Left main and/or three-vessel disease in patients with non-ST-segment elevation myocardial infarction and low-risk GRACE score: Prevalence, clinical outcomes and predictors | Revista Portuguesa de Cardiologia (English edition)

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ACS: acute coronary syndrome; GRACE: Global Registry of Acute Coronary Events; LM/3VD: left main and/or three-vessel disease; MI: myocardial infarction; NSTE-ACS: non-ST-segment elevation acute coronary syndrome; NSTEMI: non-ST-segment elevation acute myocardial infarction; STEMI: ST-segment elevation myocardial infarction." ] ] ] "textoCompleto" => "IntroductionNon-ST-elevation acute coronary syndrome (NSTE-ACS) is a heterogeneous clinical entity in which prospective risk stratification is essential to identify patients at high risk of adverse events<a class="elsevierStyleCrossRefs" href="#bib0165">1,2</a> and to offer them, if appropriate, an early invasive strategy to improve short and long-term prognosis.<a class="elsevierStyleCrossRefs" href="#bib0175">3,4</a>Current clinical guidelines from the European Society of Cardiology<a class="elsevierStyleCrossRef" href="#bib0185">5</a> and the American Heart Association/American College of Cardiology<a class="elsevierStyleCrossRef" href="#bib0190">6</a> recommend the use of risk scores. Both recommend the use of the Global Registry of Acute Coronary Events (GRACE) score at admission to predict the risk of in-hospital mortality. The GRACE score is derived from eight clinical, electrocardiographic and laboratory variables: five semiquantitative (age, systolic blood pressure, heart rate, Killip class and serum creatinine level) and three dichotomous (cardiac arrest during presentation, ST-segment deviation and elevated cardiac enzymes), and ranges from 1 to 372 points.<a class="elsevierStyleCrossRef" href="#bib0170">2</a> It has good accuracy for predicting in-hospital death in this cohort of patients.Patients with NSTE-ACS and a GRACE score ≤108 points at admission are classified as low-risk, defined as <1% risk of in-hospital death,<a class="elsevierStyleCrossRef" href="#bib0170">2</a> and as suitable for initially conservative management.<a class="elsevierStyleCrossRefs" href="#bib0185">5,6</a> However, risk scores, including GRACE, are not intended to determine the severity of coronary artery disease (CAD) and, if an initial conservative approach is adopted in accordance with the calculated risk, this may result in failure to identify patients with severe CAD requiring revascularization, such as left main and/or three-vessel disease (LM/3VD).<a class="elsevierStyleCrossRef" href="#bib0195">7</a>Several studies have evaluated the performance of clinical risk scores for detecting and predicting the severity of CAD.In patients with NSTE-ACS, the TIMI risk score has a modest ability to predict obstructive CAD, defined as the presence of at least one ≥50% stenosis,<a class="elsevierStyleCrossRefs" href="#bib0200">8,9</a> while a TIMI score >4 shows a modest<a class="elsevierStyleCrossRef" href="#bib0210">10</a> to good<a class="elsevierStyleCrossRef" href="#bib0215">11</a> performance in detecting three-vessel CAD. In one study, sensitivity of 53% and specificity of 83% were demonstrated for this diagnosis (area under the curve [AUC] 0.71; 95% CI 0.61-0.81, p<0.001).<a class="elsevierStyleCrossRef" href="#bib0215">11</a>Variability in accuracy for prediction of CAD using the GRACE score is greater due to the different cut-off points studied. Its performance is good for the detection of multivessel disease (AUC 0.72; 95% CI 0.64-0.80, p=0.001)<a class="elsevierStyleCrossRef" href="#bib0220">12</a> but only modest for three-vessel disease with a cut-off of >119<a class="elsevierStyleCrossRef" href="#bib0215">11</a> or LM/3VD with a cut-off of >117.<a class="elsevierStyleCrossRef" href="#bib0225">13</a> The GRACE score has better predictive ability for three-vessel disease when the cut-off is >133,<a class="elsevierStyleCrossRef" href="#bib0210">10</a> and higher sensitivity but lower specificity than the TIMI risk score.<a class="elsevierStyleCrossRef" href="#bib0215">11</a>This study aimed to determine the prevalence of LM/3VD in non-ST-elevation myocardial infarction (NSTEMI) patients with a GRACE score ≤108 at admission, to assess its impact on clinical outcomes, and to determine its predictors.MethodsStudy design, population and variablesThis was a retrospective study based on the data of the second phase of the Portuguese Registry on Acute Coronary Syndromes (ProACS). Details of the study design, outcome definitions, patients, and main results of the first phase have been published.<a class="elsevierStyleCrossRefs" href="#bib0230">14,15</a> Data are collected from all participating centers in Portugal and entered in a web-based platform at discharge and at one-year follow-up. Information is recorded on demographics, cardiovascular risk factors, clinical presentation, laboratory and imaging results, coronary angiography and revascularization, medication and in-hospital adverse events (reinfarction, congestive heart failure, cardiogenic shock, atrial fibrillation, advanced atrioventricular block, resuscitated cardiac arrest, stroke, major bleeding and death).Between October 1, 2010 and November 4, 2015, a total of 13322 patients with a diagnosis of acute coronary syndrome (ACS) were included in the ProACS. After exclusion of patients with STEMI, unknown location myocardial infarction, unstable angina or GRACE score >109, or missing data for calculation of the GRACE score, 1378 had a diagnosis of NSTEMI and a GRACE score ≤108 at admission, of whom only the 1196 patients who had undergone coronary angiography were included. Detailed information on the study selection process is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The total proportion of missing data on baseline characteristics was low (3.7% of the total variables) and all the patients and information on their baseline characteristics were included.CAD was defined as the presence of a ≥50% stenosis in any major vessel (left main, left anterior descending [LAD], left circumflex or right coronary artery).For the purpose of this study, the patients were divided in two groups: the LM/3VD group (patients with angiographic evidence of LM/3VD) and the non-LM/3VD group (all other patients).The primary endpoint was defined as major adverse cardiac and cerebrovascular events (MACCE) (in-hospital mortality, reinfarction, non-fatal stroke or heart failure) and the secondary endpoint as the need for coronary artery bypass grafting (CABG) during hospitalization.Statistical analysisBaseline characteristics were compared between patient groups using the Student's t test for continuous variables and the chi-square test or Fisher's exact test for categorical variables. Continuous variables were expressed as mean ± standard deviation or median and interquartile range (IQR). Categorical variables were expressed as absolute or relative frequencies.Multivariate logistic regression analysis was performed to assess independent predictors of LM/3VD in this population and its influence on in-hospital mortality or MACCE. The variables included were age; gender; admission creatinine, heart rate, blood pressure and Killip class; cardiovascular risk factors; previous medical history (excluding previous CABG); ST-segment deviation or T-wave inversion; and left ventricular function. Odds ratios (OR) and hazard ratios were calculated with 95% confidence intervals (CI). The logistic regression included only patients without missing data regarding the main variables (1098 out of 1196 patients, 91.8%).Survival at one-year follow-up, describing cumulative mortality since admission, was analyzed using Kaplan-Meier curves with the log-rank test. Multivariate Cox regression was performed. The number of patients with complete one-year follow-up was 528 (44.1%).IBM SPSS Statistics® version 19.0 was used for the statistical analysis and a two-tailed p-value of <0.05 was considered statistically significant.ResultsBaseline characteristicsIn this cohort of patients with NSTEMI and GRACE score ≤108 at admission, the incidence of LM/3VD was 18.2% (n=218). The baseline and admission characteristics of the study population are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, which also shows univariate associations with the presence of LM/3VD.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Patients in the LM/3VD group were slightly older and more frequently male, and had a slightly higher GRACE score and higher prevalences of hypertension, diabetes and previous myocardial infarction, heart failure and peripheral arterial disease (PAD). Although the main presenting symptom was chest pain in both groups, interestingly there was a higher proportion of patients presenting atypically with syncope in the LM/3VD group. There were no differences between groups regarding electrocardiographic data, left ventricular function or serum creatinine.Coronary angiography and revascularization dataMost patients underwent coronary angiography within 24 hours of admission; median time from admission to coronary angiography was 0 days (IQR 0-1 days). The prevalence of left main disease was 26.5% and that of three-vessel disease was 89.9% in the LM/3VD group, whereas patients in the non-LM/3VD group were more frequently diagnosed with single-vessel disease (55.6%). Patients with LM/3VD were more likely to have an unidentified culprit artery, to undergo two or more coronary angiographies, and to have a higher rate of femoral access but a lower probability of undergoing angioplasty. They were also more frequently planned for CABG. The results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Impact of left main and/or three-vessel disease in patients with low-risk GRACE scoreThe presence of LM/3VD was not associated with a statistically significant difference in in-hospital adverse events, but there was a trend towards higher absolute values of in-hospital mortality and the primary endpoint of MACCE (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). LM/3VD was also associated with increased length of hospital stay (median five vs. three days, p<0.001) and with more frequent need for CABG during hospitalization (4.1 vs. 0.3%, p<0.001). After multivariate regression analysis, the presence of LM/3VD was not found to be an independent predictor of in-hospital MACCE (OR 1.32, 95% CI 0.56-3.14, p=0.526), however it was an independent predictor of the secondary endpoint (OR 13.22, 95% CI 3.34-52.30, p<0.001).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Patients in the LM/3VD group had higher one-year mortality (2.4 vs. 0.5%, p=0.005) but, after multivariate Cox regression analysis, the presence of this coronary anatomy did not confer an increased risk of one-year mortality. The results are displayed in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>Predictors of left main and/or three-vessel disease in patients with low-risk GRACE scoreThe results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>. Older age, male gender, higher resting heart rate, previous diagnosis of heart failure and PAD were identified as independent predictors of the presence of LM/3VD. The risk was higher for each 10-bpm increase in heart rate (OR 1.23, 95% CI 1.12-1.36, p<0.001) and for each 10-year increase in age (OR 1.39, 95% CI 1.14-1.69, p<0.001).<elsevierMultimedia ident="tbl0025"></elsevierMultimedia>DiscussionThe major findings of this study are that patients admitted with NSTEMI and a low-risk GRACE score (≤108) have a low risk of in-hospital adverse events despite almost one fifth of them having high-risk coronary anatomy, but that these patients had not only a worse long-term prognosis, with higher one-year mortality, but also higher in-hospital morbidity, as shown by increased length of hospital stay, and a trend for higher absolute values of mortality and MACCE. The findings indicate that these patients are not in fact at such low risk and should be identified promptly.Another important finding was that simple clinical variables appeared as independent predictors of LM/3VD in this population: two of them included in the GRACE score (age and heart rate), male gender, and important known comorbidities (heart failure and PAD).The relationship between the GRACE risk score and the severity and complexity of CAD has been studied in several publications,<a class="elsevierStyleCrossRefs" href="#bib0200">8–13,16,17</a> however very few stratified patients within the three GRACE risk categories and, to our knowledge, none analyzed predictors of LM/3VD disease in low-risk patients.In the largest study, Beigel et al.<a class="elsevierStyleCrossRef" href="#bib0240">16</a> assessed 923 consecutive patients with moderate-high risk NSTE-ACS enrolled in the Acute Coronary Syndrome Israeli Survey and found that the major predictors of high-risk coronary anatomy (defined as >50% stenosis in the left main, >70% in the proximal LAD and/or two- or three-vessel disease involving the LAD) were GRACE score >140 (high-risk) (OR 1.88, 95% CI 1.29-2.75, p<0.001), PAD (OR 1.88, 95% CI 1.62-5.8, p<0.001) and chronic renal failure (OR 1.7, 95% CI 1.02-2.80, p=0.03). Likewise, Mahmood et al. found that patients with a GRACE score >133 had a higher likelihood of LM/3VD (OR 3.41, 95% CI 2.16-5.36, p<0.01).<a class="elsevierStyleCrossRef" href="#bib0210">10</a> Other groups have set out to correlate the severity of CAD in NSTE-ACS patients with their GRACE score. GRACE >119 had only moderate accuracy for prediction of three-vessel disease, with sensitivity of 80% and specificity of 55% (AUC 0.68; 95% CI 0.58-0.78, p=0.001),<a class="elsevierStyleCrossRef" href="#bib0215">11</a> while GRACE >117 had modest accuracy for predicting LM/3VD, with sensitivity of 66% and specificity of 59% (AUC 0.66; 95% CI 0.58-0.74, p=0.01).<a class="elsevierStyleCrossRef" href="#bib0225">13</a>By contrast, in a study by Barbosa et al.<a class="elsevierStyleCrossRef" href="#bib0200">8</a> the GRACE score was unable to identify the presence of LM/3VD (AUC 0.59; 95% CI 0.48-0.70, p=0.13), and there were no statistical differences between the three GRACE tertiles regarding the prevalence of LM/3VD (25%, 33% and 37%, respectively; p=0.56). Santos et al.<a class="elsevierStyleCrossRef" href="#bib0205">9</a> also showed that the GRACE score had only moderate predictive ability even for the presence of at least one-vessel disease (AUC 0.62; 95% CI 0.573-0.673, p<0.001).Two studies assessed the severity of CAD according to the number of diseased vessels stratified by GRACE risk categories. In the study by Cakar et al.,<a class="elsevierStyleCrossRef" href="#bib0220">12</a> 356 patients with NSTE-ACS were analyzed retrospectively, 39.6% of them with a low-risk GRACE score. The prevalence of LM/3VD was 15.5%, with no in-hospital mortality and a low rate of reinfarction or revascularization (2.1%). These findings were similar to our study. However, they did not assess potential predictors of severe CAD in this population. In a retrospective study of 95 patients with NSTE-ACS, another group reported that 40% of the population had a low-risk GRACE score, with a prevalence of 39.4% for three-vessel disease and 5.2% for left main disease.<a class="elsevierStyleCrossRef" href="#bib0245">17</a> No report on outcomes was available.Our search of the literature revealed no studies regarding determination of predictors of LM/3VD in low-risk GRACE populations.Many simple predictors of worse prognosis are correlated with severe CAD. Clinical variables like increasing age and high resting heart rate are well-known risk factors.<a class="elsevierStyleCrossRef" href="#bib0250">18</a> Both these variables are features of the GRACE score and in our study were also found to be predictors of LM/3VD, which is in line with the literature.<a class="elsevierStyleCrossRef" href="#bib0255">19</a> This could mean that, even for low-risk patients, extra care should be taken regarding tachycardic and elderly patients.PAD is associated with increased risk for cardiovascular death<a class="elsevierStyleCrossRef" href="#bib0260">20</a> and higher in-hospital mortality in ACS,<a class="elsevierStyleCrossRef" href="#bib0265">21</a> and there are several reports associating its presence with greater severity and complexity of CAD.