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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Introdu&#231;&#227;o</span><p id="par0055" class="elsevierStylePara elsevierViewall">A estrat&#233;gia terap&#234;utica invasiva associada a medica&#231;&#227;o antitromb&#243;tica mais agressiva nos doentes com s&#237;ndrome coron&#225;ria aguda sem supradesnivelamento do segmento ST &#40;SCANST&#41; tem demonstrado reduzir as complica&#231;&#245;es isqu&#233;micas&#44; associando&#8208;se&#44; contudo&#44; ao aumento de complica&#231;&#245;es hemorr&#225;gicas<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a>&#46; A pondera&#231;&#227;o do risco&#8208;benef&#237;cio destas terap&#234;uticas &#233; fundamental para a redu&#231;&#227;o da mortalidade nesta popula&#231;&#227;o de doentes&#44; sendo atualmente recomendada pela Sociedade Europeia de Cardiologia a utiliza&#231;&#227;o de <span class="elsevierStyleItalic">scores</span> de estratifica&#231;&#227;o de risco isqu&#233;mico&#44; como o GRACE<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#44; e de risco hemorr&#225;gico&#44; como o CRUSADE<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A idade avan&#231;ada associa&#8208;se a maior preval&#234;ncia e extens&#227;o de doen&#231;a coron&#225;ria&#44; maior risco de complica&#231;&#245;es isqu&#233;micas e mortalidade&#44; sendo que 30&#37; das mortes relacionadas com enfarte agudo do mioc&#225;rdio ocorrem em doentes com mais de 85 anos<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> e que a principal causa de morte nos doentes com &#8805;<span class="elsevierStyleHsp" style=""></span>75 anos se deve a complica&#231;&#245;es isqu&#233;micas<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46; Tendo em conta este aumento de risco&#44; os mais idosos ser&#227;o&#44; em teoria&#44; os que mais beneficiam das terap&#234;uticas com impacto progn&#243;stico<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#8211;11</span></a>&#46; Contudo&#44; esta faixa et&#225;ria apresenta caracter&#237;sticas pr&#243;prias&#44; como a presen&#231;a de m&#250;ltiplas comorbilidades&#44; redu&#231;&#227;o da capacidade para as atividades de vida di&#225;ria&#44; fragilidade fisiol&#243;gica&#44; psicol&#243;gica e cognitiva&#44; que influenciam o progn&#243;stico ap&#243;s SCANST e que limitam o benef&#237;cio de terap&#234;uticas mais agressivas<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Por outro lado&#44; nos idosos tamb&#233;m se encontra alterada a metaboliza&#231;&#227;o de f&#225;rmacos&#44; em virtude da deteriora&#231;&#227;o da fun&#231;&#227;o renal e hep&#225;tica&#44; intera&#231;&#227;o medicamentosa por polimedica&#231;&#227;o&#44; altera&#231;&#227;o da composi&#231;&#227;o corporal e comorbilidades&#46; Estes fatores condicionam maior vulnerabilidade &#224; terap&#234;utica e s&#227;o respons&#225;veis pelo aumento significativo das complica&#231;&#245;es hemorr&#225;gicas nesta faixa et&#225;ria<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#44; conduzindo ao receio da utiliza&#231;&#227;o de terap&#234;uticas invasivas e medica&#231;&#227;o antitromb&#243;tica agressiva nos idosos&#44; apesar do potencial benef&#237;cio&#46; Este facto tem&#8208;se traduzido&#44; nas diferentes s&#233;ries publicadas&#44; numa percentagem baixa de acesso &#224;s referidas terap&#234;uticas nas faixas et&#225;rias mais avan&#231;adas&#44; mesmo na aus&#234;ncia de contraindica&#231;&#245;es<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Apesar da complexidade acrescida na orienta&#231;&#227;o dos idosos com SCANST&#44; os dados existentes s&#227;o limitados para a faixa et&#225;ria acima dos 80 anos&#44; em virtude destes doentes terem sido frequentemente exclu&#237;dos dos ensaios