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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Contrast-induced nephropathy &#40;CIN&#41; is an iatrogenic disease occurring after the intravascular injection of iodinated radiographic contrast media and is a significant cause of acute renal failure&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> The mechanism of CIN is as yet not clearly understood&#46; It is associated with increased in-hospital mortality and subsequently contributes to morbidity and prolonged hospitalization&#44; and increases the costs of health care&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">2&#44;3</span></a> The incidence of CIN varies depending on the study population&#44; although it has decreased in recent years due to use of less nephrotoxic contrast agents and better prevention strategies&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">4</span></a> However&#44; CIN developing after coronary angiography is still a major cause of mortality and morbidity&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">5</span></a> It is therefore clinically important to predict the risk of developing CIN and there is a need to identify new biomarkers for its rapid and accurate diagnosis&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Pituitary vasopressin plays important roles in the regulation of osmotic pressure and homeostasis&#46; Copeptin is the C-terminal part of pro-arginine vasopressin and may serve as a potent biomarker of cardiovascular disease&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">6</span></a> Vasopressin plays an important role in water homeostasis&#44; but has a very short half-life and is unstable in vitro&#44; which makes it difficult to quantify&#46; The function of copeptin remains unknown&#44; but it is secreted in equimolar quantities to vasopressin and has the advantage of high stability in blood samples&#46; Owing to its involvement in the adrenocorticotropic hormone cycle&#44; copeptin has been proposed to be a marker of severe stress reactions as well as of hemodynamic triggers&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">7&#44;8</span></a> In recent years&#44; studies have also found that copeptin may increase albuminuria<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">9</span></a> and predict the outcomes of adverse cardiac and renal events&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">10</span></a> We therefore hypothesized that copeptin may be a sensitive biomarker to predict changes in renal function&#44; with clinical importance in the early diagnosis and assessment of progression of CIN in STEMI patients&#46; The association of copeptin and CIN in STEMI patients was also investigated in the present study&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patient population</span><p id="par0015" class="elsevierStylePara elsevierViewall">After approval from the Ethics Committee&#44; a total of 274 consecutive patients &#40;229 male&#44; 45 female&#41; admitted to our hospital due to acute STEMI who had undergone primary percutaneous coronary intervention &#40;PCI&#41; &#40;angioplasty and&#47;or stent implantation&#41; between December 2016 and April 2017 were prospectively included in the study&#46; The clinical and demographic characteristics of the patients were recorded&#46; The following diagnostic criteria for STEMI were used&#58; ST-segment elevation in &#8805;2 contiguous leads &#40;&#8805;2 mm in precordial leads&#44; &#8805;1 mm in limb leads&#41; or new-onset left bundle branch block&#59; ischemic type chest pain lasting more than 30 min&#59; and a two-fold or greater elevation in serum creatine kinase-myocardial band &#40;CK-MB&#41; and troponin levels&#46; Patients with severe infection&#44; those allergic to contrast media and those undergoing chronic dialysis were excluded from the study&#44; as were those under treatment with any thrombolytic agents or who died within 48-72 hours in the coronary intensive care unit&#46; A 12-lead ECG recording was obtained for all patients just after admission and the type of myocardial infarction &#40;MI&#41; was determined&#46; Blood samples were obtained at the time of admission and during follow-up and analyzed on a Coulter LH 780 analyzer &#40;Beckman Coulter Ireland Inc&#46;&#44; Mervue&#44; Galway&#44; Ireland&#41;&#46; Echocardiography &#40;Vingmed&#44; GE&#44; Horten&#44; Norway&#41; was performed by an experienced cardiologist at the coronary intensive care unit just after the PCI procedure&#44; and left ventricular ejection fraction was calculated using the modified Simpson method&#46; Daily blood samples were taken and changes in serum creatinine were determined&#46; Patients were divided into two groups according to the presence &#40;CIN&#43;&#41; or absence &#40;CIN-&#41; of CIN&#44; which was defined as impairment of renal function measured as either a 25&#37; increase in serum creatinine from baseline or a 0&#46;5 mg&#47;dl &#40;44 &#956;mol&#47;l&#41; increase in absolute serum creatinine within 48-72 hours of intravenous contrast administration&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">11</span></a> A diagnosis of anemia was made if hemoglobin was &#60;11&#46;5 g&#47;dl&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Coronary angiography and in-hospital follow-up</span><p id="par0020" class="elsevierStylePara elsevierViewall">All PCI procedures were performed via the femoral route by an experienced cardiologist using an Axiom Artis Zee system &#40;Siemens&#44; Germany&#41;&#46; Non-ionic low osmolality contrast medium &#40;Omnipaque 350 mg&#47;ml&#59; GE Healthcare&#44; Cork&#44; Ireland&#41; was used for the procedures&#46; All patients were given 300 mg aspirin&#44; 600 mg clopidogrel or 180 mg ticagrelor loading dose prior to the procedure&#44; and 100 U&#47;kg heparin was administered after visualization of the arterial anatomy&#46; Use of glycoprotein IIb&#47;IIIa inhibitors was at the discretion of the physician&#46; All patients were transferred to the intensive care unit after the procedure and treatment continued with 100 mg aspirin&#44; 75 mg clopidogrel or 90 mg ticagrelor twice daily&#46; The decision for concurrent use of statins&#44; angiotensin-converting enzyme inhibitors and beta-blockers was made according to the guidelines of the American College of Cardiology&#47;American Heart Association&#46; Use of nephrotoxic agents and non-steroidal anti-inflammatory drugs was avoided&#46; Patients who did not have congestive heart failure were administered 1 ml&#47;kg&#47;h of 0&#46;9&#37; isotonic saline solution for 24 hours&#46; Oral fluid intake was begun 90 min after the procedure for patients with good general status&#46; Blood pressure and electrocardiographic monitoring were performed at the intensive care unit and control blood samples were obtained&#46; Plasma creatinine values were monitored for 72 hours after the procedure&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0025" class="elsevierStylePara elsevierViewall">The statistical analysis was performed using SPSS 15&#46;0 for Windows Evaluation Version&#46; Normality of distribution was assessed using the Kolmogorov-Smirnov test&#46; Continuous variables were presented as mean &#177; standard deviation or median &#40;interquartile range&#41; and categorical variables were summarized as frequencies&#46; Differences between the two groups in continuous variables were determined by the independent samples t test&#46; Categorical variables were compared by the chi-square test or Fisher&#39;s exact test&#46; Logistic regression analysis was used to determine the effect of potential prognostic factors on the occurrence of CIN&#44; and independent predictors were determined by inclusion of significant risk factors in the logistic regression model&#46; Receiver operating characteristic &#40;ROC&#41; curve analysis was used to determine the optimum cut-off level of sensitivity and specificity&#46; A p-value of &#60;0&#46;05 was accepted as statistically significant with 95&#37; confidence interval and 5&#37; margin of error&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0030" class="elsevierStylePara elsevierViewall">The study population &#40;n&#61;274&#44; mean age 56&#46;69&#177;11&#46;85&#44; 16&#46;4&#37; female&#41; was divided into two groups as follows&#58; 69 &#40;25&#46;1&#37;&#41; CIN&#43; and 205 &#40;74&#46;8&#37;&#41; CIN-&#46; There was no significant difference in mean age between the groups&#44; but the prevalence of females was significantly higher in the CIN- group than in the CIN&#43; group &#40;19&#37; vs&#46; 8&#46;6&#37;&#59; p&#60;0&#46;05&#41;&#46; No differences were observed between the groups with regard to other demographic characteristics&#46; Copeptin levels &#40;10&#46;68&#177;6&#46;43 vs&#46; 7&#46;07&#177;05&#46;53 pmol&#47;l&#59; p&#60;0&#46;001&#41; and peak creatinine &#40;1&#46;46&#177;1&#46;20 vs&#46; 