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in the context of CS has progressively increased in recent years&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Unlike MI patients who are not hemodynamically unstable&#44; in whom only the culprit lesion should be treated&#44; complete revascularization of all critical coronary lesions is a class I recommendation&#44; level of evidence B&#44; for patients with CS in the European Society of Cardiology guidelines on myocardial revascularization&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> which reflects the fact that two or more coronary territories are frequently involved in the genesis of CS due to pump failure&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Besides revascularization&#44; other diagnostic and therapeutic measures are also crucial to management of CS&#44; particularly vasopressor and inotropic agents&#44; invasive mechanical ventilation&#44; renal replacement therapy and mechanical support therapies such as intra-aortic balloon pump counterpulsation&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> When necessary&#44; some of these measures can be begun in a pre-hospital context&#46; Invasive hemodynamic monitoring&#44; insertion of an arterial line and pulmonary artery catheterization to measure right and left pressures and outputs and calculate pulmonary and systemic vascular resistance are essential in assessing the efficacy of such measures&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Despite advances in the management and treatment of patients with CS&#44; mortality has not changed significantly in recent years and remains high&#58; around 50&#37; of MI patients who suffer CS die in hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> On the other hand&#44; those who recover have good long-term survival&#44; which makes it imperative to develop strategies to stabilize these patients&#44; especially in the first hours following the event&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The aim of this study was to analyze changes in the clinical characteristics&#44; treatment and mortality of patients with MI complicated by CS due to left ventricular pump failure over a 10-year time span&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Population</span><p id="par0035" class="elsevierStylePara elsevierViewall">We performed a retrospective analysis of two patient populations admitted to the cardiac intensive care unit &#40;CICU&#41; with a diagnosis of CS following MI&#44; in the periods May 1998-May 2001 &#40;group A&#41; and May 2008-May 2011 &#40;group B&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Patients who developed CS during hospitalization were excluded from the analysis&#44; as were those with CS due to mechanical complications or right ventricular failure following MI as assessed by transthoracic echocardiography&#46; Patients were selected on the basis of data recorded prospectively using Cardiobase<span class="elsevierStyleSup">&#174;</span> software &#40;Infortucano&#44; Lisbon&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The diagnosis of CS at hospital admission was based on the following clinical criteria&#58; persistent hypotension &#40;systolic blood pressure &#91;SBP&#93; &#60;90 mmHg&#41; following intravenous rehydration therapy or need for vasopressor support to maintain SBP &#8805;90 mmHg&#44; together with signs of peripheral hypoperfusion &#40;oliguria or anuria or cold clammy extremities&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> For both periods under consideration&#44; management included immediate coronary angiography with a view to revascularization&#46; In most patients&#44; insertion of an intra-aortic balloon pump and orotracheal intubation for mechanical ventilation were carried out in the hemodynamic laboratory and pulmonary artery catheterization was performed in the CICU following coronary angiography&#46; These techniques were used at the operator&#39;s discretion&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Clinical events</span><p id="par0050" class="elsevierStylePara elsevierViewall">The following in-hospital events were analyzed&#58; ischemia &#40;reinfarction and stroke&#41;&#44; arrhythmias &#40;atrial fibrillation&#44; ventricular fibrillation and complete atrioventricular block&#41;&#44; major bleeding &#40;TIMI criteria&#41;&#44; and mortality&#46; Reinfarction was defined as re-elevation of troponin I above the decision limit&#44; together with de novo symptoms or electrocardiographic findings suggestive of myocardial ischemia&#46; Stroke was defined as focal neurological signs persisting longer than 24 hours with evidence of infarction on brain imaging &#40;ischemic&#41; or without &#40;undetermined etiology&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The clinical events assessed during follow-up were all-cause mortality at 30 days and six months&#46; No patient was lost to follow-up&#46; Clinical data were obtained by consultation of patients&#8217; medical records and databases or by telephone contact with the patient or relatives&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Categorical variables were expressed as percentages and frequencies and compared by the chi-square test&#46; Continuous variables were expressed as means &#177; standard deviation and compared using the Student&#39;s t test when appropriate &#40;as assessed by the Shapiro-Wilks test&#41;&#46; In-hospital events and mortality during follow-up were assessed by Kaplan-Meier analysis&#44; statistical differences between the two groups being determined by the log rank test&#46; Multivariate analysis using Cox proportional hazard models was performed to identify independent predictors of mortality at six months&#46; The first model included baseline characteristics &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; associated with the study&#39;s clinical event that showed p&#60;0&#46;10 on univariate analysis&#46; Variables related to drug therapy in the acute phase &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; and to invasive techniques and myocardial revascularization &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; were added in subsequent models&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Results with p&#60;0&#46;05 were considered statistically significant&#46; The data were analyzed using Statistical Package for the Social Sciences<span class="elsevierStyleSup">&#174;</span> for Windows&#44; version 19&#46;0 &#40;SPSS&#44; Inc&#46;&#44; Chicago&#44; Illinois&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Characteristics of the study population</span><p id="par0070" class="elsevierStylePara elsevierViewall">The incidence of CS was 3&#46;7&#37; &#40;25&#47;683&#41; and 4&#46;8&#37; &#40;42&#47;875&#41; in the first and second periods&#44; respectively &#40;p&#61;0&#46;330&#41;&#46; Group B were significantly older &#40;66&#46;5&#177;11&#46;3 vs&#46; 60&#46;2&#177;12&#46;3 years in group A&#44; p&#61;0&#46;043&#41;&#46; The proportion of patients admitted within six hours of symptom onset was also significantly higher in group B &#40;54&#46;8&#37; vs&#46; 29&#46;2&#37; in group A&#44; p&#61;0&#46;045&#41;&#46; Other demographic and baseline clinical characteristics did not differ significantly between the two groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">With regard to clinical presentation&#44; most patients in both groups were admitted for ST-elevation MI&#44; mainly of the anterior wall&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Diagnosis and treatment</span><p id="par0080" class="elsevierStylePara elsevierViewall">Vasopressor and inotropic agents were administered to most patients in both groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Use of dopamine did not differ significantly between the groups&#44; but dobutamine was used more frequently in group A &#40;96&#46;0&#37; vs&#46; 57&#46;1&#37; in group B&#44; p&#61;0&#46;001&#41;&#46; Noradrenaline and levosimendan were used in group B only&#46; Around half the patients in both groups received glycoprotein IIb&#47;IIIa inhibitors&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Transthoracic echocardiography in the acute phase showed ejection fraction of less than 40&#37; in most patients&#44; with no significant difference between the groups &#40;83&#46;3&#37; of group A vs&#46; 78&#46;6&#37; of group B&#44; p&#61;0&#46;793&#41;&#46; Invasive techniques&#44; reperfusion methods in the first 12 hours and myocardial revascularization procedures are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; There was a statistically significant reduction between the first and second periods in the proportion of patients undergoing pulmonary artery catheterization &#40;52&#46;0&#37; vs&#46; 19&#46;0&#37;&#44; p&#61;0&#46;005&#41; and an increase in dialysis &#40;4&#46;0&#37; vs&#46; 28&#46;6&#37;&#44; p&#61;0&#46;014&#41;&#46; There were no significant differences in the proportion of patients reperfused within 12 hours of symptom onset or revascularized&#59; however&#44; PCI was used significantly more often in group B &#40;92&#46;9&#37; vs&#46; 75&#46;0&#37; in group A&#44; p&#61;0&#46;042&#41;&#44; the opposite being observed for surgical revascularization &#40;32&#46;0&#37; in group A vs&#46; 7&#46;1&#37; in group B&#44; p&#61;0&#46;008&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">All patients underwent coronary angiography&#44; which showed that the majority in both groups had multivessel disease &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Stenosis