<a class="elsevierStyleCrossRefs" href="#bib0255">19,22</a> In our study, despite the low prevalence of PAD in both groups, which was significantly less than in modern cohorts of ACS patients,<a class="elsevierStyleCrossRef" href="#bib0275">23</a> it was an independent predictor of LM/3VD, as it also was in the study by Beigel et al.<a class="elsevierStyleCrossRef" href="#bib0240">16</a> and in a meta-analysis.<a class="elsevierStyleCrossRef" href="#bib0255">19</a> An ankle-brachial index of <0.9 is known to be a predictor of PAD<a class="elsevierStyleCrossRef" href="#bib0280">24</a> and of multivessel CAD in patients admitted with ACS,<a class="elsevierStyleCrossRef" href="#bib0285">25</a> so this simple measure from the physical examination could potentially improve detection of this important comorbidity.In heart failure, long-term prognosis is directly related to the angiographic extent and severity of CAD,<a class="elsevierStyleCrossRefs" href="#bib0290">26,27</a> in patients with both reduced and preserved systolic function.<a class="elsevierStyleCrossRef" href="#bib0300">28</a> In the setting of ACS, development of acute heart failure is considered a powerful predictor of LM/3VD,<a class="elsevierStyleCrossRef" href="#bib0255">19</a> but less is known about the predictive ability of a previous history of chronic heart failure. However, in our study neither the proportion of patients in Killip class II-IV nor the incidence of new-onset heart failure during hospitalization differed between the groups. There were also no differences in the incidence of left ventricular dysfunction. These findings are not surprising, since the population only included patients with a low-risk GRACE score, which means that most patients would be in Killip class I. Another finding is that a previous history of heart failure was an independent predictor of LM/3VD. Nonetheless, this result should be interpreted with caution, since it reached only a borderline significant p-value and the number of patients affected was low.We also found that male gender was an independent predictor for the presence of LM/3VD, which is in line with other studies that show that men with myocardial infarction have more severe CAD.<a class="elsevierStyleCrossRefs" href="#bib0305">29–32</a>In our study, there were no differences between groups in in-hospital adverse events. Although patients with LM/3VD had non-significantly more MACCE and higher in-hospital mortality, the rates were low, as would be accurately predicted by the GRACE score.<a class="elsevierStyleCrossRef" href="#bib0170">2</a> However, a significant interaction was found with the secondary endpoint of urgent referral for CABG during hospitalization, which was more frequent in the LM/3VD group. Indeed, one reason for the need to be able to predict severe CAD using clinical risk scores is to improve assessment of patients who would most likely be indicated for CABG. This is important because it could have therapeutic implications for the timing and duration of dual antiplatelet therapy.Study limitationsThis was a retrospective study with all the limitations of this type of study design, however it also reflects the real-world population of patients that clinicians see in daily practice. Another important issue is the definition of CAD used. Many authors agree that CAD should be defined as the presence of >50% luminal stenosis, the cut-off used in this study due to the ProACS design. However, from a physiological standpoint, only >70% stenoses are considered hemodynamically significant and requiring revascularization. This may have led to the inclusion of less severe patients in the LM/3VD group, which could have influenced in-hospital outcomes. Another major limitation is the small number of patients who underwent CABG during hospitalization, and therefore the results should be interpreted with caution. Also, we do not know if post-hospitalization CABG contributed to higher mortality in the LM/3VD group. Nevertheless, even though CABG could have played a role in one-year mortality, it would have been performed as a consequence of having LM/3VD, and thus higher mortality could be attributed, at least in part, to the disease itself.ConclusionPatients admitted for NSTEMI with a low-risk GRACE score of ≤108 at admission had few in-hospital adverse events and low mortality, even though almost one in five had LM/3VD. Nonetheless, despite this apparently good in-hospital prognosis for hard clinical endpoints, these patients had higher absolute values of in-hospital mortality and MACCE, and LM/3VD was associated with longer hospital stay and higher one-year mortality, and was also an independent predictor for CABG during hospitalization. Simple clinical variables are independent predictors of this high-risk coronary anatomy, like older age, higher resting heart rate, male gender, previous diagnosis of heart failure and PAD, and could help the clinician to identify patients who would benefit from an early invasive strategy.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1127642" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1061245" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1127641" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1061244" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study design, population and variables" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0025" "titulo" => "Results" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Baseline characteristics" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Coronary angiography and revascularization data" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Impact of left main and/or three-vessel disease in patients with low-risk GRACE score" ] 3 => array:2 [ "identificador" => "sec0045" "titulo" => "Predictors of left main and/or three-vessel disease in patients with low-risk GRACE score" ] ] ] 7 => array:3 [ "identificador" => "sec0050" "titulo" => "Discussion" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Study limitations" ] ] ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-11-06" "fechaAceptado" => "2018-03-11" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1061245" "palabras" => array:6 [ 0 => "Non-ST-elevation myocardial infarction" 1 => "GRACE score" 2 => "Coronary angiography" 3 => "Left main disease" 4 => "Three-vessel disease" 5 => "Prognosis" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec1061244" "palabras" => array:6 [ 0 => "Enfarte agudo do miocárdio sem elevação do segmento ST" 1 => "Score GRACE" 2 => "Angiografia coronária" 3 => "Doença do tronco comum" 4 => "Doença de três vasos" 5 => "Prognóstico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionA low-risk GRACE score identifies patients with a lower incidence of major cardiac events, however it can erroneously classify patients with severe coronary artery disease as low-risk. We assessed the prevalence, clinical outcomes and predictors of left main and/or three-vessel disease (LM/3VD) in non-ST-elevation acute myocardial infarction (NSTEMI) patients with a GRACE score of ≤108 at admission. MethodsUsing data from the Portuguese Registry on Acute Coronary Syndromes, 1196 patients with NSTEMI and a GRACE score of ≤108 who underwent coronary angiography were studied. Independent predictors of LM/3VD and its impact on in-hospital complications and one-year mortality were retrospectively analyzed. ResultsLM/3VD was present in 18.2% of patients. Its prevalence was higher in males and associated with hypertension, diabetes, previous myocardial infarction, heart failure and peripheral arterial disease (PAD). Although there were no differences in in-hospital complications, these patients had higher mortality (0.9 vs. 0.0%) and more major adverse cardiac and cerebrovascular events (MACCE) (4.1 vs. 2.5%, p=0.172), and higher one-year mortality (2.4 vs. 0.5%, p=0.005). Independent predictors of LM/3VD were age (OR 1.03; 95% CI 1.01-1.0, p=0.003), male gender (OR 2.56; 95% CI 1.56-4.17, p<0.001), heart rate (1.02; 95% CI 1.01-1.03, p<0.001), PAD (OR 3.21; 95% CI 1.47-7.00, p<0.001) and heart failure (OR 3.38; 95% CI 1.02-11.15, p=0.046). ConclusionsLM/3VD was found in one in five patients. These patients had a tendency for higher in-hospital mortality and more MACCE, and higher one-year mortality. Simple clinical variables could help predict this severe coronary anatomy." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "IntroduçãoUm baixo Score GRACE está associado a menor incidência de eventos cardíacos major porém pode erradamente classificar de baixo risco doentes com doença coronária severa. Pretendeu-se avaliar a prevalência, prognóstico e preditores de doença do tronco comum/três vasos em doentes com enfarte agudo do miocárdio sem elevação do segmento ST e Score GRACE≤108 pontos à admissão. MétodosUtilizando dados do Registo Nacional de Síndromes Coronárias Agudas, estudámos 1196 doentes com enfarte agudo do miocárdio sem elevação do segmento ST e GRACE≤108 que realizaram coronariografia. Analisados retrospetivamente os preditores independentes de doença do tronco comum e/ou três vasos e o seu impacto prognóstico. ResultadosDoença do tronco comum e/ou três vasos ocorreu em 18,2%. A prevalência foi superior no género masculino e associou-se a hipertensão, diabetes, enfarte prévio, insuficiência cardíaca e doença arterial periférica. Apesar da ausência de diferenças nas complicações hospitalares, tiveram mais eventos cardiocerebrovasculares major (4,1 versus 2,5%, p=0,172), maior mortalidade hospitalar (0,9 versus 0,0%) e a um ano (2,4 versus 0,5%, p=0,005). Considerados preditores de doença do tronco comum e/ou três vasos: idade (OR 1,03 [1,01-1,05], CI 95%,p=0,003), género masculino (OR 2,56 [1,56-4,17], CI 95%, p<0,001), frequência cardíaca (OR 1,02 [1,01-1,03], CI 95%, p<0,001), doença arterial periférica (OR 3,21 [1,47-7,00], CI 95%, p<0,001) e insuficiência cardíaca (OR 3,38 [1,02-11,15], CI 95%, p=0,046). ConclusõesDoença do tronco comum e/ou três vasos ocorre em cerca de um em cada cinco doentes. Verificou-se tendência para maior mortalidade hospitalar e eventos cardio-cerebrovasculares major, e maior mortalidade anual. Variáveis clínicas simples podem ajudar a predizer esta anatomia coronária severa." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] ] "nomenclatura" => array:1 [ 0 => array:3 [ "identificador" => "nom0005" "titulo" => "List of abbreviations" "listaDefinicion" => array:1 [ 0 => array:1 [ "definicion" => array:13 [ 0 => array:2 [ "termino" => "ACS" "descripcion" => "acute coronary syndrome" ] 1 => array:2 [ "termino" => "CABG" "descripcion" => "coronary artery bypass grafting" ] 2 => array:2 [ "termino" => "CAD" "descripcion" => "coronary artery disease" ] 3 => array:2 [ "termino" => "GRACE" "descripcion" => "Global Registry of Acute Coronary Events" ] 4 => array:2 [ "termino" => "LAD" "descripcion" => "left anterior descending artery" ] 5 => array:2 [ "termino" => "LM/3VD" "descripcion" => "left main and/or three-vessel disease" ] 6 => array:2 [ "termino" => "MACCE" "descripcion" => "major adverse cardiac and cerebrovascular events" ] 7 => array:2 [ "termino" => "NSTE-ACS" "descripcion" => "non-ST-elevation acute coronary syndrome" ] 8 => array:2 [ "termino" => "NSTEMI" "descripcion" => "non-ST-elevation myocardial infarction" ] 9 => array:2 [ "termino" => "OR" "descripcion" => "odds ratio" ] 10 => array:2 [ "termino" => "PAD" "descripcion" => "peripheral arterial disease" ] 11 => array:2 [ "termino" => "ProACS" "descripcion" => "Portuguese Registry on Acute Coronary Syndromes" ] 12 => array:2 [ "termino" => "TIMI" "descripcion" => "Thrombolysis In Myocardial Infarction" ] ] ] ] ] ] "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" "Alto" => 2214 "Ancho" => 2167 "Tamanyo" => 283739 ] ] "descripcion" => array:1 [ "en" => "Flowchart of patient selection. ACS: acute coronary syndrome; GRACE: Global Registry of Acute Coronary Events; LM/3VD: left main and/or three-vessel disease; MI: myocardial infarction; NSTE-ACS: non-ST-segment elevation acute coronary syndrome; NSTEMI: non-ST-segment elevation acute myocardial infarction; STEMI: ST-segment elevation myocardial infarction." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "ACEI: angiotensin-converting enzyme inhibitor; ARB: angiotensin receptor blocker; BMI: body mass index; BP: blood pressure; CABG: coronary artery bypass grafting; ECG: electrocardiogram; GRACE score: Global Registry of Acute Coronary Events; HR: heart rate; IQR: interquartile range; LM/3VD: left main and/or three-vessel disease; LVEF: left ventricular ejection fraction; MI: myocardial infarction; PAD: peripheral arterial disease; PCI: percutaneous coronary intervention; SBP: systolic blood pressure." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LM/3VD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No LM/3VD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean age, years (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">54±9 (1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56±8 (218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53±9 (978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81.5 (975/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88.5 (193/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80.0 (782/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI, kg/m2(n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28.1±4.4 (1094) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28.2±4.0% (203) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28.1±4.5% (891) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.749 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smoking, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46.6 (557/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">45.0 (98/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46.9 (459/987) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.596 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypertension, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59.0 (691/1171) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">69.8 (150/215) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56.6 (541/956) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21.2 (249/1173) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30.0 (64/213) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.3 (185/960) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56.6 (643/1137) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62.6 (129/206) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">55.2 (514/931) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.052 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous MI, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16.9 (201/1191) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.9 (54/217) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.1(147/974) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous PCI, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.2 (158/1193) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.1 (37/217) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.4 (121/976) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.067 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous CABG, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.3 (27/1195) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.6 (21/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.6 (6/977) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous renal failure, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.0 (12/1192) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.4 (3/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.9 (9/974) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.468 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous PAD, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.9 (34/1188) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.9 (17/216) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.7 (17/972) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous stroke, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.9 (47/1194) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.1 (9/217) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.9 (38/977) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.860 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous heart failure, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.3 (15/1194) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.2 (7/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.8 (8/976) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.011 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">GRACE