1&#46;03&#177;0&#46;20 mg&#47;dl&#59; p&#61;0&#46;005&#41; were significantly higher in the CIN&#43; group compared to the CIN- group&#46; No differences were observed between the groups with regard to other laboratory findings&#46; Previous prescription of diuretics was significantly higher in the CIN&#43; group &#40;8&#46;6&#37; vs&#46; 2&#46;9&#37;&#59; p&#61;0&#46;047&#41;&#46; No significant difference was observed between the groups in quantity of contrast media used &#40;196&#46;75&#177;53&#46;57 vs&#46; 180&#46;65&#177;54&#46;68 cc&#59; p&#61;0&#46;143&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Four patients &#40;5&#46;8&#37;&#41; who developed CIN required dialysis in hospital follow-up&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Among the demographic and laboratory findings &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#44; variables associated with CIN were analyzed as potential risk factors and were assessed by logistic regression analysis&#46; Copeptin level at admission &#40;odds ratio &#91;OR&#93;&#58; 2&#46;36&#44; p&#61;0&#46;005&#41;&#44; and peak creatinine &#40;OR&#58; 6&#46;44&#44; p&#61;0&#46;004&#41; were found to be independent predictors of development of CIN&#46; Female gender and diuretic use were not found to be independent predictors of CIN development &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; In ROC curve analysis&#44; admission copeptin above a cut-off of 7&#46;72 pmol&#47;l predicted CIN with sensitivity of 73&#46;9&#37; and specificity of 73&#46;7&#37; &#40;area under the curve&#58; 0&#46;72&#59; 95&#37; confidence interval&#58; 0&#46;65-0&#46;79&#59; p&#60;0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">CIN is an important cause of concern for physicians and is a significant cause of iatrogenic acute renal failure&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> A biomarker that predicts CIN development could thus enable measures to be taken to prevent renal failure&#46; In this study&#44; we determined that copeptin is a independent predictor of CIN in patients with STEMI&#46; To the best of our knowledge&#44; this study is the first to determine such a relationship between copeptin and CIN&#46; The results indicate that the CIN rate increases significantly in patients with high copeptin levels who have undergone primary PCI for STEMI&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The mechanism of CIN is not yet fully understood&#46; Reactive oxygen species &#40;ROS&#41;-induced combined hypoxic and toxic injury is important in the development of CIN&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">12</span></a> Renal oxygenation is significantly decreased and medullary hypoxia leads to ROS production and thus increased oxidative stress&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">13</span></a> While ROS trigger vasoconstrictive signals such as angiotensin II and endothelin I&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">14</span></a> they also reduce the bioavailability of nitric oxide&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">15</span></a> There are also studies indicating that contrast administration leads to vasoconstriction in the renal arteries&#44; reducing renal blood flow&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">16</span></a> As is evident&#44; the underlying pathophysiology of CIN is complex and further studies are needed to understand this issue&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The incidence of CIN varies depending on the population&#46; The main risk factors for its development include impaired renal function&#44; heart failure&#44; age &#40;&#62;65 years&#41;&#44; diabetes&#44; nephrotoxic drugs&#44; decreased intravascular volume&#44; long-standing hypotension&#44; anemia&#44; renal transplantation&#44; female gender&#44; high doses of contrast medium and multiple contrast injections within 72 hours&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">17</span></a> Contrast-medium osmolality is also important&#46; Use of low-osmolality instead of high-osmolality contrast medium has been shown to be better for prevention of CIN&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">18</span></a> Therefore&#44; in our study we opted to use low-osmolality contrast medium&#44; aimed to maintain sufficient hydration and avoided the use of nephrotoxic drugs&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The incidence of CIN is higher in patients who undergo coronary angiography than in outpatients &#40;10-15&#37; vs&#46; &#60;5&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">17</span></a> and previous studies have shown rates up to 25&#37; in STEMI patients&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">18</span></a> The higher incidence in this group may be associated with the high-risk profile of these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">19</span></a> The rate was found to be 25&#46;1&#37; in our study&#46; We consider that this high rate may be related to the fact that our study population was composed of high-risk patients with many comorbidities&#46; It also appears that the use of intra-arterial contrast administration is one of the causes of the high CIN rate in patients undergoing coronary intervention&#59; intra-arterial administration is associated with more risk than intravenous administration&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">20</span></a> In addition&#44; timing is important in determining the incidence of CIN&#44; since creatinine elevation is relatively slow&#44; 48-72 hours being required to identify many cases of CIN&#44; and therefore studies assessing CIN at 24-48 hours after contrast exposure underestimate its rate&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">21</span></a> CIN incidence may be assumed to be low in patients undergoing elective PCI&#44; due to early discharge of these patients and lack of blood tests in the early post-discharge period&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">22</span></a> Our study has shown that CIN is still common among hospitalized patients&#44; but its development can be predicted and its incidence can be decreased if appropriate measures are taken&#46; The current European guidelines on myocardial revascularization recommend risk assessment for acute renal damage for prevention of CIN&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">25</span></a> This indicates the importance of risk detection for CIN&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">We believe that copeptin&#44; which has been associated with cardiovascular and renal disease in previous studies&#44; can help in this regard&#46; The close relationship between copeptin and renal disease has been revealed in many studies&#46; Copeptin was found to be affected by mean blood pressure and blood volume and is elevated during pre-dialysis and dialysis periods&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a> and is an early indicator of reduced glomerular filtration rate and renal function in diabetic patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">24&#44;25</span></a> In addition&#44; a community-based cohort study revealed an independent positive relationship between plasma copeptin level and progression to chronic kidney disease &#40;CKD&#41;&#44; demonstrating that its close relationship with renal function is valid not only in patients with CKD&#44; but also in the general population&#44;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">26</span></a> and copeptin is associated with increased risk of CKD even in the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">27</span></a> Furthermore&#44; elevated copeptin has proved a valuable prognostic factor for mid-term mortality in patients with both coronary artery disease and kidney disease&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">28</span></a> The relationship between copeptin and cardiac disorders such as heart failure&#44; coronary artery disease and hypertension has been shown in many previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">29&#8211;31</span></a> Copeptin has been shown to be an independent marker for long-term prognosis in heart failure&#44;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">32&#44;33</span></a> it may be a marker for diagnosis of left ventricular dysfunction in hemodialysis patients&#44;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">34</span></a> and is associated with coronary atherosclerosis in diabetic patients<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">35&#44;36</span></a> and with resistant hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">37</span></a> A rise in copeptin levels two days after STEMI has also been shown to be related to larger acute and chronic infarct size&#44; and initially elevated copeptin level is related to myocardial function and remodeling four months after STEMI&#46; These