of the left anterior descending artery was more common in group A &#40;91&#46;7&#37; vs&#46; 64&#46;3&#37; in group B&#44; p&#61;0&#46;014&#41;&#46; PCI of the right coronary &#40;29&#46;3&#37; vs&#46; 4&#46;2&#37;&#44; p&#61;0&#46;015&#41;&#44; the circumflex artery &#40;53&#46;7&#37; vs&#46; 12&#46;5&#37;&#44; p&#61;0&#46;001&#41; and multiple vessels &#40;39&#46;0&#37; vs&#46; 8&#46;3&#37;&#44; p&#61;0&#46;008&#41;&#44; and stenting &#40;45&#46;8&#37; vs&#46; 88&#46;1&#37;&#41; were more frequent in group B&#46; The overall rate of complete revascularization was 54&#46;5&#37;&#44; but was significantly higher in group A &#40;70&#46;8 vs&#46; 45&#46;2&#44; p&#61;0&#46;045&#41;&#46; Drug-eluting stents and percutaneous intracoronary thrombus aspiration were employed in group B patients only&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Clinical events</span><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> shows in-hospital complications&#46; There were no significant differences between the two groups in the incidence of ischemic or arrhythmic complications&#44; major bleeding or mortality during initial hospital stay&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">All-cause mortality at 30-day and six-month follow-up did not differ significantly between the groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Independent predictors of six-month mortality</span><p id="par0105" class="elsevierStylePara elsevierViewall">In multivariate analysis&#44; diabetes was the only baseline characteristic that was an independent predictor of death at six months &#40;adjusted hazard ratio &#91;HR&#93; 3&#46;02&#59; 95&#37; confidence interval &#91;CI&#93; 1&#46;38-6&#46;60&#44; p&#61;0&#46;006&#41;&#46; Revascularized patients had lower six-month mortality &#40;adjusted HR 0&#46;11&#59; 95&#37; CI 0&#46;03-0&#46;42&#59; p&#61;0&#46;001&#41;&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">In this study of patients admitted for CS due to left ventricular pump failure following MI&#44; short- and medium-term mortality did not differ significantly over a 10-year time span&#44; despite earlier arrival at hospital and increased use of support measures and PCI in the more recent patient group&#46; This may be because myocardial revascularization&#44; the only intervention shown to reduce mortality in CS following MI&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> was used in a similar proportion of patients in both groups &#8211; 92&#46;0&#37; in group A and 95&#46;2&#37; in group B&#46; In our study&#44; myocardial revascularization was the only intervention that was independently associated with lower mortality at six months&#46; Among baseline characteristics&#44; diabetes was the only independent predictor of six-month mortality&#44; and its prevalence was similar in both groups&#46; The impact of diabetes on mortality in patients with CS has also been reported by other authors&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Despite the large percentage of patients revascularized&#44; mortality in both groups A and B was high &#8211; respectively 28&#46;0&#37; and 33&#46;3&#37; during initial hospitalization&#44; 32&#46;0&#37; and 35&#46;7&#37; at 30 days&#44; and 36&#46;0&#37; and 42&#46;9&#37; at six months &#8211; but similar to other contemporary series&#46; Among patients enrolled in the US National Registry of Myocardial Infarction during the period 1995-2004&#44; in-hospital mortality from CS also remained high&#44; despite a reduction over time &#40;60&#46;3&#37; in 1995 vs&#46; 47&#46;9&#37; in 2004&#44; p&#60;0&#46;001&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In the Melbourne Interventional Group registry&#44; 30-day mortality in CS patients undergoing coronary angioplasty between 2004 and 2007 was 36&#46;1&#37; in those aged under 75 and 43&#46;2&#37; in those aged 75 or over&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Greenberg et al&#46; reported six-month mortality of 52&#37; between 2001 and 2005&#44; and 59&#37; between 2006 and 2011&#44; in 170 CS patients undergoing PCI in an Israeli reference center&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">This persistently high mortality may be due to the pathophysiological mechanisms involved in the natural history of CS&#44; which are not altered by current treatments&#46; In CS there is a systemic inflammatory response with activation of complement&#44; release of cytokines and increased production of NO through overexpression of inducible NO synthase&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> At the same time&#44; despite the unquestionable benefit of myocardial revascularization in such patients&#44; paradoxically coronary reperfusion can contribute to perpetuating CS due to reperfusion injury&#46; Various mechanisms may be involved in such injury&#44; such as distal microembolization&#44; leukocyte infiltration&#44; generation of oxygen free radicals and activation of the complement system&#44; thus worsening microvascular damage&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">In our study&#44; the more recent patient group was treated by PCI and stenting more often than the group admitted between 1998 and 2001&#46; Drug-eluting stents and intracoronary thrombus aspiration were employed only in those treated between 2008 and 2011 since these techniques were not available during the earlier period&#46; Increased use of PCI resulted in a reduction in surgical revascularization&#44; even though the center has a cardiac surgery department&#46; These findings are similar to those reported in other studies of MI patients with CS&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;9&#44;10</span></a> Multivessel angioplasty was used significantly more frequently in patients treated between 2008 and 2011&#44; in accordance with current guidelines&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> with a significant increase in PCI of the right coronary and circumflex arteries&#46; Nevertheless&#44; the rate of complete revascularization was higher in the earlier period due to the higher rate of surgical revascularization in these patients&#46; It should be noted that there have been no randomized studies demonstrating the prognostic benefit of treating all angiographically significant lesions by PCI&#46; For example&#44; in the SHOCK trial&#44; survival of patients undergoing complete surgical revascularization was similar irrespective of the number of vessels treated&#44; while in those in whom only the culprit lesion were treated by PCI&#44; mortality increased in proportion to the number of vessels with angiographically significant lesions&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> which suggests that complete revascularization confers potential benefits&#46; However&#44; in the recently published EHS-PCI registry&#44; multivessel revascularization was not associated with lower mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Stead and Ebert first demonstrated in 1942 that the systemic manifestations of CS are due to left ventricular pump failure&#44; characterized clinically by marked reduction in cardiac output and tissue hypoxia&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Over 70 years after this initial description&#44; much remains to be clarified concerning the management of CS&#44; and its prognosis has remained largely unchanged throughout this period&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Given the complex pathophysiological mechanisms involved in CS&#44; many of the therapies developed and tested in these critically ill patients have shown no beneficial impact on prognosis&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Pulmonary artery catheterization by Swan-Ganz catheter&#44; traditionally used for hemodynamic assessment to guide therapy&#44; is not associated with lower mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a> Controversy surrounding the benefit of this procedure has resulted in a decrease in its use over time&#44; from 52&#37; to 19&#37; in our study population&#44; which is in agreement with other series&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Intra-aortic balloon pump counterpulsation was used in around 70&#37; of patients from both periods&#46; Although use of circulatory support in the context of left ventricular pump failure seems intuitive&#44; its benefit has not been demonstrated in randomized clinical trials&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Left ventricular assist devices have been shown to provide greater improvement in hemodynamic parameters than intra-aortic balloon pump counterpulsation&#44; but have no impact on mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In our study&#44; the need for renal support therapy increased between the two periods &#40;4&#46;0&#37; of patients in group A vs&#46; 28&#46;6&#37; in group B&#41;&#46; Apart from its role in treating water and salt retention&#44; continuous veno-venous hemofiltration helps to correct metabolic acidosis&#44; which has harmful negative inotropic and vasodilatory effects&#44; and also removes inflammatory cytokines&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Although NO has been shown to be involved in CS&#44; the promising results obtained in preliminary studies on inhibiting its release were not validated in subsequent randomized trials&#44; such as the TRIUMPH trial&#44; in which tilarginine&#44; a non-selective NO synthase inhibitor&#44; did not reduce mortality in CS