cl&#237;nicos<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;11</span></a>&#46; As recomenda&#231;&#245;es atuais para esta popula&#231;&#227;o baseiam&#8208;se&#44; portanto&#44; na extrapola&#231;&#227;o de dados obtidos para doentes mais jovens&#44; que pode n&#227;o refletir a realidade deste extremo cronol&#243;gico&#44; n&#227;o se conhecendo&#44; nomeadamente&#44; se os <span class="elsevierStyleItalic">scores</span> recomendados para avalia&#231;&#227;o de risco isqu&#233;mico e hemorr&#225;gico se adequam a esta faixa et&#225;ria&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A obten&#231;&#227;o de conhecimento atrav&#233;s de outras fontes&#44; como os registos&#44; adquire&#44; por isso&#44; especial relev&#226;ncia nesta popula&#231;&#227;o&#46; O Registo Nacional de S&#237;ndromes Coron&#225;rias Agudas da Sociedade Portuguesa de Cardiologia &#40;RNSC&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> apresenta a robustez necess&#225;ria para a avalia&#231;&#227;o desta popula&#231;&#227;o&#44; como demonstrado por outros trabalhos resultantes da sua atividade<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Este trabalho tem como principal objetivo avaliar a adequa&#231;&#227;o dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE em doentes com SCANST e idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos&#44; e adicionalmente identificar os principais preditores de mortalidade intra&#8208;hospitalar &#40;MIH&#41; e hemorragia <span class="elsevierStyleItalic">major</span> &#40;HM&#41; nesta popula&#231;&#227;o&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Desenho do estudo</span><p id="par0080" class="elsevierStylePara elsevierViewall">Estudo observacional&#44; multic&#234;ntrico&#44; de doentes inclu&#237;dos prospetivamente na segunda fase do Registo Nacional de S&#237;ndromes Coron&#225;rias Agudas &#40;RNSCA&#41;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#44; com o diagn&#243;stico de SCANST e idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos&#46; Foram avaliados os preditores de MIH e HM durante o internamento e criados modelos preditores &#40;MP&#41; destes <span class="elsevierStyleItalic">endpoints</span>&#46; Os <span class="elsevierStyleItalic">scores</span> GRACE&#44; CRUSADE&#44; MP&#8208;MIH e MP&#8208;HM foram posteriormente avaliados e comparados na predi&#231;&#227;o de MIH e HM&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Sele&#231;&#227;o de doentes</span><p id="par0085" class="elsevierStylePara elsevierViewall">Foram avaliados 544 doentes consecutivos com idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos e diagn&#243;stico de SCANST inclu&#237;dos no RNSCA no per&#237;odo de 1 de outubro de 2010 a 25 de outubro de 2012&#44; provenientes de 14 hospitais portugueses&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A defini&#231;&#227;o de SCANST incluiu os diagn&#243;sticos de admiss&#227;o&#58; enfarte agudo do mioc&#225;rdio sem supradesnivelamento do segmento ST &#40;EAMNST&#58; aus&#234;ncia de supradesnivelamento persistente &#91;&#60; 30 minutos&#93; do segmento ST associada a eleva&#231;&#227;o dos marcadores de necrose mioc&#225;rdica &#91;troponina ou CK&#8208;mb&#93; em contexto cl&#237;nico sugestivo de isquemia mioc&#225;rdica&#41;&#44; e angina inst&#225;vel &#40;AI&#58; cl&#237;nica sugestiva de angor ou equivalente anginoso&#44; associada ou n&#227;o a altera&#231;&#245;es electrocardiogr&#225;ficas indicativas de isquemia&#44; na aus&#234;ncia de eleva&#231;&#227;o de biomarcadores de necrose do mioc&#225;rdio&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">O RNSCA<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> &#233; um estudo observacional com inclus&#227;o cont&#237;nua e prospetiva de doentes adultos &#40;&#62;<span class="elsevierStyleHsp" style=""></span>18 