results highlight the role of copeptin as a biomarker of negative post-STEMI results&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">38</span></a> Copeptin has also been shown to be useful for diagnosing or excluding acute coronary syndrome &#40;ACS&#41; and for safe and early discharge or shortening duration of emergency room stay in low- or moderate-risk patients suspected of suffering ACS when the results of copeptin and troponin are used in combination&#44; as copeptin is elevated in the early period of ACS&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">39&#44;40</span></a> In addition to these findings&#44; rapid copeptin measurement is suggested as a practical and useful tool for medium- and long-term risk assessment in the emergency room&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">In a study assessing acute renal damage in STEMI patients&#44; Guerchicoff et al&#46; investigated the relationship between acute renal damage and B-type natriuretic peptide &#40;BNP&#41;&#44; chemokine &#40;C-C motif&#41; ligand 23&#44; D-dimer&#44; endothelial cell-selective adhesion molecule&#44; C-reactive protein&#44; cystatin C&#44; adiponectin and von Willebrand factor&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">22</span></a> Levels of these biomarkers on admission were not found to be significant predictors for CIN development&#44; except for BNP&#46; Although a significant relationship was seen between these biomarkers and CIN during hospital stay and after discharge&#44; we consider that&#44; except for BNP&#44; they have limited benefit in predicting CIN development&#44; and taking measurements within 48-72 hours of contrast administration is important for preventing CIN development&#46; Our study differs from that of Guerchicoff et al&#46;&#44; as it investigates the relationship between copeptin and CIN&#44; and our study has revealed that copeptin levels on admission can predict CIN&#46; This may help clinicians to assess the risk and to take appropriate measures&#46; In addition&#44; a statistically significant relationship was found between CIN and peak creatinine level in our study&#46; However&#44; since CIN has already developed by the time peak creatinine is detected&#44; peak creatinine is not a predictive marker&#44; but has only diagnostic value&#44; and is not useful for taking measures to prevent CIN development&#46; As in Guerchicoff et al&#46;&#44; no relationship was found between adinopectin level on admission and CIN development in our study&#46; We therefore consider that copeptin is a more valuable marker than adinopectin for prediction of CIN&#46; Copeptin levels also have the advantage of being detected rapidly and easily&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Our findings indicate that physicians should be aware of the possibility of CIN development in patients with high copeptin levels and that preventive measures should start early&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Study limitations</span><p id="par0075" class="elsevierStylePara elsevierViewall">The present study has some limitations&#46; It was based on a single center&#44; included only STEMI patients and not those with other forms of MI&#44; and did not fully analyze potential nephrotoxic agents&#46; Another limitation is that this study did not include long-term results such as copeptin level after reversal of contrast nephropathy&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Copeptin level is an independent predictor of CIN development in patients with acute STEMI&#46; One of the advantages of measuring copeptin compared to other biomarkers is that copeptin at admission can predict CIN at an early stage&#46; Assessment of copeptin level may be helpful for taking measures to prevent CIN development in patients who are to undergo PCI&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Funding</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors received no financial support for the research&#44; authorship&#44; and&#47;or publication of this article&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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              "titulo" => "Coronary angiography and in-hospital follow-up"
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    "fechaRecibido" => "2018-12-18"
    "fechaAceptado" => "2019-06-22"
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            0 => "Contrast-induced nephropathy"
            1 => "Copeptin"
            2 => "Myocardial infarction"
            3 => "Percutaneous coronary intervention"
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            0 => "Nefropatia induzida por contraste"
            1 => "Copeptina"
            2 => "Enfarte do mioc&#225;rdio"
            3 => "Interven&#231;&#227;o coron&#225;ria percut&#226;nea"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to investigate the predictive value of copeptin levels in the development of contrast-induced nephropathy &#40;CIN&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A total of 274 patients diagnosed with ST-elevation myocardial infarction &#40;STEMI&#41; and who had undergone primary percutaneous coronary intervention were included in the study&#46; The patients were divided into two groups according to the presence &#40;CIN&#43;&#41; or absence &#40;CIN-&#41; of CIN&#46; These groups were compared in terms of demographic characteristics&#44; laboratory findings and risk factors&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Copeptin levels &#40;10&#46;68&#177;6&#46;43 vs&#46; 7&#46;07&#177;05&#46;53 pmol&#47;l&#59; p&#60;0&#46;001&#41; and peak creatinine &#40;1&#46;46&#177;1&#46;20 vs&#46; 1&#46;03&#177;0&#46;20 mg&#47;dl&#59; p&#61;0&#46;005&#41; were significantly higher in the CIN&#43; group than in the CIN- group&#46; Female gender was significantly more prevalent in the CIN- group compared to the CIN&#43; group &#40;19&#37; vs&#46; 8&#46;6&#37;&#59; p&#60;0&#46;05&#41;&#46; Copeptin level at hospital admission &#40;OR&#58; 2&#46;36&#44; p&#61;0&#46;005&#41; was found to be an independent predictor for CIN development&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Copeptin level is an independent predictor of CIN development in patients with acute STEMI that can be detected rapidly and easily&#46; This result indicates that physicians should be aware of the possibility of CIN development in patients with high copeptin levels and preventive measures should start early&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise do valor preditivo dos n&#237;veis de copeptina no desenvolvimento da nefropatia induzida por contraste &#40;NIC&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos no estudo 274 doentes&#44; diagnosticados com enfarte do mioc&#225;rdio com eleva&#231;&#227;o do segmento ST &#40;STEMI&#41; e submetidos a angioplastia coron&#225;ria prim&#225;ria&#46; Os doentes foram divididos em dois grupos de acordo com a confirma&#231;&#227;o de NIC&#46; Estes grupos foram comparados quanto &#224;s caracter&#237;sticas demogr&#225;ficas&#44; achados laboratoriais e fatores de risco&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">O n&#237;vel de copeptina &#40;10&#44;68&#177;6&#44;43 <span class="elsevierStyleItalic">versus</span> 7&#44;07&#177;5&#44;53&#59; p&#60;0&#44;001&#41; e o pico dos n&#237;veis de creatinina &#40;1&#44;46&#177;1&#44;20 <span class="elsevierStyleItalic">versus</span> 1&#44;03&#177;0&#44;20&#59; p&#61;0&#44;005&#41; foram significativamente superiores nos grupos de NIC &#40;&#43;&#41; quando comparados com os grupos de NIC &#40;-&#41;&#46; A percentagem do g&#233;nero feminino foi significativamente superior no grupo NIC &#40;-&#41; quando comparada com o grupo NIC &#40;&#43;&#41; &#40;19&#37; <span class="elsevierStyleItalic">versus</span> 8&#44;6&#37;&#59; p&#60;0&#44;05&#41;&#46; O n&#237;vel da copeptina no momento do internamento &#40;OR&#58; 2&#44;36&#44; p&#61;0&#44;005&#41; foi considerado como um valor preditor independente no desenvolvimento da NIC&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O n&#237;vel da copeptina &#233; um fator preditor independente do desenvolvimento da NIC em doentes com STEMI agudo&#46; Pode ser detetado r&#225;pida e facilmente e este resultado indica que os m&#233;dicos devem ser mais cuidadosos em rela&#231;&#227;o ao desenvolvimento da NIC em doentes com n&#237;veis de copeptina levados&#46; Medidas preventivas devem ser tomadas precocemente&#46;</p></span>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Receiver operating characteristic curve of copeptin level and contrast-induced nephropathy&#46; AUC&#58; area under the curve&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CABG&#58; coronary artery bypass grafting&#59; CCBs&#58; calcium channel blockers&#59; CIN&#43;&#58; patients with contrast-induced nephropathy&#59; CIN-&#58; patients without contrast-induced nephropathy&#59; CK-MB&#58; creatine