patients&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Another intervention that could have prognostic impact in these patients is therapeutic hypothermia&#44; which limits the systemic inflammatory response following cardiopulmonary arrest&#44; by reducing the release of oxygen free radicals and pro-inflammatory cytokines in CS&#44; among other effects&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Prospective randomized studies will be required to confirm this hypothesis&#46; With regard to inotropic and vasopressor support&#44; which is essential for clinical and hemodynamic stabilization of patients with left ventricular pump failure&#44; drugs less frequently used in this context&#44; such as levosimendan&#44; may be safe and efficacious alternatives&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> Noradrenaline and levosimendan were used in the more recent patient group&#44; but in the inclusion period of the earlier group indications for use of the former were still the subject of debate and the latter was not available&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#8211;27</span></a> In addition&#44; there was a reduction in use of dobutamine&#44; in favor of amines with vasoconstrictive action&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Among the present study&#39;s limitations is the fact that it was performed in a tertiary center&#44; which may have led to selection bias&#46; More critical patients may have died before being transferred&#44; especially in the earlier patient group&#44; in whom the delay between symptom onset and admission was longer&#46; In the SHOCK trial&#44; patients transferred to tertiary hospitals presented lower mortality than those admitted directly to the specialist centers included in the trial&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Other limitations include the retrospective nature of the analysis&#44; the small number of patients included&#44; the fact that it was a single-center study&#44; and the difficulty in establishing with any precision the time of onset of shock and the hemodynamic parameters at diagnosis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">Cardiogenic shock due to left ventricular pump failure following MI is associated with high mortality&#44; despite widespread use of myocardial revascularization&#46; In the present study of patients with MI complicated by CS&#44; mortality remained unchanged over a 10-year time span&#44; despite an increased proportion of patients admitted within six hours of symptom onset&#44; and greater use of PCI and support therapies&#46; This finding probably reflects the fact that the pathophysiology of CS remains unclear&#44; and current therapeutic options are unable to control the mechanisms involved in its genesis and perpetuation&#46; It is thus essential to continue the search for new treatments that will improve the survival of patients with MI complicated by CS&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Ethical disclosures</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Protection of human and animal subjects</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association &#40;Declaration of Helsinki&#41;&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Confidentiality of data</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Right to privacy and informed consent</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec280626"
          "palabras" => array:4 [
            0 => "Cardiogenic shock"
            1 => "Left ventricular pump failure"
            2 => "Acute myocardial infarction"
            3 => "Myocardial revascularization"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec280625"
          "palabras" => array:4 [
            0 => "Choque cardiog&#233;nico"
            1 => "Fal&#234;ncia ventricular esquerda"
            2 => "Enfarte agudo do mioc&#225;rdio"
            3 => "Revasculariza&#231;&#227;o mioc&#225;rdica"
          ]
        ]
      ]
    ]
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    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Despite improvements in treatment&#44; mortality associated with cardiogenic shock &#40;CS&#41; following acute myocardial infarction remains high&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Aim</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To compare two groups of patients admitted with CS over a 10-year time span&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective analysis of two patient populations presenting with CS admitted in the periods May 1998-May 2001 &#40;group A&#41; and May 2008-May 2011 &#40;group B&#41;&#46; Clinical characteristics&#44; diagnostic methods&#44; treatment and outcomes were compared&#44; and independent predictors of death at six months were analyzed&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The incidence of CS was 3&#46;7&#37; in group A &#40;n&#61;25&#41; and 4&#46;8&#37; in group B &#40;n&#61;42&#41;&#46; There were no significant differences in clinical characteristics except for age &#40;60&#46;2&#177;12&#46;3 vs&#46; 66&#46;5&#177;11&#46;3 years&#59; p&#61;0&#46;043&#41; and the proportion of patients admitted within six hours of symptom onset &#40;29&#46;2&#37; vs&#46; 54&#46;8&#37;&#44; p&#61;0&#46;045&#41;&#46; There was a reduction in use of pulmonary artery catheterization &#40;52&#46;0&#37; vs&#46; 19&#46;0&#37;&#44; p&#61;0&#46;005&#41; but an increase in dialysis &#40;4&#46;0&#37; vs&#46; 28&#46;6&#37;&#44; p&#61;0&#46;014&#41;&#46; There was no difference in the proportion of patients reperfused within 12 hours or revascularized&#44; but use of percutaneous coronary intervention &#40;PCI&#41; increased &#40;75&#46;0&#37; vs&#46; 92&#46;9&#37;&#44; p&#61;0&#46;042&#41;&#46; There were no differences in outcomes&#44; including mortality at 30 days &#40;32&#46;0 vs&#46; 35&#46;7&#37;&#59; p&#61;0&#46;757&#41; and six months &#40;36&#46;0 vs&#46; 42&#46;9&#37;&#59; p&#61;0&#46;683&#41;&#46; Diabetes was the sole baseline characteristic identified as an independent predictor of death at six months &#40;hazard ratio &#91;HR&#93; 3&#46;02&#59; 95&#37; confidence interval &#91;CI&#93; 1&#46;38-6&#46;60&#59; p&#61;0&#46;006&#41; and mortality was lower among revascularized patients &#40;HR 0&#46;11&#59; 95&#37; CI 0&#46;03-0&#46;42&#59; p&#61;0&#46;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Over a 10-year time span&#44; despite earlier hospital admission and increased use of support therapies and PCI&#44; short- and medium-term mortality remained unchanged&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introdu&#231;&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Apesar dos avan&#231;os terap&#234;uticos&#44; a letalidade do choque cardiog&#233;nico &#40;<span class="elsevierStyleSmallCaps">CC</span>&#41; associado ao enfarte agudo do mioc&#225;rdio &#40;EAM&#41; permanece elevada&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Comparar 2 grupos de doentes com CC associado ao EAM&#44; admitidos com um intervalo de 10 anos&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise retrospetiva de 2 popula&#231;&#245;es de doentes com CC associado ao EAM admitidos entre maio&#47;1998-maio&#47;2001 &#40;Grupo A&#41; e maio&#47;2008-maio&#47;2011 &#40;Grupo B&#41;&#46; Compararam-se as caracter&#237;sticas cl&#237;nicas&#44; diagn&#243;stico&#44; tratamento e complica&#231;&#245;es e analisaram-se os preditores de morte aos 6 meses&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A incid&#234;ncia de CC foi 3&#44;7&#37; no Grupo A &#40;n &#61; 25&#41; e 4&#44;8&#37; no Grupo B &#40;n &#61; 42&#41;&#46; N&#227;o existiram diferen&#231;as significativas nas caracter&#237;sticas demogr&#225;ficas e cl&#237;nicas&#44; exceto na idade &#40;60&#44;2 &#177; 12&#44;3 <span class="elsevierStyleItalic">versus</span> 66&#44;5 &#177; 11&#44;3 anos&#59; p &#61; 0&#44;043&#41; e doentes admitidos com &#60; 6 h de sintomas &#40;29&#44;2 <span class="elsevierStyleItalic">versus</span> 54&#44;8&#37;&#44; p &#61; 0&#44;045&#41;&#46; O cateterismo da art&#233;ria pulmonar diminuiu &#40;52&#44;0 <span class="elsevierStyleItalic">versus</span> 19&#44;0&#37;&#44; p &#61; 0&#44;005&#41; e as t&#233;cnicas dial&#237;ticas aumentaram &#40;4&#44;0 <span class="elsevierStyleItalic">versus</span> 28&#44;6&#37;&#44; p &#61; 0&#44;014&#41;&#46; A propor&#231;&#227;o de doentes reperfundidos nas primeiras 12 h ou revascularizados foi semelhante&#44; mas a interven&#231;&#227;o coron&#225;ria percut&#226;nea &#40;ICP&#41; aumentou &#40;75&#44;0 <span class="elsevierStyleItalic">versus</span> 92&#44;9&#37;&#44; p &#61; 0&#44;042&#41;&#46; As complica&#231;&#245;es intra-hospitalares&#44; mortalidade aos 30 d &#40;32&#44;0 <span class="elsevierStyleItalic">versus</span> 35&#44;7&#37;&#59; p &#61; 0&#44;757&#41; e 6 meses &#40;36&#44;0 <span class="elsevierStyleItalic">versus</span> 42&#44;9&#37;&#59; p &#61; 0&#44;683&#41; n&#227;o diferiram&#46; A diabetes foi a &#250;nica caracter&#237;stica basal preditora independente de morte aos 6 meses &#40;HR 3&#44;02&#59; IC 95&#37; 1&#44;38-6&#44;60&#59; p &#61; 0&#44;006&#41; e os doentes revascularizados apresentaram menor mortalidade &#40;HR 0&#44;11&#59; IC95&#37; 0&#44;03-0&#44;42&#59; p &#61; 0&#44;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclus&#227;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Nos &#250;ltimos 10 anos&#44; apesar da chegada mais precoce dos doentes ao hospital&#44; da maior utiliza&#231;&#227;o de algumas medidas de suporte e acesso &#224; ICP&#44; a mortalidade a curto e m&#233;dio prazo n&#227;o se alterou&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Dores H&#44; Ferreira J&#44; Costa F&#44; et al&#46; Choque cardiog&#233;nico no enfarte agudo do mioc&#225;rdio&#58; o que mudou nos &#250;ltimos 10 anos&#63; Rev Port Cardiol&#46; 2013&#59;32&#58;673&#8211;680&#46;</p>"