score at admission (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90.3±13.1 (1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">92.0±12.4 (218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">89.9±13.3 (978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.024 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Patient presentation</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chest pain, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">97.7 (1168/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">96.3 (210/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">98.0 (958/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.151 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Syncope, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.8 (10/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.3 (5/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5 (5/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.022 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean HR, bpm (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73±14 (1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">76±15 (218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73±14 (978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean SBP, mmHg (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">151±29 (1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">154±29 (218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">150±28 (978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.035 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Killip II-IV, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5 (6/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5 (1/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5 (5/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">ECG</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49.7 (594/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48.2 (105/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50.0 (189/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.624 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">T-wave inversion, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34.9 (417/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36.7 (80/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34.5 (337/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.530 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ST-segment deviation, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.8 (22/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.3 (5/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.7 (17/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.577 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serum creatinine, median mg/dl (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.8 [IQR 0.7;1] (1196/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.8 [IQR 0.7;1] (218/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.8 [IQR 0.7;1] (978/987) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.477 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEF <50%, % (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.2 (197/1148) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21.3 (44/207) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16.3 (153/941) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.084 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Medication during hospitalization, % (n)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aspirin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">99.2 (1185/1194) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">99.1 (215/217) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">99.3 (970/977) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.671 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clopidogrel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">92.1 (1099/1193) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">92.7 (202/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">92.0 (897/975) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.743 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enoxaparin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67.8 (809/1194) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70.2 (153/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67.2 (656/976) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.396 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ACEI or ARB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88.3 (1052/1192) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90.8 (198/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">87.7 (854/974) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.192 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Statin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">97.0 (1158/1194) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95.9 (209/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">97.2 (949/976) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.288 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Beta-blocker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">87.7 (1045/1192) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">91.7 (200/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">86.8 (845/974) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.043 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1922107.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline and admission characteristics of the study population." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "CABG: coronary artery bypass grafting; LAD: left anterior descending artery; LCx: left circumflex artery; LM: left main; LM/3VD: left main and/or three-vessel disease; NA: not applicable; RCA: right coronary artery." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total, % (n) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LM/3VD, % (n) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No LM/3VD, % (n) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">≥1 coronary angiographies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.8 (68/1177) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26/215 (12.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42/962 (4.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Femoral access \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">197/1174 (16.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61/214 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">136/960 (14.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Diseased vessels<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">None \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">152/1177 (12.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0/199 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">152/978 (15.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">544/1177 (46.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0/199 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">544/978 (55.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">302/1177 (25.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20/199 (10.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">282/978 (28.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">179/1177 (15.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">179/199 (89.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0/978 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LM (isolated or not) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53/1178 (4.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53/200 (26.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0/978 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Culprit artery</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.7 (17/985) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.1 (16/198) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.1 (1/787) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32.7 (322/985) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16.7 (33/198) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36.7 (289/787) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LCx \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.6 (242/985) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.6 (25/198) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27.6 (217/787) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">209/985 (21.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33/198 (16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">176/787 (22.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.080 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Graft \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.4 (4/985) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.0 (4/198) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0 (0/787) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Unidentified \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.4 (191/985) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43.9 (87/198) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.2 (104/787) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Angioplasty performed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">65.9 (788/1195) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52.8 (115/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68.9 (673/977) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">CABG</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Urgent/secondary endpoint \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.0 (12/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.1 (9/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3/978 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Planned after transfer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">77/1196 (6.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53/218 (24.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.5 (24/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Planned after discharge \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.7 (32/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.3 (18/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.4 (14/987) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Planned and performed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.1 (121/1196) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36.7 (80/218) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.2 (41/978) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1922108.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Patients with missing data were excluded. Patients for whom not all registry fields for the presence of >50% stenosis were completed could not be stratified by number of diseased vessels. Therefore they were not considered in this analysis, such as a patient with LM and LAD stenosis but no information regarding the RCA or LCx." ] ] ] "descripcion" => array:1 [ "en" => "Coronary angiography, revascularization and secondary endpoint of the study population." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "LM/3VD: left main and/or three-vessel disease; MACCE: major adverse cerebrovascular events (defined as in-hospital mortality, non-fatal stroke, reinfarction or heart failure); NA: not applicable." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable, n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total (n=1196) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LM/3VD (n=218) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No LM/3VD (n=978) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Reinfarction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (1.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (0.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.123 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stroke \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.087 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Heart failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (1.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (1.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.566 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cardiogenic shock<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atrial fibrillation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atrioventricular block \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (1.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.063 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Resuscitated cardiac arrest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.227 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Major bleeding \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">MACCE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (2.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.172 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">In-hospital mortality \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1922110.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "Four patients in the non-LM/3VD group were excluded due to missing data." ] ] ] "descripcion" => array:1 [ "en" => "In-hospital adverse events and in-hospital mortality." ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "CI: confidence interval; HR: hazard ratio; LM/3VD: left main and/or three-vessel disease; SE: standard error." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Beta \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SE \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LM/3VD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.757 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.748 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.312 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.13 (0.49-9.24) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Inotropes during hospitalization \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.213 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.287 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.55 (5.42-841) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nitrates at discharge \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.094 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.748 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.12 (1.88-35.17) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1922111.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Multivariate Cox regression assessing hazard ratios for one-year mortality." ] ] 5 => array:8 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at5" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "CI: confidence interval; OR: odds ratio; PAD: peripheral arterial disease; SE: standard error." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Predictor \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Beta \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SE \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.033 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.03 (1.01-1.05) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.945 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.250 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.56 (1.56-4.17) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">History of heart failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.217 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.609 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.046 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.38 (1.02-11.15) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Heart rate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.021 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.02 (1.01-1.03) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.166 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.398 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.21 (1.47-7.00) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1922109.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Multivariate logistic regression assessing predictors of left main and/or three-vessel disease in patients with non-ST-elevation myocardial infarction and low-risk GRACE score." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0165" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E.M. 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Original Article