kinase-myocardial band&#59; DBP&#58; diastolic blood pressure&#59; eGFR&#58; estimated glomerular filtration rate&#59; HDL-C&#58; high-density lipoprotein cholesterol&#59; LDL-C&#58; low-density lipoprotein cholesterol&#59; LVEF&#58; left ventricular ejection fraction&#59; MI&#58; myocardial infarction&#59; PCI&#58; percutaneous coronary intervention&#59; SBP&#58; systolic blood pressure&#59; WBC&#58; white blood cell count&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Continuous variables are reported as mean &#177; standard deviation or median &#40;interquartile range&#41;&#46; Categorical variables are reported as n &#40;&#37;&#41;&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CIN&#43; &#40;n&#61;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CIN- &#40;n&#61;205&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Mean age&#44; years&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">57&#46;50&#177;13&#46;53&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">56&#46;42&#177;11&#46;27&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;552&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Female gender&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">39 &#40;19&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;047&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Diabetes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">21 &#40;30&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">55 &#40;26&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;502&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hypertension&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24 &#40;34&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">79 &#40;38&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;651&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Family history&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">31 &#40;44&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">83 &#40;40&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;439&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hyperlipidemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;23&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">61 &#40;29&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;428&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Current smoker&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">20 &#40;28&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">70 &#40;34&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;678&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">LVEF&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">47&#46;12&#177;10&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">47&#46;66&#177;11&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;770&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cerebrovascular disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;2&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">9 &#40;4&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;603&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">BMI&#44; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27&#46;98&#177;3&#46;57&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27&#46;15&#177;4&#46;03&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;176&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Previous CABG&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2 &#40;2&#46;89&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5 &#40;2&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;793&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">PCI history&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">6 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">13 &#40;6&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;448&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Killip class</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;23&#177;0&#46;76&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;11&#177;0&#46;52&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Anterior MI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">34 &#40;49&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">86 &#40;41&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;275&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Shock&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;5&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;3&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;490&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Anemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">16 &#40;23&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41 &#40;20&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;536&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">SBP&#44; mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127&#46;0&#177;24&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">125&#46;98&#177;23&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;761&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">DBP&#44; mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&#46;51&#177;15&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;02&#177;15&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Heart rate&#44; bpm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#46;74&#177;19&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;85&#177;19&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Laboratory findings</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Copeptin&#44; pmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;68&#177;6&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;07&#177;5&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adiponectin&#44; &#956;g&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;41&#177;17&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;09&#177;6&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;277&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>First day creatinine&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;82&#177;0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;88&#177;0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;086&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peak creatinine&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;46&#177;1&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;03&#177;0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peak CK-MB&#44; U&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">180&#46;67&#177;126&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">186&#46;02&#177;180&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;824&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Troponin&#44; ng&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;67&#177;30&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;31&#177;33&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;957&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LDL-C&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114&#46;22&#177;32&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124&#46;64&#177;40&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HDL-C&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#177;9&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;77&#177;9&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;559&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Triglycerides&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163&#46;60&#177;72&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163&#46;83&#177;85&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;984&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HbA1c&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;08&#177;0&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;26&#177;1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;356&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sodium&#44; mmol&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#46;57&#177;7&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">137&#46;26&#177;3&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Potassium&#44; mmol&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;31&#177;0&#46;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;21&#177;0&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>eGFR&#44; ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103&#46;94&#177;41&#46;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#46;47&#177;32&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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Original Article
Association between copeptin and contrast-induced nephropathy in patients with ST-elevation myocardial infarction
Associação entre a copeptina e a nefropatia induzida por contraste nos doentes com enfarte do miocárdio com elevação do segmento ST
Ersin Yildirima,
Corresponding author
ersinyil44@gmail.com

Corresponding author.