      ]
    ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kaplan-Meier analysis of all-cause mortality at six months&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BP&#58; blood pressure&#59; MI myocardial infarction&#59; PCI&#58; percutaneous coronary intervention&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">69&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;929&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">56&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">54&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;921&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">31&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;929&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">50&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;874&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Smoking</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;824&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">32&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">16&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">19&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Surgical revascularization</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;706&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Time since symptom onset &#40;min&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">483&#177;345&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">418&#177;357&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">89&#177;18&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">83&#177;29&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;428&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">ST-elevation MI</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;492&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anterior MI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">47&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inferior&#47;lateral MI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27&#46;3&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">47&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unfractionated heparin&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">88&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;276&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glycoprotein IIb&#47;IIIa inhibitors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;976&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Intravenous drug therapy in the acute phase&#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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Invasive techniques</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PA catheterization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IABP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;798&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;634&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dialysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Reperfusion &#60;12 h from symptom onset&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fibrinolysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Primary angioplasty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;069&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Revascularization</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;588&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Surgical revascularization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Complete<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            ]
          ]
        ]
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        "identificador" => "tbl0020"
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        "tipo" => "MULTIMEDIATABLA"
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              "tabla" => array:1 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left main&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;134&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anterior descending&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Circumflex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;112&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right coronary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;539&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronary graft&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;706&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multivessel&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;672&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Angioplasty</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left main&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;607&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anterior descending&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;543&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Circumflex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right coronary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multivessel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stenting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Drug-eluting stent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Thrombectomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab433152.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Angiographic features and coronary angioplasty&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">AVB&#58; atrioventricular block&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Reinfarction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;706&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stroke&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>30 days&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">35&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;757&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;683&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Implications of the timing of onset of cardiogenic shock after acute myocardial infarction&#58; a report from the SHOCK Trial Registry&#46; SHould we emergently revascularize Occluded Coronaries for cardiogenic shock&#63;"
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                        0 => array:2 [
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                        "tituloSerie" => "J Am Coll Cardiol"
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                        "volumen" => "36"
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                        "paginaFinal" => "1090"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10985709"
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                      "titulo" => "Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Babaev"
                            1 => "P&#46;D&#46; Frederick"
                            2 => "D&#46;J&#46; Pasta"
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                      "doi" => "10.1001/jama.294.4.448"
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                        "tituloSerie" => "JAMA"
                        "fecha" => "2005"
                        "volumen" => "294"
                        "paginaInicial" => "448"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16046651"
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                      "titulo" => "Cardiogenic shock complicating acute myocardial infarction-etiologies&#44; management and outcome&#58; a report from the SHOCK Trial Registry&#46; SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK&#63;"
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                  ]
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                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Crit Care Emerg Med"
                        "fecha" => "2010"
                        "volumen" => "2"
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                      "titulo" => "Early revascularization in acute myocardial infarction complicated by cardiogenic shock&#46; SHOCK Investigators&#46; Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock"
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                        "tituloSerie" => "N Engl J Med"
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                            0 => "J&#46;S&#46; Hochman"
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                        "volumen" => "295"
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                      "titulo" => "Guidelines on myocardial revascularization"
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                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehq277"
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                        "fecha" => "2010"
                        "volumen" => "31"
                        "paginaInicial" => "2501"
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                          "autores" => array:3 [
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Original Article
Acute myocardial infarction complicated by cardiogenic shock: What changed over a 10-year time span
Choque cardiogénico no enfarte agudo do miocárdio: o que mudou nos últimos 10 anos?