anos&#41; com o diagn&#243;stico de s&#237;ndrome coron&#225;ria aguda com &#60;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>h de evolu&#231;&#227;o&#46; Foram exclu&#237;dos deste registo enfartes dos tipos 4&#44; 5 e 2 &#40;classifica&#231;&#227;o de acordo com a redefini&#231;&#227;o do enfarte do mioc&#225;rdio de 2007 da <span class="elsevierStyleItalic">Joint ESC&#47;ACCF&#47;AHA&#47;WHF Task Force</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleItalic">&#46;</span> Informa&#231;&#227;o adicional em rela&#231;&#227;o ao protocolo deste registo pode ser consultada no s&#237;tio da Sociedade Portuguesa de Cardiologia<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Colheita de dados</span><p id="par0100" class="elsevierStylePara elsevierViewall">De entre as vari&#225;veis existentes no RNSCA&#44; foram avaliadas as seguintes&#44; que foram inclu&#237;das na an&#225;lise univari&#225;vel&#58; dados demogr&#225;ficos &#40;idade&#44; g&#233;nero&#44; &#237;ndice de massa corporal&#41;&#59; fatores de risco cardiovascular &#40;definidos por hist&#243;ria conhecida de hipertens&#227;o arterial&#44; diabetes&#44; dislipidemia&#44; tabagismo atual &#91;se consumo at&#233; 30 dias antes da admiss&#227;o&#93;&#44; e hist&#243;ria familiar de doen&#231;a coron&#225;ria&#41;&#59; antecedentes pessoais cardiovasculares &#40;antecedentes de enfarte agudo do mioc&#225;rdio&#44; insufici&#234;ncia card&#237;aca&#44; acidente vascular cerebral&#47;acidente isqu&#233;mico transit&#243;rio&#41; e antecedentes n&#227;o&#8208;cardiovasculares &#40;neoplasia&#44; hemorragia &#91;clinicamente significativa ou que tenha colocado a vida em risco&#93;&#44; dem&#234;ncia&#44; doen&#231;a pulmonar obstrutiva cr&#243;nica &#91;DPOC&#93;&#44; insufici&#234;ncia renal cr&#243;nica &#91;definida como hist&#243;ria pr&#233;via ou presen&#231;a de pelo menos um dos seguintes crit&#233;rios&#58; creatinina pr&#233;via ao internamento &#62; 2 mg&#47;dL&#44; di&#225;lise ou transplante renal&#93;&#41;&#59; medica&#231;&#227;o pr&#233;via &#224; admiss&#227;o &#40;antiagregantes &#91;aspirina&#44; clopidogrel&#44; ambos&#44; outros&#93;&#59; anticoagulantes &#91;antagonistas da vitamina K&#44; outros&#93;&#41;&#59; dados relativos &#224; admiss&#227;o hospitalar &#40;local&#44; forma de transporte para o hospital&#44; cl&#237;nica&#44; tens&#227;o arterial&#44; frequ&#234;ncia card&#237;aca&#44; classe Killip<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#44; infradesnivelamento do segmento ST no eletrocardiograma&#44; e avalia&#231;&#227;o anal&#237;tica &#224; admiss&#227;o &#91;eleva&#231;&#227;o isolada de troponina&#44; valor de hemoglobina&#44; hemat&#243;crito&#44; plaquetas&#44; glicemia&#44; HbA1c e creatinina&#93;&#41;&#46; O valor do hemat&#243;crito foi calculado a partir da hemoglobina&#44; de acordo com a equa&#231;&#227;o descrita por Bain e Bates<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> &#40;hemat&#243;crito &#61; hemoglobina &#91;g&#47;dl&#93; &#215; 3&#41;&#46; O valor do <span class="elsevierStyleItalic">clearance</span> de creatinina foi estimado atrav&#233;s da f&#243;rmula de Cockcroft&#8208;Gault<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; Foram ainda avaliados dados relativos ao internamento&#44; tais como a dura&#231;&#227;o&#44; vari&#225;veis anal&#237;ticas &#40;hemoglobina m&#237;nima&#44; creatinina m&#225;xima&#41;&#44; medica&#231;&#227;o administrada &#40;antiagregantes&#58; &#225;cido acetilsalic&#237;lico &#91;AAS&#93;&#41;&#44; clopidogrel&#44; outros n&#227;o&#8208;AAS&#47;clopidogrel&#59; anticoagulantes&#58; heparina n&#227;o fracionada&#44; enoxaparina&#44; fondaparinux&#44; antagonistas da vitamina K&#44; outros&#59; inibidores da glicoprote&#237;na IIb&#47;IIIa&#44; bloqueador&#8208;beta&#44; inibidor