, Ayca Turer Cabbarb
a Istanbul Umraniye Education and Research Hospital, University of Health Sciences, Department of Cardiology, Turkey
b Yeditepe University Faculty of Medicine, Department of Cardiology, Turkey
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Contrast-induced nephropathy &#40;CIN&#41; is an iatrogenic disease occurring after the intravascular injection of iodinated radiographic contrast media and is a significant cause of acute renal failure&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> The mechanism of CIN is as yet not clearly understood&#46; It is associated with increased in-hospital mortality and subsequently contributes to morbidity and prolonged hospitalization&#44; and increases the costs of health care&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">2&#44;3</span></a> The incidence of CIN varies depending on the study population&#44; although it has decreased in recent years due to use of less nephrotoxic contrast agents and better prevention strategies&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">4</span></a> However&#44; CIN developing after coronary angiography is still a major cause of mortality and morbidity&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">5</span></a> It is therefore clinically important to predict the risk of developing CIN and there is a need to identify new biomarkers for its rapid and accurate diagnosis&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Pituitary vasopressin plays important roles in the regulation of osmotic pressure and homeostasis&#46; Copeptin is the C-terminal part of pro-arginine vasopressin and may serve as a potent biomarker of cardiovascular disease&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">6</span></a> Vasopressin plays an important role in water homeostasis&#44; but has a very short half-life and is unstable in vitro&#44; which makes it difficult to quantify&#46; The function of copeptin remains unknown&#44; but it is secreted in equimolar quantities to vasopressin and has the advantage of high stability in blood samples&#46; Owing to its involvement in the adrenocorticotropic hormone cycle&#44; copeptin has been proposed to be a marker of severe stress reactions as well as of hemodynamic triggers&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">7&#44;8</span></a> In recent years&#44; studies have also found that copeptin may increase albuminuria<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">9</span></a> and predict the outcomes of adverse cardiac and renal events&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">10</span></a> We therefore hypothesized that copeptin may be a sensitive biomarker to predict changes in renal function&#44; with clinical importance in the early diagnosis and assessment of progression of CIN in STEMI patients&#46; The association of copeptin and CIN in STEMI patients was also investigated in the present study&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patient population</span><p id="par0015" class="elsevierStylePara elsevierViewall">After approval from the Ethics Committee&#44; a total of 274 consecutive patients &#40;229 male&#44; 45 female&#41; admitted to our hospital due to acute STEMI who had undergone primary percutaneous coronary intervention &#40;PCI&#41; &#40;angioplasty and&#47;or stent implantation&#41; between December 2016 and April 2017 were prospectively included in the study&#46; The clinical and demographic characteristics of the patients were recorded&#46; The following diagnostic criteria for STEMI were used&#58; ST-segment elevation in &#8805;2 contiguous leads &#40;&#8805;2 mm in precordial leads&#44; &#8805;1 mm in limb leads&#41; or new-onset left bundle branch block&#59; ischemic type chest pain lasting more than 30 min&#59; and a two-fold or greater elevation in serum creatine kinase-myocardial band &#40;CK-MB&#41; and troponin levels&#46; Patients with severe infection&#44; those allergic to contrast media and those undergoing chronic dialysis were excluded from the study&#44; as were those under treatment with any thrombolytic agents or who died within 48-72 hours in the coronary intensive care unit&#46; A 12-lead ECG recording was obtained for all patients just after admission and the type of myocardial infarction &#40;MI&#41; was determined&#46; Blood samples were obtained at the time of admission and during follow-up and analyzed on a Coulter LH 780 analyzer &#40;Beckman Coulter Ireland Inc&#46;&#44; Mervue&#44; Galway&#44; Ireland&#41;&#46; Echocardiography &#40;Vingmed&#44; GE&#44; Horten&#44; Norway&#41; was performed by an experienced cardiologist at the coronary intensive care unit just after the PCI procedure&#44; and left ventricular ejection fraction was calculated using the modified Simpson method&#46; Daily blood samples were taken and changes in serum creatinine were determined&#46; Patients were divided into two groups according to the presence &#40;CIN&#43;&#41; or absence &#40;CIN-&#41; of CIN&#44; which was defined as impairment of renal function measured as either a 25&#37; increase in serum creatinine from baseline or a 0&#46;5 mg&#47;dl &#40;44 &#956;mol&#47;l&#41; increase in absolute serum creatinine within 48-72 hours of intravenous contrast administration&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">11</span></a> A diagnosis of anemia was made if hemoglobin was &#60;11&#46;5 g&#47;dl&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Coronary angiography and in-hospital follow-up</span><p id="par0020" class="elsevierStylePara elsevierViewall">All PCI procedures were performed via the femoral route by an experienced cardiologist using an Axiom Artis Zee system &#40;Siemens&#44; Germany&#41;&#46; Non-ionic low osmolality contrast medium &#40;Omnipaque 350 mg&#47;ml&#59; GE Healthcare&#44; Cork&#44; Ireland&#41; was used for the procedures&#46; All patients were given 300 mg aspirin&#44; 600 mg clopidogrel or 180 mg ticagrelor loading dose prior to the procedure&#44; and 100 U&#47;kg heparin was administered after visualization of the arterial anatomy&#46; Use of glycoprotein IIb&#47;IIIa inhibitors was at the discretion of the physician&#46; All patients were transferred to the intensive care unit after the procedure and treatment continued with 100 mg aspirin&#44; 75 mg clopidogrel or 90 mg ticagrelor twice daily&#46; The decision for concurrent use of statins&#44; angiotensin-converting enzyme inhibitors and beta-blockers was made according to the guidelines of the American College of Cardiology&#47;American Heart Association&#46; Use of nephrotoxic agents and non-steroidal anti-inflammatory drugs was avoided&#46; Patients who did not have congestive heart failure were administered 1 ml&#47;kg&#47;h of 0&#46;9&#37; isotonic saline solution for 24 hours&#46; Oral fluid intake was begun 90 min after the procedure for patients with good general status&#46; Blood pressure and electrocardiographic monitoring were performed at the intensive care unit and control blood samples were obtained&#46; Plasma creatinine values were monitored for 72 hours after the procedure&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0025" class="elsevierStylePara elsevierViewall">The statistical analysis was performed using SPSS 15&#46;0 for Windows Evaluation Version&#46; Normality of distribution was assessed using the Kolmogorov-Smirnov test&#46; Continuous variables were presented as mean &#177; standard deviation or median &#40;interquartile range&#41; and categorical variables were summarized as frequencies&#46; Differences between the two groups in continuous variables were determined by the independent samples t test&#46; Categorical variables were compared by the chi-square test or Fisher&#39;s exact test&#46; Logistic regression analysis was used to determine the effect of potential prognostic factors on the occurrence of CIN&#44; and independent predictors were determined by inclusion of significant risk factors in the logistic regression model&#46; Receiver operating characteristic &#40;ROC&#41; curve analysis was used to determine the optimum cut-off level of sensitivity and specificity&#46; A p-value of &#60;0&#46;05 was accepted as statistically significant with 95&#37; confidence interval and 5&#37; margin of error&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0030" class="elsevierStylePara elsevierViewall">The study population &#40;n&#61;274&#44; mean age 56&#46;69&#177;11&#46;85&#44; 16&#46;4&#37; female&#41; was divided into two groups as follows&#58; 69 &#40;25&#46;1&#37;&#41; CIN&#43; and 205 &#40;74&#46;8&#37;&#41; CIN-&#46; There was no significant difference in mean age between the groups&#44; but the prevalence of females was significantly higher in the CIN- group than in the CIN&#43; group &#40;19&#37; vs&#46; 8&#46;6&#37;&#59; p&#60;0&#46;05&#41;&#46; No differences were observed between