Left main and/or three-vessel disease in patients with non-ST-segment elevation myocardial infarction and low-risk GRACE score: Prevalence, clinical outcomes and predictors

Doença do tronco comum e/ou doença arterial coronária de três vasos em doentes com enfarte agudo do miocárdio sem elevação do segmento ST e Score Grace de baixo risco: prevalência, prognóstico clínico e preditores

João Filipe Carvalhoa,

Corresponding author

jtostecarvalho@gmail.com

Corresponding author.

, Adriana Belob, Kisa Congoa, David Nevesa, Ana Rita Santosa, Bruno Piçarraa, Ana Filipa Damásioc, José Aguiara, on behalf of the investigators of the Portuguese Registry on Acute Coronary Syndromes (ProACS)

a Cardiology Department, Hospital do Espírito Santo de Évora, Évora, Portugal

b Biostatistics Department, Portuguese Society of Cardiology, Lisbon, Portugal

c Cardiology Department, Hospital Distrital de Santarém, Santarém, Portugal

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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart of patient selection&#46; ACS&#58; acute coronary syndrome&#59; GRACE&#58; Global Registry of Acute Coronary Events&#59; LM&#47;3VD&#58; left main and&#47;or three-vessel disease&#59; MI&#58; myocardial infarction&#59; NSTE-ACS&#58; non-ST-segment elevation acute coronary syndrome&#59; NSTEMI&#58; non-ST-segment elevation acute myocardial infarction&#59; STEMI&#58; ST-segment elevation myocardial infarction&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0070" class="elsevierStylePara elsevierViewall">Non-ST-elevation acute coronary syndrome &#40;NSTE-ACS&#41; is a heterogeneous clinical entity in which prospective risk stratification is essential to identify patients at high risk of adverse events<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#44;2</span></a> and to offer them&#44; if appropriate&#44; an early invasive strategy to improve short and long-term prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Current clinical guidelines from the European Society of Cardiology<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">5</span></a> and the American Heart Association&#47;American College of Cardiology<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">6</span></a> recommend the use of risk scores&#46; Both recommend the use of the Global Registry of Acute Coronary Events &#40;GRACE&#41; score at admission to predict the risk of in-hospital mortality&#46; The GRACE score is derived from eight clinical&#44; electrocardiographic and laboratory variables&#58; five semiquantitative &#40;age&#44; systolic blood pressure&#44; heart rate&#44; Killip class and serum creatinine level&#41; and three dichotomous &#40;cardiac arrest during presentation&#44; ST-segment deviation and elevated cardiac enzymes&#41;&#44; and ranges from 1 to 372 points&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> It has good accuracy for predicting in-hospital death in this cohort of patients&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Patients with NSTE-ACS and a GRACE score &#8804;108 points at admission are classified as low-risk&#44; defined as &#60;1&#37; risk of in-hospital death&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> and as suitable for initially conservative management&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">5&#44;6</span></a> However&#44; risk scores&#44; including GRACE&#44; are not intended to determine the severity of coronary artery disease &#40;CAD&#41; and&#44; if an initial conservative approach is adopted in accordance with the calculated risk&#44; this may result in failure to identify patients with severe CAD requiring revascularization&#44; such as left main and&#47;or three-vessel disease &#40;LM&#47;3VD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">7</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Several studies have evaluated the performance of clinical risk scores for detecting and predicting the severity of CAD&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In patients with NSTE-ACS&#44; the TIMI risk score has a modest ability to predict obstructive CAD&#44; defined as the presence of at least one &#8805;50&#37; stenosis&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8&#44;9</span></a> while a TIMI score &#62;4 shows a modest<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a> to good<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a> performance in detecting three-vessel CAD&#46; In one study&#44; sensitivity of 53&#37; and specificity of 83&#37; were demonstrated for this diagnosis &#40;area under the curve &#91;AUC&#93; 0&#46;71&#59; 95&#37; CI 0&#46;61-0&#46;81&#44; p&#60;0&#46;001&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Variability in accuracy for prediction of CAD using the GRACE score is greater due to the different cut-off points studied&#46; Its performance is good for the detection of multivessel disease &#40;AUC 0&#46;72&#59; 95&#37; CI 0&#46;64-0&#46;80&#44; p&#61;0&#46;001&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> but only modest for three-vessel disease with a cut-off of &#62;119<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a> or LM&#47;3VD with a cut-off of &#62;117&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a> The GRACE score has better predictive ability for three-vessel disease when the cut-off is &#62;133&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a> and higher sensitivity but lower specificity than the TIMI risk score&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">This study aimed to determine the prevalence of LM&#47;3VD in non-ST-elevation myocardial infarction &#40;NSTEMI&#41; patients with a GRACE score &#8804;108 at admission&#44; to assess its impact on clinical outcomes&#44; and to determine its predictors&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study design&#44; population and variables</span><p id="par0105" class="elsevierStylePara elsevierViewall">This was a retrospective study based on the data of the second phase of the Portuguese Registry on Acute Coronary Syndromes &#40;ProACS&#41;&#46; Details of the study design&#44; outcome definitions&#44; patients&#44; and main results of the first phase have been published&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">14&#44;15</span></a> Data are collected from all participating centers in Portugal and entered in a web-based platform at discharge and at one-year follow-up&#46; Information is recorded on demographics&#44; cardiovascular risk factors&#44; clinical presentation&#44; laboratory and imaging results&#44; coronary angiography and revascularization&#44; medication and in-hospital adverse events &#40;reinfarction&#44; congestive heart failure&#44; cardiogenic shock&#44; atrial fibrillation&#44; advanced atrioventricular block&#44; resuscitated cardiac arrest&#44; stroke&#44; major bleeding and death&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Between October 1&#44; 2010 and November 4&#44; 2015&#44; a total of 13<span class="elsevierStyleHsp" style=""></span>322 patients with a diagnosis of acute coronary syndrome &#40;ACS&#41; were included in the ProACS&#46; After exclusion of patients with STEMI&#44; unknown location myocardial infarction&#44; unstable angina or GRACE score &#62;109&#44; or missing data for calculation of the GRACE score&#44; 1378 had a diagnosis of NSTEMI and a GRACE score &#8804;108 at admission&#44; of whom only the 1196 patients who had undergone coronary angiography were included&#46; Detailed information on the study selection process is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The total proportion of missing data on baseline characteristics was low &#40;3&#46;7&#37; of the total variables&#41; and all the patients and information on their baseline characteristics were included&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">CAD was defined as the presence of a &#8805;50&#37; stenosis in any major vessel &#40;left main&#44; left anterior descending &#91;LAD&#93;&#44; left circumflex or right coronary artery&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">For the purpose of this study&#44; the patients were divided in two groups&#58; the LM&#47;3VD group &#40;patients with angiographic evidence of LM&#47;3VD&#41; and the non-LM&#47;3VD group &#40;all other patients&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The primary endpoint was defined as major adverse cardiac and cerebrovascular events &#40;MACCE&#41; &#40;in-hospital mortality&#44; reinfarction&#44; non-fatal stroke or heart failure&#41; and the secondary endpoint as the need for coronary artery bypass grafting &#40;CABG&#41; during hospitalization&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0135" class="elsevierStylePara elsevierViewall">Baseline characteristics were compared between patient groups using the Student&#39;s t test for continuous variables and the chi-square test or Fisher&#39;s exact test for categorical variables&#46; Continuous variables were expressed as mean &#177; standard deviation or median and interquartile range &#40;IQR&#41;&#46; Categorical variables were expressed as absolute or relative frequencies&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Multivariate logistic regression analysis was performed to assess independent predictors of LM&#47;3VD in this population and its influence on in-hospital mortality or MACCE&#46; The variables included were age&#59; gender&#59; admission creatinine&#44; heart rate&#44; blood pressure and Killip class&#59; cardiovascular risk factors&#59; previous medical history &#40;excluding previous CABG&#41;&#59; ST-segment deviation or T-wave inversion&#59; and left ventricular function&#46; Odds ratios &#40;OR&#41; and hazard ratios were calculated with 95&#37; confidence intervals &#40;CI&#41;&#46; The logistic regression included only patients without missing data regarding the main variables &#40;1098 out of 1196 patients&#44; 91&#46;8&#37;&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Survival at one-year follow-up&#44; describing cumulative mortality since admission&#44; was analyzed using Kaplan-Meier curves with the log-rank test&#46; Multivariate Cox regression was performed&#46; The number of patients with complete one-year follow-up was 528 &#40;44&#46;1&#37;&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">IBM SPSS Statistics<span class="elsevierStyleSup">&#174;</span> version 19&#46;0 was used for the statistical analysis and a two-tailed p-value of &#60;0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Baseline characteristics</span><p id="par0155" class="elsevierStylePara elsevierViewall">In this cohort of patients with NSTEMI and GRACE score &#8804;108 at admission&#44; the incidence of LM&#47;3VD was 18&#46;2&#37; &#40;n&#61;218&#41;&#46; The baseline and admission characteristics of the study population are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; which also shows univariate associations with the presence of LM&#47;3VD&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">Patients in the LM&#47;3VD group were slightly older and more frequently male&#44; and had a slightly higher GRACE score and higher prevalences of hypertension&#44; diabetes and previous myocardial infarction&#44; heart failure and peripheral arterial disease &#40;PAD&#41;&#46; Although the main presenting symptom was chest pain in both groups&#44; interestingly there was a higher proportion of patients presenting atypically with syncope in the LM&#47;3VD group&#46; There were no differences between groups regarding electrocardiographic data&#44; left ventricular function or serum creatinine&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Coronary angiography and revascularization data</span><p id="par0165" class="elsevierStylePara elsevierViewall">Most patients underwent coronary angiography within 24 hours of admission&#59; median time from admission to coronary angiography was 0 days &#40;IQR 0-1 days&#41;&#46; The prevalence of left main disease was 26&#46;5&#37; and that of three-vessel disease was 89&#46;9&#37; in the LM&#47;3VD group&#44; whereas patients in the non-LM&#47;3VD group were more frequently diagnosed with single-vessel disease &#40;55&#46;6&#37;&#41;&#46; Patients with LM&#47;3VD were more likely to have an unidentified culprit artery&#44; to undergo two or more coronary angiographies&#44; and to have a higher rate of femoral access but a lower probability of undergoing angioplasty&#46; They were also more frequently planned for CABG&#46; The results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Impact of left main and&#47;or three-vessel disease in patients with low-risk GRACE score</span><p id="par0170" class="elsevierStylePara elsevierViewall">The presence of LM&#47;3VD was not associated with a statistically significant difference in in-hospital adverse events&#44; but there was a trend towards higher absolute values of in-hospital mortality and the primary endpoint of MACCE &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; LM&#47;3VD was also associated with increased length of hospital stay &#40;median five vs&#46; three days&#44; p&#60;0&#46;001&#41; and with more frequent need for CABG during hospitalization &#40;4&#46;1 vs&#46; 0&#46;3&#37;&#44; p&#60;0&#46;001&#41;&#46; After multivariate regression analysis&#44; the presence of LM&#47;3VD was not found to be an independent predictor of in-hospital MACCE &#40;OR 1&#46;32&#44; 95&#37; CI 0&#46;56-3&#46;14&#44; p&#61;0&#46;526&#41;&#44; however it was an independent predictor of the secondary endpoint &#40;OR 13&#46;22&#44; 95&#37; CI 3&#46;34-52&#46;30&#44; p&#60;0&#46;001&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">Patients in the LM&#47;3VD group had higher one-year mortality &#40;2&#46;4 vs&#46; 0&#46;5&#37;&#44; p&#61;0&#46;005&#41; but&#44; after multivariate Cox regression analysis&#44; the presence of this coronary anatomy did not confer an increased risk of one-year mortality&#46; The results are displayed in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Predictors of left main and&#47;or three-vessel disease in patients with low-risk GRACE score</span><p id="par0180" class="elsevierStylePara elsevierViewall">The results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#46; Older age&#44; male gender&#44; higher resting heart rate&#44; previous diagnosis of heart failure and PAD were identified as