Hélder Doresa,
Corresponding author
heldores@hotmail.com

Corresponding author.
, Jorge Ferreiraa, Francisco Costaa, Carlos Aguiara, Gonçalo Cardosoa, Rui Telesa, Pedro de Araújo Gonçalvesa, Luís Raposoa, Marisa Trabuloa, Manuel de Sousa Almeidaa, José Pedro Nevesb, Miguel Mendesa
a Serviço de Cardiologia, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
b Serviço de Cirurgia Cardiotorácica, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
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in the context of CS has progressively increased in recent years&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Unlike MI patients who are not hemodynamically unstable&#44; in whom only the culprit lesion should be treated&#44; complete revascularization of all critical coronary lesions is a class I recommendation&#44; level of evidence B&#44; for patients with CS in the European Society of Cardiology guidelines on myocardial revascularization&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> which reflects the fact that two or more coronary territories are frequently involved in the genesis of CS due to pump failure&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Besides revascularization&#44; other diagnostic and therapeutic measures are also crucial to management of CS&#44; particularly vasopressor and inotropic agents&#44; 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which makes it imperative to develop strategies to stabilize these patients&#44; especially in the first hours following the event&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The aim of this study was to analyze changes in the clinical characteristics&#44; treatment and mortality of patients with MI complicated by CS due to left ventricular pump failure over a 10-year time span&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Population</span><p id="par0035" class="elsevierStylePara elsevierViewall">We performed a retrospective analysis of two patient populations admitted to the cardiac intensive care unit &#40;CICU&#41; with a diagnosis of CS following MI&#44; in the periods May 1998-May 2001 &#40;group A&#41; and May 2008-May 2011 &#40;group B&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Patients who developed CS during hospitalization were excluded from the analysis&#44; as were those with CS due to mechanical complications or right ventricular failure following MI as assessed by transthoracic echocardiography&#46; Patients were selected on the basis of data recorded prospectively using Cardiobase<span class="elsevierStyleSup">&#174;</span> software &#40;Infortucano&#44; Lisbon&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The diagnosis of CS at hospital admission was based on the following clinical criteria&#58; persistent hypotension &#40;systolic blood pressure &#91;SBP&#93; &#60;90 mmHg&#41; following intravenous rehydration therapy or need for vasopressor support to maintain SBP &#8805;90 mmHg&#44; together with signs of peripheral hypoperfusion &#40;oliguria or anuria or cold clammy extremities&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> For both periods under consideration&#44; management included immediate coronary angiography with a view to revascularization&#46; In most patients&#44; insertion of an intra-aortic balloon pump and orotracheal intubation for mechanical ventilation were carried out in the hemodynamic laboratory and pulmonary artery catheterization was performed in the CICU following coronary angiography&#46; These techniques were used at the operator&#39;s discretion&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Clinical events</span><p id="par0050" class="elsevierStylePara elsevierViewall">The following in-hospital events were analyzed&#58; ischemia &#40;reinfarction and stroke&#41;&#44; arrhythmias &#40;atrial fibrillation&#44; ventricular fibrillation and complete atrioventricular block&#41;&#44; major bleeding &#40;TIMI criteria&#41;&#44; and mortality&#46; Reinfarction was defined as re-elevation of troponin I above the decision limit&#44; together with de novo symptoms or electrocardiographic findings suggestive of myocardial ischemia&#46; Stroke was defined as focal neurological signs persisting longer than 24 hours with evidence of infarction on brain imaging &#40;ischemic&#41; or without &#40;undetermined etiology&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The clinical events assessed during follow-up were all-cause mortality at 30 days and six months&#46; No patient was lost to follow-up&#46; Clinical data were obtained by consultation of patients&#8217; medical records and databases or by telephone contact with the patient or relatives&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Categorical variables were expressed as percentages and frequencies and compared by the chi-square test&#46; Continuous variables were expressed as means &#177; standard deviation and compared using the Student&#39;s t test when appropriate &#40;as assessed by the Shapiro-Wilks test&#41;&#46; In-hospital events and mortality during follow-up were assessed by Kaplan-Meier analysis&#44; statistical differences between the two groups being determined by the log rank test&#46; Multivariate analysis using Cox proportional hazard models was performed to identify independent predictors of mortality at six months&#46; The first model included baseline characteristics &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; associated with the study&#39;s clinical event that showed p&#60;0&#46;10 on univariate analysis&#46; Variables related to drug therapy in the acute phase &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; and to invasive techniques and myocardial revascularization &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; were added in subsequent models&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Results with p&#60;0&#46;05 were considered statistically significant&#46; The data were analyzed using Statistical Package for the Social Sciences<span class="elsevierStyleSup">&#174;</span> for Windows&#44; version 19&#46;0 &#40;SPSS&#44; Inc&#46;&#44; Chicago&#44; Illinois&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Characteristics of the study population</span><p id="par0070" class="elsevierStylePara elsevierViewall">The incidence of CS was 3&#46;7&#37; &#40;25&#47;683&#41; and 4&#46;8&#37; &#40;42&#47;875&#41; in the first and second periods&#44; respectively &#40;p&#61;0&#46;330&#41;&#46; Group B were significantly older &#40;66&#46;5&#177;11&#46;3 vs&#46; 60&#46;2&#177;12&#46;3 years in group A&#44; p&#61;0&#46;043&#41;&#46; The proportion of patients admitted within six hours of symptom onset was also significantly higher in group B &#40;54&#46;8&#37; vs&#46; 29&#46;2&#37; in group A&#44; p&#61;0&#46;045&#41;&#46; Other demographic and baseline clinical characteristics did not differ significantly between the two groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">With regard to clinical presentation&#44; most patients in both groups were admitted for ST-elevation MI&#44; mainly of the anterior wall&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Diagnosis and treatment</span><p id="par0080" class="elsevierStylePara elsevierViewall">Vasopressor and inotropic agents were administered to most patients in both groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Use of dopamine did not differ significantly between the groups&#44; but dobutamine was used more frequently in group A &#40;96&#46;0&#37; vs&#46; 57&#46;1&#37; in group B&#44; p&#61;0&#46;001&#41;&#46; Noradrenaline and levosimendan were used in group B only&#46; Around half the patients in both groups received glycoprotein IIb&#47;IIIa inhibitors&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Transthoracic echocardiography in the acute phase showed ejection fraction of less than 40&#37; in most patients&#44; with no significant difference between the groups &#40;83&#46;3&#37; of group A vs&#46; 78&#46;6&#37; of group B&#44; p&#61;0&#46;793&#41;&#46; Invasive techniques&#44; reperfusion methods in the first 12 hours and myocardial revascularization procedures are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; There was a statistically significant reduction between the first and second periods in the proportion of patients undergoing pulmonary artery catheterization &#40;52&#46;0&#37; vs&#46; 19&#46;0&#37;&#44; p&#61;0&#46;005&#41; and an increase in dialysis &#40;4&#46;0&#37; vs&#46; 28&#46;6&#37;&#44; p&#61;0&#46;014&#41;&#46; There were no significant differences in the proportion of patients reperfused within 12 hours of symptom onset or revascularized&#59; however&#44; PCI was used significantly more often in group B &#40;92&#46;9&#37; vs&#46; 75&#46;0&#37; in group A&#44; p&#61;0&#46;042&#41;&#44; the opposite being observed for surgical revascularization &#40;32&#46;0&#37; in group A vs&#46; 7&#46;1&#37; in group B&#44; p&#61;0&#46;008&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">All patients underwent coronary angiography&#44; which showed that the majority in both groups had multivessel disease &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Stenosis of the left anterior descending artery was more common in group A &#40;91&#46;7&#37; vs&#46; 64&#46;3&#37; in group B&#44; p&#61;0&#46;014&#41;&#46; PCI of the right coronary &#40;29&#46;3&#37; vs&#46; 4&#46;2&#37;&#44; p&#61;0&#46;015&#41;&#44; the circumflex artery &#40;53&#46;7&#37; vs&#46; 12&#46;5&#37;&#44; p&#61;0&#46;001&#41; and multiple vessels &#40;39&#46;0&#37; vs&#46; 8&#46;3&#37;&#44; p&#61;0&#46;008&#41;&#44; and stenting &#40;45&#46;8&#37; vs&#46; 88&#46;1&#37;&#41; were more