the groups with regard to other demographic characteristics&#46; Copeptin levels &#40;10&#46;68&#177;6&#46;43 vs&#46; 7&#46;07&#177;05&#46;53 pmol&#47;l&#59; p&#60;0&#46;001&#41; and peak creatinine &#40;1&#46;46&#177;1&#46;20 vs&#46; 1&#46;03&#177;0&#46;20 mg&#47;dl&#59; p&#61;0&#46;005&#41; were significantly higher in the CIN&#43; group compared to the CIN- group&#46; No differences were observed between the groups with regard to other laboratory findings&#46; Previous prescription of diuretics was significantly higher in the CIN&#43; group &#40;8&#46;6&#37; vs&#46; 2&#46;9&#37;&#59; p&#61;0&#46;047&#41;&#46; No significant difference was observed between the groups in quantity of contrast media used &#40;196&#46;75&#177;53&#46;57 vs&#46; 180&#46;65&#177;54&#46;68 cc&#59; p&#61;0&#46;143&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Four patients &#40;5&#46;8&#37;&#41; who developed CIN required dialysis in hospital follow-up&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Among the demographic and laboratory findings &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#44; variables associated with CIN were analyzed as potential risk factors and were assessed by logistic regression analysis&#46; Copeptin level at admission &#40;odds ratio &#91;OR&#93;&#58; 2&#46;36&#44; p&#61;0&#46;005&#41;&#44; and peak creatinine &#40;OR&#58; 6&#46;44&#44; p&#61;0&#46;004&#41; were found to be independent predictors of development of CIN&#46; Female gender and diuretic use were not found to be independent predictors of CIN development &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; In ROC curve analysis&#44; admission copeptin above a cut-off of 7&#46;72 pmol&#47;l predicted CIN with sensitivity of 73&#46;9&#37; and specificity of 73&#46;7&#37; &#40;area under the curve&#58; 0&#46;72&#59; 95&#37; confidence interval&#58; 0&#46;65-0&#46;79&#59; p&#60;0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">CIN is an important cause of concern for physicians and is a significant cause of iatrogenic acute renal failure&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a> A biomarker that predicts CIN development could thus enable measures to be taken to prevent renal failure&#46; In this study&#44; we determined that copeptin is a independent predictor of CIN in patients with STEMI&#46; To the best of our knowledge&#44; this study is the first to determine such a relationship between copeptin and CIN&#46; The results indicate that the CIN rate increases significantly in patients with high copeptin levels who have undergone primary PCI for STEMI&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The mechanism of CIN is not yet fully understood&#46; Reactive oxygen species &#40;ROS&#41;-induced combined hypoxic and toxic injury is important in the development of CIN&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">12</span></a> Renal oxygenation is significantly decreased and medullary hypoxia leads to ROS production and thus increased oxidative stress&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">13</span></a> While ROS trigger vasoconstrictive signals such as angiotensin II and endothelin I&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">14</span></a> they also reduce the bioavailability of nitric oxide&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">15</span></a> There are also studies indicating that contrast administration leads to vasoconstriction in the renal arteries&#44; reducing renal blood flow&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">16</span></a> As is evident&#44; the underlying pathophysiology of CIN is complex and further studies are needed to understand this issue&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The incidence of CIN varies depending on the population&#46; The main risk factors for its development include impaired renal function&#44; heart failure&#44; age &#40;&#62;65 years&#41;&#44; diabetes&#44; nephrotoxic drugs&#44; decreased intravascular volume&#44; long-standing hypotension&#44; anemia&#44; renal transplantation&#44; female gender&#44; high doses of contrast medium and multiple contrast injections within 72 hours&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">17</span></a> Contrast-medium osmolality is also important&#46; Use of low-osmolality instead of high-osmolality contrast medium has been shown to be better for prevention of CIN&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">18</span></a> Therefore&#44; in our study we opted to use low-osmolality contrast medium&#44; aimed to maintain sufficient hydration and avoided the use of nephrotoxic drugs&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The incidence of CIN is higher in patients who undergo coronary angiography than in outpatients &#40;10-15&#37; vs&#46; &#60;5&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">17</span></a> and previous studies have shown rates up to 25&#37; in STEMI patients&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">18</span></a> The higher incidence in this group may be associated with the high-risk profile of these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">19</span></a> The rate was found to be 25&#46;1&#37; in our study&#46; We consider that this high rate may be related to the fact that our study population was composed of high-risk patients with many comorbidities&#46; It also appears that the use of intra-arterial contrast administration is one of the causes of the high CIN rate in patients undergoing coronary intervention&#59; intra-arterial administration is associated with more risk than intravenous administration&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">20</span></a> In addition&#44; timing is important in determining the incidence of CIN&#44; since creatinine elevation is relatively slow&#44; 48-72 hours being required to identify many cases of CIN&#44; and therefore studies assessing CIN at 24-48 hours after contrast exposure underestimate its rate&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">21</span></a> CIN incidence may be assumed to be low in patients undergoing elective PCI&#44; due to early discharge of these patients and lack of blood tests in the early post-discharge period&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">22</span></a> Our study has shown that CIN is still common among hospitalized patients&#44; but its development can be predicted and its incidence can be decreased if appropriate measures are taken&#46; The current European guidelines on myocardial revascularization recommend risk assessment for acute renal damage for prevention of CIN&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">25</span></a> This indicates the importance of risk detection for CIN&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">We believe that copeptin&#44; which has been associated with cardiovascular and renal disease in previous studies&#44; can help in this regard&#46; The close relationship between copeptin and renal disease has been revealed in many studies&#46; Copeptin was found to be affected by mean blood pressure and blood volume and is elevated during pre-dialysis and dialysis periods&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a> and is an early indicator of reduced glomerular filtration rate and renal function in diabetic patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">24&#44;25</span></a> In addition&#44; a community-based cohort study revealed an independent positive relationship between plasma copeptin level and progression to chronic kidney disease &#40;CKD&#41;&#44; demonstrating that its close relationship with renal function is valid not only in patients with CKD&#44; but also in the general population&#44;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">26</span></a> and copeptin is associated with increased risk of CKD even in the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">27</span></a> Furthermore&#44; elevated copeptin has proved a valuable prognostic factor for mid-term mortality in patients with both coronary artery disease and kidney disease&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">28</span></a> The relationship between copeptin and cardiac disorders such as heart failure&#44; coronary artery disease and hypertension has been shown in many previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">29&#8211;31</span></a> Copeptin has been shown to be an independent marker for long-term prognosis in heart failure&#44;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">32&#44;33</span></a> it may be a marker for diagnosis of left ventricular dysfunction in hemodialysis patients&#44;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">34</span></a> and is associated with coronary atherosclerosis in diabetic patients<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">35&#44;36</span></a> and