casa del Mar&#44; La Coru&#241;a &#8211;La Coru&#241;a&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Manuel Pedro Ayechu Red&#237;n &#40;C&#46;S&#46; de Puente la Reina&#44; Puente de la Reina &#8211;Navarra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Margarita Beatriz Reboredo Otero &#40;C&#46;S&#46; La Ca&#241;iza&#44; La Ca&#241;iza &#8211; Pontevedra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Margarita Maortua Maortua &#40;Amb&#46; Dr&#46; Areilza&#44; Bilbao &#8211;Vizcaya&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maria Antonia Sanchez Calavera &#40;C&#46;S&#46; Canal Imperial&#44; Zaragoza &#8211;Zaragoza&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maria del Mar D&#237;ez Ponce &#40;C&#46;S&#46; Calle Cuba&#44; Vigo &#8211;Pontevedra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maria Isabel Lopez Abietar &#40;C&#46;S&#46; Casas Iba&#241;ez&#44; Casas-Ib&#225;&#241;ez &#8211;Albacete&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Maria Victoria Vilar Linares &#40;C&#46;S&#46; Torre del Mar&#44; Torre del Mar &#8211;M&#225;laga&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mariano de la Figuera &#40;CAP Sardenya&#44; Barcelona &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mariano Leal Hernandez &#40;C&#46;S&#46; San Andres&#44; Murcia &#8211;Murcia&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Marta Guz&#243;n Centeno &#40;C&#46;S&#46; Goya&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Marta D&#8217;Lacoste Farre &#40;CAP San Ildefons&#44; Cornell&#224; de Llobregat &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mart&#237;n San Mill&#225;n Honrado &#40;C&#46;S San Andres del Rabanedo&#44; San Andr&#233;s del Rabanedo &#8211;Le&#243;n&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mercedes Lasa Garmendia &#40;Amb&#46; Amara Berri&#44; Donostia &#8211; Guip&#250;zcoa&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Muti Mahmoud-Ibrahim &#40;C&#46;S&#46; La Almunia&#44; La Almunia de Do&#241;a Godina &#8211;Zaragoza&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Olga Garcia Vallejos &#40;CS Comillas&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pablo Guti&#233;rrez Mu&#241;oz &#40;C&#46;S&#46; Montej&#237;car&#44; Montej&#237;car &#8211;Granada&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pedro Ca&#241;ones &#40;C&#46;S&#46; Isla de Oza&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rafael Luqu&#237;n Mart&#237;nez &#40;C&#46;S&#46; Virgen de la Caridad&#44; Cartagena &#8211;Murcia&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rodrigo C&#243;rdoba Garc&#237;a &#40;CAP&#46; Dromda&#95;Delicias Sur&#44; Zaragoza &#95;Zaragoza&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rodrigo Mayo Cabeza &#40;C&#46;S&#46; Fuengirola &#8211; Oeste&#44; Fuengirola &#8211;M&#225;laga&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Roque Lucas S&#225;nchez &#40;CAP Palau de Plegamans&#44; Palau-Solit&#224; i Plegamans &#8211;Barcelona&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rosario Alustiza Vergara &#40;Ambulatorio de Bergara&#44; Vergara &#8211;Guip&#250;zcoa&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sergio Cinza &#40;C S&#46; Porto do Son&#44; Porto do Son &#8211;La Coru&#241;a&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Silvia Medrano Sanz &#40;C&#46;S&#46; Garcia Noblejas&#44; Madrid &#8211;Madrid&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Susana Davi&#241;a Romero &#40;C&#46;S&#46; Chapela&#44; Chapela &#8211;Pontevedra&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tomas Hernandez Corral &#40;C&#46;S San Juan&#44; Salamanca &#8211;Salamanca&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:33 [
            0 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "The Task Force for the management of atrial fibrillation of the European Society of Cardiology &#40;ESC&#41;&#46; Developed with the special contribution of the European Heart Rhythm Association &#40;EHRA&#41; of the ESC&#46; Endorsed by the European Stroke Organisation &#40;ESO&#41;"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Kirchhof"
                            1 => "S&#46; Benussi"
                            2 => "D&#46; Kotecha"
                            3 => "A&#46; Ahlsson"
                            4 => "D&#46; Atar"
                            5 => "B&#46; Casadei"
                          ]
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                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehw210"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2016"
                        "volumen" => "37"
                        "paginaInicial" => "2893"
                        "paginaFinal" => "2962"
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Información del artículo
ISSN: 11383593
Idioma original: Español
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2019 Junio 56 29 85
2019 Mayo 142 26 168
2019 Abril 46 33 79
2019 Marzo 17 7 24
2019 Febrero 21 6 27
2019 Enero 12 6 18
2018 Diciembre 0 2 2
2018 Octubre 5 0 5
2018 Septiembre 3 2 5
2018 Agosto 4 3 7
2018 Julio 29 16 45
2018 Febrero 0 1 1
2018 Enero 0 7 7
2017 Diciembre 0 2 2
2017 Noviembre 0 1 1
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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