independent predictors of the presence of LM&#47;3VD&#46; The risk was higher for each 10-bpm increase in heart rate &#40;OR 1&#46;23&#44; 95&#37; CI 1&#46;12-1&#46;36&#44; p&#60;0&#46;001&#41; and for each 10-year increase in age &#40;OR 1&#46;39&#44; 95&#37; CI 1&#46;14-1&#46;69&#44; p&#60;0&#46;001&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0185" class="elsevierStylePara elsevierViewall">The major findings of this study are that patients admitted with NSTEMI and a low-risk GRACE score &#40;&#8804;108&#41; have a low risk of in-hospital adverse events despite almost one fifth of them having high-risk coronary anatomy&#44; but that these patients had not only a worse long-term prognosis&#44; with higher one-year mortality&#44; but also higher in-hospital morbidity&#44; as shown by increased length of hospital stay&#44; and a trend for higher absolute values of mortality and MACCE&#46; The findings indicate that these patients are not in fact at such low risk and should be identified promptly&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Another important finding was that simple clinical variables appeared as independent predictors of LM&#47;3VD in this population&#58; two of them included in the GRACE score &#40;age and heart rate&#41;&#44; male gender&#44; and important known comorbidities &#40;heart failure and PAD&#41;&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">The relationship between the GRACE risk score and the severity and complexity of CAD has been studied in several publications&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8&#8211;13&#44;16&#44;17</span></a> however very few stratified patients within the three GRACE risk categories and&#44; to our knowledge&#44; none analyzed predictors of LM&#47;3VD disease in low-risk patients&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">In the largest study&#44; Beigel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">16</span></a> assessed 923 consecutive patients with moderate-high risk NSTE-ACS enrolled in the Acute Coronary Syndrome Israeli Survey and found that the major predictors of high-risk coronary anatomy &#40;defined as &#62;50&#37; stenosis in the left main&#44; &#62;70&#37; in the proximal LAD and&#47;or two- or three-vessel disease involving the LAD&#41; were GRACE score &#62;140 &#40;high-risk&#41; &#40;OR 1&#46;88&#44; 95&#37; CI 1&#46;29-2&#46;75&#44; p&#60;0&#46;001&#41;&#44; PAD &#40;OR 1&#46;88&#44; 95&#37; CI 1&#46;62-5&#46;8&#44; p&#60;0&#46;001&#41; and chronic renal failure &#40;OR 1&#46;7&#44; 95&#37; CI 1&#46;02-2&#46;80&#44; p&#61;0&#46;03&#41;&#46; Likewise&#44; Mahmood et al&#46; found that patients with a GRACE score &#62;133 had a higher likelihood of LM&#47;3VD &#40;OR 3&#46;41&#44; 95&#37; CI 2&#46;16-5&#46;36&#44; p&#60;0&#46;01&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a> Other groups have set out to correlate the severity of CAD in NSTE-ACS patients with their GRACE score&#46; GRACE &#62;119 had only moderate accuracy for prediction of three-vessel disease&#44; with sensitivity of 80&#37; and specificity of 55&#37; &#40;AUC 0&#46;68&#59; 95&#37; CI 0&#46;58-0&#46;78&#44; p&#61;0&#46;001&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a> while GRACE &#62;117 had modest accuracy for predicting LM&#47;3VD&#44; with sensitivity of 66&#37; and specificity of 59&#37; &#40;AUC 0&#46;66&#59; 95&#37; CI 0&#46;58-0&#46;74&#44; p&#61;0&#46;01&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">By contrast&#44; in a study by Barbosa et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">8</span></a> the GRACE score was unable to identify the presence of LM&#47;3VD &#40;AUC 0&#46;59&#59; 95&#37; CI 0&#46;48-0&#46;70&#44; p&#61;0&#46;13&#41;&#44; and there were no statistical differences between the three GRACE tertiles regarding the prevalence of LM&#47;3VD &#40;25&#37;&#44; 33&#37; and 37&#37;&#44; respectively&#59; p&#61;0&#46;56&#41;&#46; Santos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">9</span></a> also showed that the GRACE score had only moderate predictive ability even for the presence of at least one-vessel disease &#40;AUC 0&#46;62&#59; 95&#37; CI 0&#46;573-0&#46;673&#44; p&#60;0&#46;001&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Two studies assessed the severity of CAD according to the number of diseased vessels stratified by GRACE risk categories&#46; In the study by Cakar et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> 356 patients with NSTE-ACS were analyzed retrospectively&#44; 39&#46;6&#37; of them with a low-risk GRACE score&#46; The prevalence of LM&#47;3VD was 15&#46;5&#37;&#44; with no in-hospital mortality and a low rate of reinfarction or revascularization &#40;2&#46;1&#37;&#41;&#46; These findings were similar to our study&#46; However&#44; they did not assess potential predictors of severe CAD in this population&#46; In a retrospective study of 95 patients with NSTE-ACS&#44; another group reported that 40&#37; of the population had a low-risk GRACE score&#44; with a prevalence of 39&#46;4&#37; for three-vessel disease and 5&#46;2&#37; for left main disease&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">17</span></a> No report on outcomes was available&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Our search of the literature revealed no studies regarding determination of predictors of LM&#47;3VD in low-risk GRACE populations&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Many simple predictors of worse prognosis are correlated with severe CAD&#46; Clinical variables like increasing age and high resting heart rate are well-known risk factors&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a> Both these variables are features of the GRACE score and in our study were also found to be predictors of LM&#47;3VD&#44; which is in line with the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> This could mean that&#44; even for low-risk patients&#44; extra care should be taken regarding tachycardic and elderly patients&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">PAD is associated with increased risk for cardiovascular death<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a> and higher in-hospital mortality in ACS&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">21</span></a> and there are several reports associating its presence with greater severity and complexity of CAD&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">19&#44;22</span></a> In our study&#44; despite the low prevalence of PAD in both groups&#44; which was significantly less than in modern cohorts of ACS patients&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a> it was an independent predictor of LM&#47;3VD&#44; as it also was in the study by Beigel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">16</span></a> and in a meta-analysis&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> An ankle-brachial index of &#60;0&#46;9 is known to be a predictor of PAD<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">24</span></a> and of multivessel CAD in patients admitted with ACS&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">25</span></a> so this simple measure from the physical examination could potentially improve detection of this important comorbidity&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">In heart failure&#44; long-term prognosis is directly related to the angiographic extent and severity of CAD&#44;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">26&#44;27</span></a> in patients with both reduced and preserved systolic function&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a> In the setting of ACS&#44; development of acute heart failure is considered a powerful predictor of LM&#47;3VD&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> but less is known about the predictive ability of a previous history of chronic heart failure&#46; However&#44; in our study neither the proportion of patients in Killip class II-IV nor the incidence of new-onset heart failure during hospitalization differed between the groups&#46; There were also no differences in the incidence of left ventricular dysfunction&#46; These findings are not surprising&#44; since the population only included patients with a low-risk GRACE score&#44; which means that most patients would be in Killip class I&#46; Another finding is that a previous history of heart failure was an independent predictor of LM&#47;3VD&#46; Nonetheless&#44; this result should be interpreted with caution&#44; since it reached only a borderline significant p-value and the number of patients affected was low&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">We also found that male gender was an independent predictor for the presence of LM&#47;3VD&#44; which is in line with other studies that show that men with myocardial infarction have more severe CAD&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">29&#8211;32</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">In our study&#44; there were no differences between groups in in-hospital adverse events&#46; Although patients with LM&#47;3VD had non-significantly more MACCE and higher in-hospital mortality&#44; the rates were low&#44; as would be accurately predicted by the GRACE score&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> However&#44; a significant interaction was found with the secondary endpoint of urgent referral for CABG during hospitalization&#44; which was more frequent in the LM&#47;3VD group&#46; Indeed&#44; one reason for the need to be able to predict severe CAD using clinical risk scores is to improve assessment of patients who would most likely be indicated for CABG&#46; This is important because it could have therapeutic implications for the timing and duration of dual antiplatelet therapy&#46;</p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Study limitations</span><p id="par0245" class="elsevierStylePara elsevierViewall">This was a retrospective study with all the limitations of this type of study design&#44; however it also reflects the real-world population of patients that clinicians see in daily practice&#46; Another important issue is the definition of CAD used&#46; Many authors agree that CAD should be defined as the presence of &#62;50&#37; luminal stenosis&#44; the cut-off used in this study due to the ProACS design&#46; However&#44; from a physiological standpoint&#44; only &#62;70&#37; stenoses are considered hemodynamically significant and requiring revascularization&#46; This may have led to the inclusion of less severe patients in the LM&#47;3VD group&#44; which could have influenced in-hospital outcomes&#46; Another major limitation is the small number of patients who underwent CABG during hospitalization&#44; and therefore the results should be interpreted with caution&#46; Also&#44; we do not know if post-hospitalization CABG contributed to higher mortality in the LM&#47;3VD group&#46; Nevertheless&#44; even though CABG could have played a role in one-year mortality&#44; it would have been performed as a consequence of having LM&#47;3VD&#44; and thus higher mortality could be attributed&#44; at least in part&#44; to the disease itself&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusion</span><p id="par0250" class="elsevierStylePara elsevierViewall">Patients admitted for NSTEMI with a low-risk GRACE score of &#8804;108 at admission had few in-hospital adverse events and low mortality&#44; even though almost one in five had LM&#47;3VD&#46; Nonetheless&#44; despite this apparently good in-hospital prognosis for hard clinical endpoints&#44; these patients had higher absolute values of in-hospital mortality and MACCE&#44; and LM&#47;3VD was associated with longer hospital stay and higher one-year mortality&#44; and was also an independent predictor for CABG during hospitalization&#46; Simple clinical variables are independent predictors of this high-risk coronary anatomy&#44; like older age&#44; higher resting heart rate&#44; male gender&#44; previous diagnosis of heart failure and PAD&#44; and could help the clinician to identify patients who would benefit from an early invasive strategy&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of interest</span><p id="par0255" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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              "titulo" => "Predictors of left main and&#47;or three-vessel disease in patients with low-risk GRACE score"
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            0 => "Non-ST-elevation myocardial infarction"
            1 => "GRACE score"
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            0 => "Enfarte agudo do mioc&#225;rdio sem eleva&#231;&#227;o do segmento ST"
            1 => "<span class="elsevierStyleItalic">Score</span> GRACE"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A low-risk GRACE score identifies patients with a lower incidence of major cardiac events&#44; however it can erroneously classify patients with severe coronary artery disease as low-risk&#46; We assessed the prevalence&#44; clinical outcomes and predictors of left main and&#47;or three-vessel disease &#40;LM&#47;3VD&#41; in non-ST-elevation acute myocardial infarction &#40;NSTEMI&#41; patients with a GRACE score of &#8804;108 at admission&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Using data from the Portuguese Registry on Acute Coronary Syndromes&#44; 1196 patients with NSTEMI and a GRACE score of &#8804;108 who underwent coronary angiography were studied&#46; Independent predictors of LM&#47;3VD and its impact on in-hospital complications and one-year mortality were retrospectively analyzed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">LM&#47;3VD was present in 18&#46;2&#37; of patients&#46; Its prevalence was higher in males and associated with hypertension&#44; diabetes&#44; previous myocardial infarction&#44; heart failure and peripheral arterial disease &#40;PAD&#41;&#46; Although there were no differences in in-hospital complications&#44; these patients had higher mortality &#40;0&#46;9 vs&#46; 0&#46;0&#37;&#41; and more major adverse cardiac and cerebrovascular events &#40;MACCE&#41; &#40;4&#46;1 vs&#46; 2&#46;5&#37;&#44; p&#61;0&#46;172&#41;&#44; and higher one-year mortality &#40;2&#46;4 vs&#46; 0&#46;5&#37;&#44; p&#61;0&#46;005&#41;&#46; Independent predictors of LM&#47;3VD were age &#40;OR 1&#46;03&#59; 95&#37; CI 1&#46;01-1&#46;0&#44; p&#61;0&#46;003&#41;&#44; male gender &#40;OR 2&#46;56&#59; 95&#37; CI 1&#46;56-4&#46;17&#44; p&#60;0&#46;001&#41;&#44; heart rate &#40;1&#46;02&#59; 95&#37; CI 1&#46;01-1&#46;03&#44; p&#60;0&#46;001&#41;&#44; PAD &#40;OR 3&#46;21&#59; 95&#37; CI 1&#46;47-7&#46;00&#44; p&#60;0&#46;001&#41; and heart failure &#40;OR 3&#46;38&#59; 95&#37; CI 1&#46;02-11&#46;15&#44; p&#61;0&#46;046&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">LM&#47;3VD was found in one in five patients&#46; These patients had a tendency for higher in-hospital mortality and more MACCE&#44; and higher one-year mortality&#46; Simple clinical variables could help predict this severe coronary anatomy&#46;</p></span>"