with resistant hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">37</span></a> A rise in copeptin levels two days after STEMI has also been shown to be related to larger acute and chronic infarct size&#44; and initially elevated copeptin level is related to myocardial function and remodeling four months after STEMI&#46; These results highlight the role of copeptin as a biomarker of negative post-STEMI results&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">38</span></a> Copeptin has also been shown to be useful for diagnosing or excluding acute coronary syndrome &#40;ACS&#41; and for safe and early discharge or shortening duration of emergency room stay in low- or moderate-risk patients suspected of suffering ACS when the results of copeptin and troponin are used in combination&#44; as copeptin is elevated in the early period of ACS&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">39&#44;40</span></a> In addition to these findings&#44; rapid copeptin measurement is suggested as a practical and useful tool for medium- and long-term risk assessment in the emergency room&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">In a study assessing acute renal damage in STEMI patients&#44; Guerchicoff et al&#46; investigated the relationship between acute renal damage and B-type natriuretic peptide &#40;BNP&#41;&#44; chemokine &#40;C-C motif&#41; ligand 23&#44; D-dimer&#44; endothelial cell-selective adhesion molecule&#44; C-reactive protein&#44; cystatin C&#44; adiponectin and von Willebrand factor&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">22</span></a> Levels of these biomarkers on admission were not found to be significant predictors for CIN development&#44; except for BNP&#46; Although a significant relationship was seen between these biomarkers and CIN during hospital stay and after discharge&#44; we consider that&#44; except for BNP&#44; they have limited benefit in predicting CIN development&#44; and taking measurements within 48-72 hours of contrast administration is important for preventing CIN development&#46; Our study differs from that of Guerchicoff et al&#46;&#44; as it investigates the relationship between copeptin and CIN&#44; and our study has revealed that copeptin levels on admission can predict CIN&#46; This may help clinicians to assess the risk and to take appropriate measures&#46; In addition&#44; a statistically significant relationship was found between CIN and peak creatinine level in our study&#46; However&#44; since CIN has already developed by the time peak creatinine is detected&#44; peak creatinine is not a predictive marker&#44; but has only diagnostic value&#44; and is not useful for taking measures to prevent CIN development&#46; As in Guerchicoff et al&#46;&#44; no relationship was found between adinopectin level on admission and CIN development in our study&#46; We therefore consider that copeptin is a more valuable marker than adinopectin for prediction of CIN&#46; Copeptin levels also have the advantage of being detected rapidly and easily&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Our findings indicate that physicians should be aware of the possibility of CIN development in patients with high copeptin levels and that preventive measures should start early&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Study limitations</span><p id="par0075" class="elsevierStylePara elsevierViewall">The present study has some limitations&#46; It was based on a single center&#44; included only STEMI patients and not those with other forms of MI&#44; and did not fully analyze potential nephrotoxic agents&#46; Another limitation is that this study did not include long-term results such as copeptin level after reversal of contrast nephropathy&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Copeptin level is an independent predictor of CIN development in patients with acute STEMI&#46; One of the advantages of measuring copeptin compared to other biomarkers is that copeptin at admission can predict CIN at an early stage&#46; Assessment of copeptin level may be helpful for taking measures to prevent CIN development in patients who are to undergo PCI&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Funding</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors received no financial support for the research&#44; authorship&#44; and&#47;or publication of this article&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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              "titulo" => "Coronary angiography and in-hospital follow-up"
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    "fechaRecibido" => "2018-12-18"
    "fechaAceptado" => "2019-06-22"
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            0 => "Contrast-induced nephropathy"
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            2 => "Myocardial infarction"
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            0 => "Nefropatia induzida por contraste"
            1 => "Copeptina"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to investigate the predictive value of copeptin levels in the development of contrast-induced nephropathy &#40;CIN&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A total of 274 patients diagnosed with ST-elevation myocardial infarction &#40;STEMI&#41; and who had undergone primary percutaneous coronary intervention were included in the study&#46; The patients were divided into two groups according to the presence &#40;CIN&#43;&#41; or absence &#40;CIN-&#41; of CIN&#46; These groups were compared in terms of demographic characteristics&#44; laboratory findings and risk factors&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Copeptin levels &#40;10&#46;68&#177;6&#46;43 vs&#46; 7&#46;07&#177;05&#46;53 pmol&#47;l&#59; p&#60;0&#46;001&#41; and peak creatinine &#40;1&#46;46&#177;1&#46;20 vs&#46; 1&#46;03&#177;0&#46;20 mg&#47;dl&#59; p&#61;0&#46;005&#41; were significantly higher in the CIN&#43; group than in the CIN- group&#46; Female gender was significantly more prevalent in the CIN- group compared to the CIN&#43; group &#40;19&#37; vs&#46; 8&#46;6&#37;&#59; p&#60;0&#46;05&#41;&#46; Copeptin level at hospital admission &#40;OR&#58; 2&#46;36&#44; p&#61;0&#46;005&#41; was found to be an independent predictor for CIN development&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Copeptin level is an independent predictor of CIN development in patients with acute STEMI that can be detected rapidly and easily&#46; This result indicates that physicians should be aware of the possibility of CIN development in patients with high copeptin levels and preventive measures should start early&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise do valor preditivo dos n&#237;veis de copeptina no desenvolvimento da nefropatia induzida por contraste &#40;NIC&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos no estudo 274 doentes&#44; diagnosticados com enfarte do mioc&#225;rdio com eleva&#231;&#227;o do segmento ST &#40;STEMI&#41; e submetidos a angioplastia coron&#225;ria prim&#225;ria&#46; Os doentes foram divididos em dois grupos de acordo com a confirma&#231;&#227;o de NIC&#46; Estes grupos foram comparados quanto &#224;s caracter&#237;sticas demogr&#225;ficas&#44; achados laboratoriais e fatores de risco&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">O n&#237;vel de copeptina &#40;10&#44;68&#177;6&#44;43 <span class="elsevierStyleItalic">versus</span> 7&#44;07&#177;5&#44;53&#59; p&#60;0&#44;001&#41; e o pico dos n&#237;veis de creatinina &#40;1&#44;46&#177;1&#44;20 <span class="elsevierStyleItalic">versus</span> 1&#44;03&#177;0&#44;20&#59; p&#61;0&#44;005&#41; foram significativamente superiores nos grupos de NIC &#40;&#43;&#41; quando comparados com os grupos de NIC &#40;-&#41;&#46; A percentagem do g&#233;nero feminino foi significativamente superior no grupo NIC &#40;-&#41; quando comparada com o grupo NIC &#40;&#43;&#41; &#40;19&#37; <span class="elsevierStyleItalic">versus</span> 8&#44;6&#37;&#59; p&#60;0&#44;05&#41;&#46; O n&#237;vel da copeptina no momento do internamento &#40;OR&#58; 2&#44;36&#44; p&#61;0&#44;005&#41; foi considerado como um valor preditor independente no desenvolvimento da NIC&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O n&#237;vel da copeptina &#233; um fator preditor independente do desenvolvimento da NIC em doentes com STEMI agudo&#46; Pode ser detetado r&#225;pida e facilmente e este resultado indica que os m&#233;dicos devem ser mais cuidadosos em rela&#231;&#227;o ao desenvolvimento da NIC em doentes com n&#237;veis de copeptina levados&#46; Medidas preventivas devem ser tomadas precocemente&#46;</p></span>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CABG&#58; coronary artery bypass grafting&#59; CCBs&#58; calcium channel blockers&#59; CIN&#43;&#58; patients with contrast-induced