do enzima de convers&#227;o da angiotensina ou antagonista dos recetores de angiotensina&#44; estatina&#44; nitratos&#44; antagonistas do c&#225;lcio&#44; ivabradina&#44; antagonistas da aldosterona&#44; diur&#233;ticos&#44; antiarr&#237;tmicos&#44; insulina&#44; antidiab&#233;ticos orais&#44; inotr&#243;picos&#44; levosimendan&#41;&#44; realiza&#231;&#227;o de coronariografia&#44; acesso vascular&#44; uso de sistemas de encerramento arterial&#44; art&#233;ria <span class="elsevierStyleItalic">culprit</span>&#44; n&#250;mero de vasos com estenose &#8805; 50&#37;&#44; angioplastia&#44; tipo de <span class="elsevierStyleItalic">stent</span> utilizado&#44; revasculariza&#231;&#227;o cir&#250;rgica&#44; fun&#231;&#227;o ventricular esquerda&#44; tratamentos como implanta&#231;&#227;o de <span class="elsevierStyleItalic">pacemaker</span> provis&#243;rio&#44; bal&#227;o intra&#8208;a&#243;rtico&#44; ventila&#231;&#227;o mec&#226;nica invasiva e n&#227;o invasiva&#44; e ainda complica&#231;&#245;es verificadas durante o internamento &#40;re&#8208;enfarte&#44; complica&#231;&#245;es mec&#226;nicas&#44; arritmias&#44; paragem cardiorrespirat&#243;ria reanimada&#44; acidente vascular cerebral&#44; insufici&#234;ncia card&#237;aca&#44; HM e morte&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Os <span class="elsevierStyleItalic">scores</span> GRACE<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> &#40;avalia&#231;&#227;o de MIH&#41; e CRUSADE<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> foram calculados para todos os doentes&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Esclarecimentos adicionais no que respeita &#224; defini&#231;&#227;o das diferentes vari&#225;veis podem ser obtidos por consulta do s&#237;tio da Sociedade Portuguesa de Cardiologia<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105"><span class="elsevierStyleItalic">Endpoints</span> do estudo</span><p id="par0115" class="elsevierStylePara elsevierViewall">Os <span class="elsevierStyleItalic">endpoints</span> deste estudo corresponderam &#224; avalia&#231;&#227;o de MIH e HM&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">A MIH foi definida como morte de qualquer causa ocorrida durante o internamento por SCANST&#46; A HM foi definida como ocorr&#234;ncia durante o internamento de hemorragia intracraniana ou hemorragia com compromisso hemodin&#226;mico requerendo interven&#231;&#227;o &#40;crit&#233;rios <span class="elsevierStyleItalic">Global Use of Strategies to Open Occluded Arteries</span><a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> &#8211; GUSTO&#41;&#46; A sele&#231;&#227;o dos crit&#233;rios GUSTO para defini&#231;&#227;o de HM deveu&#8208;se ao facto de ser esta a classifica&#231;&#227;o utilizada no RNSCA&#46; Contudo&#44; os autores consideram que se trata tamb&#233;m da classifica&#231;&#227;o mais adequada &#224; popula&#231;&#227;o e aos objetivos do estudo&#44; uma vez que importa identificar a hemorragia suficientemente grave para justificar a n&#227;o utiliza&#231;&#227;o de terap&#234;uticas efetivas na redu&#231;&#227;o das complica&#231;&#245;es isqu&#233;micas&#44; mas que aumentam o risco hemorr&#225;gico no SCA&#46;</p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lise estat&#237;stica</span><p id="par0125" class="elsevierStylePara elsevierViewall">Foi realizada uma caracteriza&#231;&#227;o global da amostra considerando todos os par&#226;metros avaliados&#46; As vari&#225;veis categ&#243;ricas foram caracterizadas por frequ&#234;ncias absolutas e relativas&#44; e as vari&#225;veis cont&#237;nuas recorrendo &#224; m&#233;dia e desvio padr&#227;o&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Foram determinados os preditores independentes de cada um dos <span class="elsevierStyleItalic">endpoints</span> considerados&#44; MIH