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      "pt" => array:3 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introdu&#231;&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Um baixo <span class="elsevierStyleItalic">Score</span> GRACE est&#225; associado a menor incid&#234;ncia de eventos card&#237;acos <span class="elsevierStyleItalic">major</span> por&#233;m pode erradamente classificar de baixo risco doentes com doen&#231;a coron&#225;ria severa&#46; Pretendeu-se avaliar a preval&#234;ncia&#44; progn&#243;stico e preditores de doen&#231;a do tronco comum&#47;tr&#234;s vasos em doentes com enfarte agudo do mioc&#225;rdio sem eleva&#231;&#227;o do segmento ST e <span class="elsevierStyleItalic">Score</span> GRACE&#8804;108 pontos &#224; admiss&#227;o&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Utilizando dados do Registo Nacional de S&#237;ndromes Coron&#225;rias Agudas&#44; estud&#225;mos 1196 doentes com enfarte agudo do mioc&#225;rdio sem eleva&#231;&#227;o do segmento ST e GRACE&#8804;108 que realizaram coronariografia&#46; Analisados retrospetivamente os preditores independentes de doen&#231;a do tronco comum e&#47;ou tr&#234;s vasos e o seu impacto progn&#243;stico&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Doen&#231;a do tronco comum e&#47;ou tr&#234;s vasos ocorreu em 18&#44;2&#37;&#46; A preval&#234;ncia foi superior no g&#233;nero masculino e associou-se a hipertens&#227;o&#44; diabetes&#44; enfarte pr&#233;vio&#44; insufici&#234;ncia card&#237;aca e doen&#231;a arterial perif&#233;rica&#46; Apesar da aus&#234;ncia de diferen&#231;as nas complica&#231;&#245;es hospitalares&#44; tiveram mais eventos cardiocerebrovasculares <span class="elsevierStyleItalic">major</span> &#40;4&#44;1 <span class="elsevierStyleItalic">versus</span> 2&#44;5&#37;&#44; p&#61;0&#44;172&#41;&#44; maior mortalidade hospitalar &#40;0&#44;9 <span class="elsevierStyleItalic">versus</span> 0&#44;0&#37;&#41; e a um ano &#40;2&#44;4 <span class="elsevierStyleItalic">versus</span> 0&#44;5&#37;&#44; p&#61;0&#44;005&#41;&#46; Considerados preditores de doen&#231;a do tronco comum e&#47;ou tr&#234;s vasos&#58; idade &#40;OR 1&#44;03 &#91;1&#44;01-1&#44;05&#93;&#44; CI 95&#37;&#44;p&#61;0&#44;003&#41;&#44; g&#233;nero masculino &#40;OR 2&#44;56 &#91;1&#44;56-4&#44;17&#93;&#44; CI 95&#37;&#44; p&#60;0&#44;001&#41;&#44; frequ&#234;ncia card&#237;aca &#40;OR 1&#44;02 &#91;1&#44;01-1&#44;03&#93;&#44; CI 95&#37;&#44; p&#60;0&#44;001&#41;&#44; doen&#231;a arterial perif&#233;rica &#40;OR 3&#44;21 &#91;1&#44;47-7&#44;00&#93;&#44; CI 95&#37;&#44; p&#60;0&#44;001&#41; e insufici&#234;ncia card&#237;aca &#40;OR 3&#44;38 &#91;1&#44;02-11&#44;15&#93;&#44; CI 95&#37;&#44; p&#61;0&#44;046&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Doen&#231;a do tronco comum e&#47;ou tr&#234;s vasos ocorre em cerca de um em cada cinco doentes&#46; Verificou-se tend&#234;ncia para maior mortalidade hospitalar e eventos cardio-cerebrovasculares <span class="elsevierStyleItalic">major</span>&#44; e maior mortalidade anual&#46; Vari&#225;veis cl&#237;nicas simples podem ajudar a predizer esta anatomia coron&#225;ria severa&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introdu&#231;&#227;o"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "nomenclatura" => array:1 [
      0 => array:3 [
        "identificador" => "nom0005"
        "titulo" => "<span class="elsevierStyleSectionTitle" id="sect0065">List of abbreviations</span>"
        "listaDefinicion" => array:1 [
          0 => array:1 [
            "definicion" => array:13 [
              0 => array:2 [
                "termino" => "ACS"
                "descripcion" => "<p id="par0005" class="elsevierStylePara elsevierViewall">acute coronary syndrome</p>"
              ]
              1 => array:2 [
                "termino" => "CABG"
                "descripcion" => "<p id="par0010" class="elsevierStylePara elsevierViewall">coronary artery bypass grafting</p>"
              ]
              2 => array:2 [
                "termino" => "CAD"
                "descripcion" => "<p id="par0015" class="elsevierStylePara elsevierViewall">coronary artery disease</p>"
              ]
              3 => array:2 [
                "termino" => "GRACE"
                "descripcion" => "<p id="par0020" class="elsevierStylePara elsevierViewall">Global Registry of Acute Coronary Events</p>"
              ]
              4 => array:2 [
                "termino" => "LAD"
                "descripcion" => "<p id="par0025" class="elsevierStylePara elsevierViewall">left anterior descending artery</p>"
              ]
              5 => array:2 [
                "termino" => "LM&#47;3VD"
                "descripcion" => "<p id="par0030" class="elsevierStylePara elsevierViewall">left main and&#47;or three-vessel disease</p>"
              ]
              6 => array:2 [
                "termino" => "MACCE"
                "descripcion" => "<p id="par0035" class="elsevierStylePara elsevierViewall">major adverse cardiac and cerebrovascular events</p>"
              ]
              7 => array:2 [
                "termino" => "NSTE-ACS"
                "descripcion" => "<p id="par0040" class="elsevierStylePara elsevierViewall">non-ST-elevation acute coronary syndrome</p>"
              ]
              8 => array:2 [
                "termino" => "NSTEMI"
                "descripcion" => "<p id="par0045" class="elsevierStylePara elsevierViewall">non-ST-elevation myocardial infarction</p>"
              ]
              9 => array:2 [
                "termino" => "OR"
                "descripcion" => "<p id="par0050" class="elsevierStylePara elsevierViewall">odds ratio</p>"
              ]
              10 => array:2 [
                "termino" => "PAD"
                "descripcion" => "<p id="par0055" class="elsevierStylePara elsevierViewall">peripheral arterial disease</p>"
              ]
              11 => array:2 [
                "termino" => "ProACS"
                "descripcion" => "<p id="par0060" class="elsevierStylePara elsevierViewall">Portuguese Registry on Acute Coronary Syndromes</p>"
              ]
              12 => array:2 [
                "termino" => "TIMI"
                "descripcion" => "<p id="par0065" class="elsevierStylePara elsevierViewall">Thrombolysis In Myocardial Infarction</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"
            "Alto" => 2214
            "Ancho" => 2167
            "Tamanyo" => 283739
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart of patient selection&#46; ACS&#58; acute coronary syndrome&#59; GRACE&#58; Global Registry of Acute Coronary Events&#59; LM&#47;3VD&#58; left main and&#47;or three-vessel disease&#59; MI&#58; myocardial infarction&#59; NSTE-ACS&#58; non-ST-segment elevation acute coronary syndrome&#59; NSTEMI&#58; non-ST-segment elevation acute myocardial infarction&#59; STEMI&#58; ST-segment elevation myocardial infarction&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
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        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">ACEI&#58; angiotensin-converting enzyme inhibitor&#59; ARB&#58; angiotensin receptor blocker&#59; BMI&#58; body mass index&#59; BP&#58; blood pressure&#59; CABG&#58; coronary artery bypass grafting&#59; ECG&#58; electrocardiogram&#59; GRACE score&#58; Global Registry of Acute Coronary Events&#59; HR&#58; heart rate&#59; IQR&#58; interquartile range&#59; LM&#47;3VD&#58; left main and&#47;or three-vessel disease&#59; LVEF&#58; left ventricular ejection fraction&#59; MI&#58; myocardial infarction&#59; PAD&#58; peripheral arterial disease&#59; PCI&#58; percutaneous coronary intervention&#59; SBP&#58; systolic blood pressure&#46;</p>"
          "tablatextoimagen" => array:1 [
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LM&#47;3VD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No LM&#47;3VD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mean age&#44; years &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#177;9 &#40;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#177;8 &#40;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#177;9 &#40;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Male&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#46;5 &#40;975&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#46;5 &#40;193&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#46;0 &#40;782&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI&#44; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;1&#177;4&#46;4 &#40;1094&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;2&#177;4&#46;0&#37; &#40;203&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;1&#177;4&#46;5&#37; &#40;891&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;749&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Smoking&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#46;6 &#40;557&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#46;0 &#40;98&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#46;9 &#40;459&#47;987&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;596&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hypertension&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#46;0 &#40;691&#47;1171&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#46;8 &#40;150&#47;215&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;6 &#40;541&#47;956&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#46;2 &#40;249&#47;1173&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#46;0 &#40;64&#47;213&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;3 &#40;185&#47;960&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dyslipidemia&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;6 &#40;643&#47;1137&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#46;6 &#40;129&#47;206&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#46;2 &#40;514&#47;931&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;052&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous MI&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;9 &#40;201&#47;1191&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;9 &#40;54&#47;217&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;1&#40;147&#47;974&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous PCI&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;2 &#40;158&#47;1193&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;1 &#40;37&#47;217&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;4 &#40;121&#47;976&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;067&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous CABG&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;3 &#40;27&#47;1195&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;6 &#40;21&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;6 &#40;6&#47;977&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous renal failure&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;0 &#40;12&#47;1192&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;4 &#40;3&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;9 &#40;9&#47;974&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;468&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous PAD&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;9 &#40;34&#47;1188&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;9 &#40;17&#47;216&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;7 &#40;17&#47;972&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous stroke&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;9 &#40;47&#47;1194&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;1 &#40;9&#47;217&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;9 &#40;38&#47;977&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;860&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous heart failure&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;3 &#40;15&#47;1194&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;2 &#40;7&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;8 &#40;8&#47;976&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GRACE score at admission &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#46;3&#177;13&#46;1 &#40;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92&#46;0&#177;12&#46;4 &#40;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89&#46;9&#177;13&#46;3 &#40;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Patient presentation</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chest pain&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#46;7 &#40;1168&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96&#46;3 &#40;210&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&#46;0 &#40;958&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;151&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Syncope&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;8 &#40;10&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;3 &#40;5&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;5 &#40;5&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean HR&#44; bpm &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#177;14 &#40;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76&#177;15 &#40;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#177;14 &#40;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean SBP&#44; mmHg &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">151&#177;29 &#40;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">154&#177;29 &#40;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150&#177;28 &#40;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Killip