nephropathy&#59; CIN-&#58; patients without contrast-induced nephropathy&#59; CK-MB&#58; creatine kinase-myocardial band&#59; DBP&#58; diastolic blood pressure&#59; eGFR&#58; estimated glomerular filtration rate&#59; HDL-C&#58; high-density lipoprotein cholesterol&#59; LDL-C&#58; low-density lipoprotein cholesterol&#59; LVEF&#58; left ventricular ejection fraction&#59; MI&#58; myocardial infarction&#59; PCI&#58; percutaneous coronary intervention&#59; SBP&#58; systolic blood pressure&#59; WBC&#58; white blood cell count&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Continuous variables are reported as mean &#177; standard deviation or median &#40;interquartile range&#41;&#46; Categorical variables are reported as n &#40;&#37;&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CIN&#43; &#40;n&#61;69&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CIN- &#40;n&#61;205&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Mean age&#44; years&#44; mean &#40;SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;50&#177;13&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&#46;42&#177;11&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;552&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Female gender&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;19&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Diabetes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;30&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;26&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;502&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hypertension&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;34&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;38&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;651&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Family history&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;44&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#40;40&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;439&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hyperlipidemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;23&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;29&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;428&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Current smoker&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;28&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;34&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;678&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">LVEF&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;12&#177;10&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;66&#177;11&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;770&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cerebrovascular disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;603&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">BMI&#44; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;98&#177;3&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;15&#177;4&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;176&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Previous CABG&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#46;89&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;2&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;793&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">PCI history&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;6&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;448&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Killip class</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;23&#177;0&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;11&#177;0&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Anterior MI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;49&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86 &#40;41&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;275&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Shock&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;5&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;3&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;490&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Anemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">16 &#40;23&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">41 &#40;20&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;536&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">SBP&#44; mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">127&#46;0&#177;24&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">125&#46;98&#177;23&#46;37&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;761&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">DBP&#44; mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">78&#46;51&#177;15&#46;59&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">77&#46;02&#177;15&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Heart rate&#44; bpm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">82&#46;74&#177;19&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">83&#46;85&#177;19&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Laboratory findings</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Copeptin&#44; pmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&#46;68&#177;6&#46;43&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&#46;07&#177;5&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adiponectin&#44; &#956;g&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&#46;41&#177;17&#46;22&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#46;09&#177;6&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;277&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>First day creatinine&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;82&#177;0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;88&#177;0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;086&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peak creatinine&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;46&#177;1&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;03&#177;0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peak CK-MB&#44; U&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">180&#46;67&#177;126&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">186&#46;02&#177;180&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;824&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Troponin&#44; ng&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;67&#177;30&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;31&#177;33&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;957&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LDL-C&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114&#46;22&#177;32&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124&#46;64&#177;40&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HDL-C&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#177;9&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;77&#177;9&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;559&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Triglycerides&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163&#46;60&#177;72&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163&#46;83&#177;85&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;984&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HbA1c&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;08&#177;0&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;26&#177;1&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;356&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sodium&#44; mmol&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#46;57&#177;7&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">137&#46;26&#177;3&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Potassium&#44; mmol&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;31&#177;0&#46;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;21&#177;0&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                      "titulo" => "Prevention of radiocontrast-induced nephropathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Asif"
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                      "doi" => "10.1053/j.ajkd.2004.04.001"
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                        "tituloSerie" => "Am J Kidney Dis"
                        "fecha" => "2004"
                        "volumen" => "44"
                        "paginaInicial" => "12"
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Article information
ISSN: 21742049
Original language: English
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Revista Portuguesa de Cardiologia (English edition)
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