frequent in group B&#46; The overall rate of complete revascularization was 54&#46;5&#37;&#44; but was significantly higher in group A &#40;70&#46;8 vs&#46; 45&#46;2&#44; p&#61;0&#46;045&#41;&#46; Drug-eluting stents and percutaneous intracoronary thrombus aspiration were employed in group B patients only&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Clinical events</span><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> shows in-hospital complications&#46; There were no significant differences between the two groups in the incidence of ischemic or arrhythmic complications&#44; major bleeding or mortality during initial hospital stay&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">All-cause mortality at 30-day and six-month follow-up did not differ significantly between the groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Independent predictors of six-month mortality</span><p id="par0105" class="elsevierStylePara elsevierViewall">In multivariate analysis&#44; diabetes was the only baseline characteristic that was an independent predictor of death at six months &#40;adjusted hazard ratio &#91;HR&#93; 3&#46;02&#59; 95&#37; confidence interval &#91;CI&#93; 1&#46;38-6&#46;60&#44; p&#61;0&#46;006&#41;&#46; Revascularized patients had lower six-month mortality &#40;adjusted HR 0&#46;11&#59; 95&#37; CI 0&#46;03-0&#46;42&#59; p&#61;0&#46;001&#41;&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">In this study of patients admitted for CS due to left ventricular pump failure following MI&#44; short- and medium-term mortality did not differ significantly over a 10-year time span&#44; despite earlier arrival at hospital and increased use of support measures and PCI in the more recent patient group&#46; This may be because myocardial revascularization&#44; the only intervention shown to reduce mortality in CS following MI&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> was used in a similar proportion of patients in both groups &#8211; 92&#46;0&#37; in group A and 95&#46;2&#37; in group B&#46; In our study&#44; myocardial revascularization was the only intervention that was independently associated with lower mortality at six months&#46; Among baseline characteristics&#44; diabetes was the only independent predictor of six-month mortality&#44; and its prevalence was similar in both groups&#46; The impact of diabetes on mortality in patients with CS has also been reported by other authors&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Despite the large percentage of patients revascularized&#44; mortality in both groups A and B was high &#8211; respectively 28&#46;0&#37; and 33&#46;3&#37; during initial hospitalization&#44; 32&#46;0&#37; and 35&#46;7&#37; at 30 days&#44; and 36&#46;0&#37; and 42&#46;9&#37; at six months &#8211; but similar to other contemporary series&#46; Among patients enrolled in the US National Registry of Myocardial Infarction during the period 1995-2004&#44; in-hospital mortality from CS also remained high&#44; despite a reduction over time &#40;60&#46;3&#37; in 1995 vs&#46; 47&#46;9&#37; in 2004&#44; p&#60;0&#46;001&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In the Melbourne Interventional Group registry&#44; 30-day mortality in CS patients undergoing coronary angioplasty between 2004 and 2007 was 36&#46;1&#37; in those aged under 75 and 43&#46;2&#37; in those aged 75 or over&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Greenberg et al&#46; reported six-month mortality of 52&#37; between 2001 and 2005&#44; and 59&#37; between 2006 and 2011&#44; in 170 CS patients undergoing PCI in an Israeli reference center&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">This persistently high mortality may be due to the pathophysiological mechanisms involved in the natural history of CS&#44; which are not altered by current treatments&#46; In CS there is a systemic inflammatory response with activation of complement&#44; release of cytokines and increased production of NO through overexpression of inducible NO synthase&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> At the same time&#44; despite the unquestionable benefit of myocardial revascularization in such patients&#44; paradoxically coronary reperfusion can contribute to perpetuating CS due to reperfusion injury&#46; Various mechanisms may be involved in such injury&#44; such as distal microembolization&#44; leukocyte infiltration&#44; generation of oxygen free radicals and activation of the complement system&#44; thus worsening microvascular damage&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">In our study&#44; the more recent patient group was treated by PCI and stenting more often than the group admitted between 1998 and 2001&#46; Drug-eluting stents and intracoronary thrombus aspiration were employed only in those treated between 2008 and 2011 since these techniques were not available during the earlier period&#46; Increased use of PCI resulted in a reduction in surgical revascularization&#44; even though the center has a cardiac surgery department&#46; These findings are similar to those reported in other studies of MI patients with CS&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;9&#44;10</span></a> Multivessel angioplasty was used significantly more frequently in patients treated between 2008 and 2011&#44; in accordance with current guidelines&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> with a significant increase in PCI of the right coronary and circumflex arteries&#46; Nevertheless&#44; the rate of complete revascularization was higher in the earlier period due to the higher rate of surgical revascularization in these patients&#46; It should be noted that there have been no randomized studies demonstrating the prognostic benefit of treating all angiographically significant lesions by PCI&#46; For example&#44; in the SHOCK trial&#44; survival of patients undergoing complete surgical revascularization was similar irrespective of the number of vessels treated&#44; while in those in whom only the culprit lesion were treated by PCI&#44; mortality increased in proportion to the number of vessels with angiographically significant lesions&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> which suggests that complete revascularization confers potential benefits&#46; However&#44; in the recently published EHS-PCI registry&#44; multivessel revascularization was not associated with lower mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Stead and Ebert first demonstrated in 1942 that the systemic manifestations of CS are due to left ventricular pump failure&#44; characterized clinically by marked reduction in cardiac output and tissue hypoxia&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Over 70 years after this initial description&#44; much remains to be clarified concerning the management of CS&#44; and its prognosis has remained largely unchanged throughout this period&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Given the complex pathophysiological mechanisms involved in CS&#44; many of the therapies developed and tested in these critically ill patients have shown no beneficial impact on prognosis&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Pulmonary artery catheterization by Swan-Ganz catheter&#44; traditionally used for hemodynamic assessment to guide therapy&#44; is not associated with lower mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a> Controversy surrounding the benefit of this procedure has resulted in a decrease in its use over time&#44; from 52&#37; to 19&#37; in our study population&#44; which is in agreement with other series&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Intra-aortic balloon pump counterpulsation was used in around 70&#37; of patients from both periods&#46; Although use of circulatory support in the context of left ventricular pump failure seems intuitive&#44; its benefit has not been demonstrated in randomized clinical trials&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Left ventricular assist devices have been shown to provide greater improvement in hemodynamic parameters than intra-aortic balloon pump counterpulsation&#44; but have no impact on mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In our study&#44; the need for renal support therapy increased between the two periods &#40;4&#46;0&#37; of patients in group A vs&#46; 28&#46;6&#37; in group B&#41;&#46; Apart from its role in treating water and salt retention&#44; continuous veno-venous hemofiltration helps to correct metabolic acidosis&#44; which has harmful negative inotropic and vasodilatory effects&#44; and also removes inflammatory cytokines&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Although NO has been shown to be involved in CS&#44; the promising results obtained in preliminary studies on inhibiting its release were not validated in subsequent randomized trials&#44; such as the TRIUMPH trial&#44; in which tilarginine&#44; a non-selective NO synthase inhibitor&#44; did not reduce mortality in CS patients&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Another intervention that could have prognostic impact in these patients is therapeutic hypothermia&#44; which limits the systemic inflammatory response following cardiopulmonary arrest&#44; by reducing the release of oxygen free radicals and pro-inflammatory cytokines in CS&#44; among other effects&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Prospective randomized studies will be required to confirm this hypothesis&#46; With regard to inotropic and vasopressor support&#44; which is essential for clinical and hemodynamic stabilization of patients with left