II-IV&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;5 &#40;6&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;5 &#40;1&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;5 &#40;5&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">ECG</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Normal&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#46;7 &#40;594&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#46;2 &#40;105&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#46;0 &#40;189&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;624&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>T-wave inversion&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#46;9 &#40;417&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#46;7 &#40;80&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#46;5 &#40;337&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;530&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ST-segment deviation&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;8 &#40;22&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;3 &#40;5&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;7 &#40;17&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;577&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Serum creatinine&#44; median mg&#47;dl &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;8 &#91;IQR 0&#46;7&#59;1&#93; &#40;1196&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;8 &#91;IQR 0&#46;7&#59;1&#93; &#40;218&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;8 &#91;IQR 0&#46;7&#59;1&#93; &#40;978&#47;987&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;477&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LVEF &#60;50&#37;&#44; &#37; &#40;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;2 &#40;197&#47;1148&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#46;3 &#40;44&#47;207&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;3 &#40;153&#47;941&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Medication during hospitalization&#44; &#37; &#40;n&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Aspirin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99&#46;2 &#40;1185&#47;1194&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99&#46;1 &#40;215&#47;217&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99&#46;3 &#40;970&#47;977&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;671&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Clopidogrel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92&#46;1 &#40;1099&#47;1193&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92&#46;7 &#40;202&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92&#46;0 &#40;897&#47;975&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;743&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enoxaparin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#46;8 &#40;809&#47;1194&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#46;2 &#40;153&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#46;2 &#40;656&#47;976&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;396&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACEI or ARB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#46;3 &#40;1052&#47;1192&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#46;8 &#40;198&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#46;7 &#40;854&#47;974&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Statin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#46;0 &#40;1158&#47;1194&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95&#46;9 &#40;209&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#46;2 &#40;949&#47;976&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;288&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Beta-blocker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87&#46;7 &#40;1045&#47;1192&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&#46;7 &#40;200&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#46;8 &#40;845&#47;974&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;043&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">CABG&#58; coronary artery bypass grafting&#59; LAD&#58; left anterior descending artery&#59; LCx&#58; left circumflex artery&#59; LM&#58; left main&#59; LM&#47;3VD&#58; left main and&#47;or three-vessel disease&#59; NA&#58; not applicable&#59; RCA&#58; right coronary artery&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LM&#47;3VD&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No LM&#47;3VD&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">&#8805;1 coronary angiographies</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;8 &#40;68&#47;1177&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#47;215 &#40;12&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#47;962 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Femoral access</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">197&#47;1174 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#47;214 &#40;28&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">136&#47;960 &#40;14&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Diseased vessels</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">152&#47;1177 &#40;12&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;199 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">152&#47;978 &#40;15&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">544&#47;1177 &#40;46&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;199 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">544&#47;978 &#40;55&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">302&#47;1177 &#40;25&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#47;199 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">282&#47;978 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">179&#47;1177 &#40;15&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">179&#47;199 &#40;89&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;978 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LM &#40;isolated or not&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#47;1178 &#40;4&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#47;200 &#40;26&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;978 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Culprit artery</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;7 &#40;17&#47;985&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;1 &#40;16&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;1 &#40;1&#47;787&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#46;7 &#40;322&#47;985&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#46;7 &#40;33&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#46;7 &#40;289&#47;787&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LCx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;6 &#40;242&#47;985&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;6 &#40;25&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;6 &#40;217&#47;787&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">209&#47;985 &#40;21&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#47;198 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">176&#47;787 &#40;22&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Graft&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;4 &#40;4&#47;985&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;0 &#40;4&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0 &#40;0&#47;787&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Unidentified&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;4 &#40;191&#47;985&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;9 &#40;87&#47;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;2 &#40;104&#47;787&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Angioplasty performed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#46;9 &#40;788&#47;1195&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#46;8 &#40;115&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#46;9 &#40;673&#47;977&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">CABG</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urgent&#47;secondary endpoint&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;0 &#40;12&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;1 &#40;9&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#47;978 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Planned after transfer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#47;1196 &#40;6&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#47;218 &#40;24&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5 &#40;24&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Planned after discharge&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;7 &#40;32&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;3 &#40;18&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;4 &#40;14&#47;987&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Planned and performed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;1 &#40;121&#47;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#46;7 &#40;80&#47;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;2 &#40;41&#47;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">LM&#47;3VD&#58; left main and&#47;or three-vessel disease&#59; MACCE&#58; major adverse cerebrovascular events &#40;defined as in-hospital mortality&#44; non-fatal stroke&#44; reinfarction or heart failure&#41;&#59; NA&#58; not applicable&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n&#61;1196&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LM&#47;3VD &#40;n&#61;218&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No LM&#47;3VD &#40;n&#61;978&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Reinfarction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;123&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stroke&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;087&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;566&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cardiogenic shock<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atrial fibrillation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atrioventricular block&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;063&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Resuscitated cardiac arrest&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;227&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Major bleeding&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;0&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">MACCE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;172&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">In-hospital mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">In-hospital adverse events and in-hospital mortality&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LM&#47;3VD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;757&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;748&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;312&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;287&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;55 &#40;5&#46;42-841&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;748&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;12 &#40;1&#46;88-35&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;56 &#40;1&#46;56-4&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;609&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;38 &#40;1&#46;02-11&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Heart rate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;02 &#40;1&#46;01-1&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;166&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;398&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;21 &#40;1&#46;47-7&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        ]
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          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Multivariate logistic regression assessing predictors of left main and&#47;or three-vessel disease in patients with non-ST-elevation myocardial infarction and low-risk GRACE score&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:32 [
            0 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The TIMI risk score for unstable angina&#47;non-ST elevation MI&#58; a method for prognostication and therapeutic decision making"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46;M&#46; Antman"
                            1 => "M&#46; Cohen"
                            2 => "P&#46;J&#46; Bernink"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2000"
                        "volumen" => "284"
                        "paginaInicial" => "835"
                        "paginaFinal" => "842"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10938172"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of hospital mortality in the Global Registry of Acute Coronary Events"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;B&#46; Granger"
                            1 => "R&#46;J&#46; Goldberg"
                            2 => "O&#46; Dabbous"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archinte.163.19.2345"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "2003"
                        "volumen" => "163"
                        "paginaInicial" => "2345"
                        "paginaFinal" => "2353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14581255"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefit of early invasive therapy in acute coronary syndromes&#58; a meta-analysis of contemporary randomized clinical trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;A&#46; Bavry"
                            1 => "D&#46;J&#46; Kumbhani"
                            2 => "A&#46;N&#46; Rassi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2006.06.050"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2006"
                        "volumen" => "48"
                        "paginaInicial" => "1319"
                        "paginaFinal" => "1325"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17010789"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "4"
              "referencia" => array:1 [
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Article information