e HM&#44; tendo&#8208;se realizado uma an&#225;lise univari&#225;vel em que se testou a associa&#231;&#227;o entre o <span class="elsevierStyleItalic">endpoint</span> e cada um dos potenciais preditores&#46; No caso das vari&#225;veis categ&#243;ricas recorreu&#8208;se ao teste Qui&#8208;Quadrado e no caso de vari&#225;veis cont&#237;nuas recorreu&#8208;se ao teste T&#46; Sempre que os pressupostos de utiliza&#231;&#227;o do teste T n&#227;o eram satisfeitos utilizou&#8208;se o teste Mann&#8208;Whitney&#46; A normalidade da distribui&#231;&#227;o dos valores das vari&#225;veis cont&#237;nuas e a igualdade das suas vari&#226;ncias foram testadas usando o teste Kolmogorov&#8208;Smirnov e o teste de Levene&#44; respetivamente&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Foram aplicadas t&#233;cnicas de regress&#227;o log&#237;stica para identificar os preditores independentes de MIH e HM tendo em conta todas as vari&#225;veis com signific&#226;ncia estat&#237;stica &#40;m&#233;todo <span class="elsevierStyleItalic">Stepwise Forward</span> com teste raz&#227;o de verosimilhan&#231;as&#41;&#46; As vari&#225;veis identificadas como preditoras independentes de HM foram adicionalmente avaliadas por regress&#227;o log&#237;stica &#40;m&#233;todo <span class="elsevierStyleItalic">Stepwise Forward</span> com teste raz&#227;o de verosimilhan&#231;as&#41;&#44; incluindo&#8208;se no modelo as vari&#225;veis utilizadas no <span class="elsevierStyleItalic">score</span> CRUSADE&#44; e separadamente vari&#225;veis relativas &#224; medica&#231;&#227;o realizada durante o internamento&#58; dupla antiagrega&#231;&#227;o&#44; ou a associa&#231;&#227;o desta a anticoagulantes &#40;terap&#234;utica tripla&#41; ou a inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">II</span>a &#40;antiagrega&#231;&#227;o tripla&#41;&#46; Os valores p de entrada e sa&#237;da do modelo considerados foram 0&#44;10 e 0&#44;15&#44; respetivamente&#46; O risco de ocorr&#234;ncia de cada <span class="elsevierStyleItalic">endpoint</span> associado a cada preditor foi estimado por interm&#233;dio do <span class="elsevierStyleItalic">Odds rtio</span> e respetivo intervalo de confian&#231;a &#40;IC&#41; a 95&#37;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Por regress&#227;o log&#237;stica &#40;m&#233;todo <span class="elsevierStyleItalic">enter</span>&#41; foram criados MP de MIH e de HM com base em vari&#225;veis presentes &#224; admiss&#227;o hospitalar&#44; com signific&#226;ncia estat&#237;stica para cada <span class="elsevierStyleItalic">endpoint</span> ou que adicionalmente apresentavam interesse cl&#237;nico&#58; MP&#8208;MIH &#8211; fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo &#60;<span class="elsevierStyleHsp" style=""></span>30&#37;&#44; classe Killip &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span>&#44; infradesnivelamento do segmento ST no eletrocardiograma&#44; tens&#227;o arterial sist&#243;lica&#44; frequ&#234;ncia card&#237;aca&#44; glicemia&#44; creatinina&#44; eleva&#231;&#227;o isolada de troponina&#59; MP&#8208;MH &#8211; antecedentes de hemorragia&#44; antecedentes de DPOC&#44; classe Killip &#224; admiss&#227;o &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span> e creatinina &#224; admiss&#227;o&#46; A calibra&#231;&#227;o dos modelos foi avaliada atrav&#233;s do teste de Hosmer&#8208;Lemeshow&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">A partir dos coeficientes de regress&#227;o estimados foram determinados os valores preditos de cada modelo para posterior avalia&#231;&#227;o da sua capacidade discriminat&#243;ria&#44; que foi feita estimando a &#225;rea sob as curvas ROC &#40;<span class="elsevierStyleItalic">Receiver Operating Characteristic Curve</span>&#41;&#44; para al&#233;m da determina&#231;&#227;o da