ventricular pump failure&#44; drugs less frequently used in this context&#44; such as levosimendan&#44; may be safe and efficacious alternatives&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> Noradrenaline and levosimendan were used in the more recent patient group&#44; but in the inclusion period of the earlier group indications for use of the former were still the subject of debate and the latter was not available&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#8211;27</span></a> In addition&#44; there was a reduction in use of dobutamine&#44; in favor of amines with vasoconstrictive action&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Among the present study&#39;s limitations is the fact that it was performed in a tertiary center&#44; which may have led to selection bias&#46; More critical patients may have died before being transferred&#44; especially in the earlier patient group&#44; in whom the delay between symptom onset and admission was longer&#46; In the SHOCK trial&#44; patients transferred to tertiary hospitals presented lower mortality than those admitted directly to the specialist centers included in the trial&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Other limitations include the retrospective nature of the analysis&#44; the small number of patients included&#44; the fact that it was a single-center study&#44; and the difficulty in establishing with any precision the time of onset of shock and the hemodynamic parameters at diagnosis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">Cardiogenic shock due to left ventricular pump failure following MI is associated with high mortality&#44; despite widespread use of myocardial revascularization&#46; In the present study of patients with MI complicated by CS&#44; mortality remained unchanged over a 10-year time span&#44; despite an increased proportion of patients admitted within six hours of symptom onset&#44; and greater use of PCI and support therapies&#46; This finding probably reflects the fact that the pathophysiology of CS remains unclear&#44; and current therapeutic options are unable to control the mechanisms involved in its genesis and perpetuation&#46; It is thus essential to continue the search for new treatments that will improve the survival of patients with MI complicated by CS&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Ethical disclosures</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Protection of human and animal subjects</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association &#40;Declaration of Helsinki&#41;&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Confidentiality of data</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Right to privacy and informed consent</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Despite improvements in treatment&#44; mortality associated with cardiogenic shock &#40;CS&#41; following acute myocardial infarction remains high&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Aim</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To compare two groups of patients admitted with CS over a 10-year time span&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective analysis of two patient populations presenting with CS admitted in the periods May 1998-May 2001 &#40;group A&#41; and May 2008-May 2011 &#40;group B&#41;&#46; Clinical characteristics&#44; diagnostic methods&#44; treatment and outcomes were compared&#44; and independent predictors of death at six months were analyzed&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The incidence of CS was 3&#46;7&#37; in group A &#40;n&#61;25&#41; and 4&#46;8&#37; in group B &#40;n&#61;42&#41;&#46; There were no significant differences in clinical characteristics except for age &#40;60&#46;2&#177;12&#46;3 vs&#46; 66&#46;5&#177;11&#46;3 years&#59; p&#61;0&#46;043&#41; and the proportion of patients admitted within six hours of symptom onset &#40;29&#46;2&#37; vs&#46; 54&#46;8&#37;&#44; p&#61;0&#46;045&#41;&#46; There was a reduction in use of pulmonary artery catheterization &#40;52&#46;0&#37; vs&#46; 19&#46;0&#37;&#44; p&#61;0&#46;005&#41; but an increase in dialysis &#40;4&#46;0&#37; vs&#46; 28&#46;6&#37;&#44; p&#61;0&#46;014&#41;&#46; There was no difference in the proportion of patients reperfused within 12 hours or revascularized&#44; but use of percutaneous coronary intervention &#40;PCI&#41; increased &#40;75&#46;0&#37; vs&#46; 92&#46;9&#37;&#44; p&#61;0&#46;042&#41;&#46; There were no differences in outcomes&#44; including mortality at 30 days &#40;32&#46;0 vs&#46; 35&#46;7&#37;&#59; p&#61;0&#46;757&#41; and six months &#40;36&#46;0 vs&#46; 42&#46;9&#37;&#59; p&#61;0&#46;683&#41;&#46; Diabetes was the sole baseline characteristic identified as an independent predictor of death at six months &#40;hazard ratio &#91;HR&#93; 3&#46;02&#59; 95&#37; confidence interval &#91;CI&#93; 1&#46;38-6&#46;60&#59; p&#61;0&#46;006&#41; and mortality was lower among revascularized patients &#40;HR 0&#46;11&#59; 95&#37; CI 0&#46;03-0&#46;42&#59; p&#61;0&#46;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Over a 10-year time span&#44; despite earlier hospital admission and increased use of support therapies and PCI&#44; short- and medium-term mortality remained unchanged&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introdu&#231;&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Apesar dos avan&#231;os terap&#234;uticos&#44; a letalidade do choque cardiog&#233;nico &#40;<span class="elsevierStyleSmallCaps">CC</span>&#41; associado ao enfarte agudo do mioc&#225;rdio &#40;EAM&#41; permanece elevada&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Comparar 2 grupos de doentes com CC associado ao EAM&#44; admitidos com um intervalo de 10 anos&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise retrospetiva de 2 popula&#231;&#245;es de doentes com CC associado ao EAM admitidos entre maio&#47;1998-maio&#47;2001 &#40;Grupo A&#41; e maio&#47;2008-maio&#47;2011 &#40;Grupo B&#41;&#46; Compararam-se as caracter&#237;sticas cl&#237;nicas&#44; diagn&#243;stico&#44; tratamento e complica&#231;&#245;es e analisaram-se os preditores de morte aos 6 meses&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A incid&#234;ncia de CC foi 3&#44;7&#37; no Grupo A &#40;n &#61; 25&#41; e 4&#44;8&#37; no Grupo B &#40;n &#61; 42&#41;&#46; N&#227;o existiram diferen&#231;as significativas nas caracter&#237;sticas demogr&#225;ficas e cl&#237;nicas&#44; exceto na idade &#40;60&#44;2 &#177; 12&#44;3 <span class="elsevierStyleItalic">versus</span> 66&#44;5 &#177; 11&#44;3 anos&#59; p &#61; 0&#44;043&#41; e doentes admitidos com &#60; 6 h de sintomas &#40;29&#44;2 <span class="elsevierStyleItalic">versus</span> 54&#44;8&#37;&#44; p &#61; 0&#44;045&#41;&#46; O cateterismo da art&#233;ria pulmonar diminuiu &#40;52&#44;0 <span class="elsevierStyleItalic">versus</span> 19&#44;0&#37;&#44; p &#61; 0&#44;005&#41; e as t&#233;cnicas dial&#237;ticas aumentaram &#40;4&#44;0 <span class="elsevierStyleItalic">versus</span> 28&#44;6&#37;&#44; p &#61; 0&#44;014&#41;&#46; A propor&#231;&#227;o de doentes reperfundidos nas primeiras 12 h ou revascularizados foi semelhante&#44; mas a interven&#231;&#227;o coron&#225;ria percut&#226;nea &#40;ICP&#41; aumentou &#40;75&#44;0 <span class="elsevierStyleItalic">versus</span> 92&#44;9&#37;&#44; p &#61; 0&#44;042&#41;&#46; As complica&#231;&#245;es intra-hospitalares&#44; mortalidade aos 30 d &#40;32&#44;0 <span class="elsevierStyleItalic">versus</span> 35&#44;7&#37;&#59; p &#61; 0&#44;757&#41; e 6 meses &#40;36&#44;0 <span class="elsevierStyleItalic">versus</span> 42&#44;9&#37;&#59; p &#61; 0&#44;683&#41; n&#227;o diferiram&#46; A diabetes foi a &#250;nica caracter&#237;stica basal preditora independente de morte aos 6 meses &#40;HR 3&#44;02&#59; IC 95&#37; 1&#44;38-6&#44;60&#59; p &#61; 0&#44;006&#41; e os doentes revascularizados apresentaram menor mortalidade &#40;HR 0&#44;11&#59; IC95&#37; 0&#44;03-0&#44;42&#59; p &#61; 0&#44;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclus&#227;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Nos &#250;ltimos 10 anos&#44; apesar da chegada mais precoce dos doentes ao hospital&#44; da maior utiliza&#231;&#227;o de algumas medidas de suporte e acesso &#224; ICP&#44; a mortalidade a curto e m&#233;dio prazo n&#227;o se alterou&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Dores H&#44; Ferreira J&#44; Costa F&#44; et al&#46; Choque cardiog&#233;nico no enfarte agudo do mioc&#225;rdio&#58; o que mudou nos &#250;ltimos 10 anos&#63; Rev Port Cardiol&#46; 2013&#59;32&#58;673&#8211;680&#46;</p>"
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kaplan-Meier analysis of all-cause mortality at six months&#46;</p>"
        ]
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      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BP&#58; blood pressure&#59; MI myocardial infarction&#59; PCI&#58; percutaneous coronary intervention&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