ISSN: 21742049
Original language: English

DOI:10.1016/j.repce.2018.03.020

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Year/Month	Html	Pdf	Total

2024 November	8	5	13
2024 October	62	32	94
2024 September	71	30	101
2024 August	65	24	89
2024 July	65	30	95
2024 June	58	27	85
2024 May	47	34	81
2024 April	48	25	73
2024 March	46	29	75
2024 February	43	25	68
2024 January	51	22	73
2023 December	55	16	71
2023 November	73	28	101
2023 October	58	17	75
2023 September	53	24	77
2023 August	50	13	63
2023 July	68	10	78
2023 June	85	19	104
2023 May	116	29	145
2023 April	73	5	78
2023 March	121	23	144
2023 February	76	21	97
2023 January	53	16	69
2022 December	76	24	100
2022 November	80	25	105
2022 October	45	24	69
2022 September	33	35	68
2022 August	37	25	62
2022 July	41	42	83
2022 June	39	23	62
2022 May	45	29	74
2022 April	62	29	91
2022 March	60	41	101
2022 February	64	34	98
2022 January	81	32	113
2021 December	60	21	81
2021 November	63	35	98
2021 October	98	43	141
2021 September	83	24	107
2021 August	101	23	124
2021 July	91	25	116
2021 June	66	41	107
2021 May	92	34	126
2021 April	251	59	310
2021 March	163	20	183
2021 February	155	18	173
2021 January	124	22	146
2020 December	115	14	129
2020 November	128	23	151
2020 October	99	10	109
2020 September	109	11	120
2020 August	117	18	135
2020 July	129	11	140
2020 June	119	10	129
2020 May	111	14	125
2020 April	128	11	139
2020 March	145	23	168
2020 February	225	30	255
2020 January	148	11	159
2019 December	224	11	235
2019 November	137	9	146
2019 October	181	14	195
2019 September	131	20	151
2019 August	60	9	69
2019 July	43	8	51
2019 June	39	18	57
2019 May	24	7	31
2019 April	28	16	44
2019 March	14	17	31
2019 February	10	10	20
2019 January	14	5	19
2018 December	9	16	25

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