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                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Group A&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Group B&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">69&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;929&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Cardiovascular risk factors</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">54&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;921&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">31&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;929&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dyslipidemia</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">50&#46;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;874&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Smoking</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">33&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;824&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Myocardial infarction</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">32&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">16&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">PCI</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">20&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Surgical revascularization</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;706&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Stroke</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;833&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Time since symptom onset &#40;min&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">483&#177;345&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">418&#177;357&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">80&#177;10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&#177;13&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Heart rate &#40;bpm&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">89&#177;18&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#177;29&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;428&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">ST-elevation MI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">81&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;492&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anterior MI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">47&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;120&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inferior&#47;lateral MI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">29&#46;2&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dobutamine&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">57&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Noradrenaline&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">47&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Levosimendan&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">12&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Other</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unfractionated heparin&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">95&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;276&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glycoprotein IIb&#47;IIIa inhibitors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;976&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Intravenous drug therapy in the acute phase&#46;</p>"
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            0 => array:2 [
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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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Invasive techniques</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PA catheterization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IABP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;798&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;634&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dialysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Reperfusion &#60;12 h from symptom onset&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fibrinolysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Primary angioplasty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;069&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Revascularization</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;588&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Surgical revascularization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Complete<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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            ]
          ]
        ]
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        "identificador" => "tbl0020"
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        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:1 [
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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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left main&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;134&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anterior descending&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Circumflex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;112&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right coronary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;539&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronary graft&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;706&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multivessel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;672&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Angioplasty</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left main&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;607&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anterior descending&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;543&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Circumflex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right coronary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multivessel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stenting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Drug-eluting stent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Thrombectomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab433152.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Angiographic features and coronary angioplasty&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">AVB&#58; atrioventricular block&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variables &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">In-hospital complications</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Reinfarction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;706&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stroke&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;172&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Atrial fibrillation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                      "titulo" => "Implications of the timing of onset of cardiogenic shock after acute myocardial infarction&#58; a report from the SHOCK Trial Registry&#46; SHould we emergently revascularize Occluded Coronaries for cardiogenic shock&#63;"
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                        0 => array:2 [
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                        "tituloSerie" => "J Am Coll Cardiol"
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                      "titulo" => "Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock"
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                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Babaev"
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                            2 => "D&#46;J&#46; Pasta"
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                      "doi" => "10.1001/jama.294.4.448"
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                        "volumen" => "294"
                        "paginaInicial" => "448"
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                      "titulo" => "Cardiogenic shock complicating acute myocardial infarction-etiologies&#44; management and outcome&#58; a report from the SHOCK Trial Registry&#46; SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK&#63;"
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                  ]
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                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Crit Care Emerg Med"
                        "fecha" => "2010"
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                        0 => array:2 [
                          "etal" => true
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                            0 => "J&#46;S&#46; Hochman"
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                        "volumen" => "295"
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                      "titulo" => "Guidelines on myocardial revascularization"
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                    0 => array:2 [
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                        "fecha" => "2010"
                        "volumen" => "31"
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                      "titulo" => "Outcome of patients presenting with ST elevation myocardial infarct and cardiogenic shock&#58; a contemporary single center&#39;s experience"
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                          "etal" => true
                          "autores" => array:3 [
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                      "doi" => "10.1161/01.CIR.0000075927.67673.F2"
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ISSN: 21742049
Original language: English
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Idiomas
Revista Portuguesa de Cardiologia (English edition)
en pt

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