sensibilidade e especificidade&#46; Estas curvas avaliam a capacidade de um modelo atribuir uma probabilidade mais elevada de eventos aos doentes que atingiram o <span class="elsevierStyleItalic">endpoint</span> em estudo&#46; Desta forma avaliou&#8208;se a acuidade diagn&#243;stica do <span class="elsevierStyleItalic">score</span> GRACE e do MP&#8208;MIH para MIH&#44; e do <span class="elsevierStyleItalic">score</span> CRUSADE e do MP&#8208;HM para HM&#46; A compara&#231;&#227;o das curvas ROC para MIH e para HM foi feita com recurso ao software MedCalc para Windows vers&#227;o 9&#46;2&#46;0&#46;1&#46; A restante an&#225;lise estat&#237;stica foi realizada usando o software SPSS vers&#227;o 19&#44; com o teste definido por Hanley e McNeil &#40;1982&#44; 1983&#41;&#46; O n&#237;vel de signific&#226;ncia utilizado nesta an&#225;lise foi de 5&#37;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Caracteriza&#231;&#227;o da popula&#231;&#227;o</span><p id="par0150" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas dos 544 doentes avaliados s&#227;o apresentadas na <a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#46; A idade m&#237;nima inclu&#237;da na amostra foi de 80 anos&#44; enquanto a m&#225;xima foi de 92 anos&#44; com uma m&#233;dia de 84 anos&#46; O diagn&#243;stico de admiss&#227;o foi EAMNST em 91&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>495&#41; dos doentes&#44; e AI em 9&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>49&#41;&#46; A <a class="elsevierStyleCrossRef" href="#fig0005">Figura 1</a> apresenta a distribui&#231;&#227;o da popula&#231;&#227;o e dos doentes com MIH e HM pelos diferentes grupos de risco dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE&#44; respetivamente&#46; Na popula&#231;&#227;o em estudo&#44; 93&#44;6&#37; dos doentes que atingiram o <span class="elsevierStyleItalic">endpoint</span> MIH foram classificados no grupo de alto risco pelo <span class="elsevierStyleItalic">score</span> GRACE&#59; j&#225; o <span class="elsevierStyleItalic">score</span> CRUSADE classificou apenas 53&#44;9&#37; dos doentes com HM na classe de risco alto ou muito alto &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figura 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">Cerca de 98&#37; dos doentes foram medicados com AAS&#44; 86&#44;9&#37; com clopidogrel e 5&#44;9&#37; com inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a&#46; A enoxaparina foi o anticoagulante mais frequentemente utilizado&#46; Foi realizada coronariografia em 59&#44;4&#37; dos doentes&#44; angioplastia em 34&#44;7&#37; e cirurgia de revasculariza&#231;&#227;o em 14&#44;7&#37;&#46; Esta popula&#231;&#227;o apresentou um <span class="elsevierStyleItalic">score</span> GRACE de 161<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27 e CRUSADE de 44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46; A dura&#231;&#227;o mediana do internamento foi de cinco dias &#40;P25&#58; 3&#59; P75&#58; 8&#41;&#44; tendo sido observado o <span class="elsevierStyleItalic">endpoint</span> MI em 6&#44;6&#37; e HM em 2&#44;9&#37; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Preditores de mortalidade intra&#8208;hospitalar</span><p id="par0160" class="elsevierStylePara elsevierViewall">Em an&#225;lise univariada&#44; a MIH associou&#8208;se a valores mais elevados de frequ&#234;ncia card&#237;aca e creatinina &#224; admiss&#227;o&#44; creatinina m&#225;xima&#44; presen&#231;a &#224; admiss&#227;o de classe Killip &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span>&#44; infradesnivelamento do segmento ST&#44; eleva&#231;&#227;o n&#227;o isolada de troponina e valores mais baixos de tens&#227;o arterial sist&#243;lica &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46; A sobreviv&#234;ncia durante o internamento associou&#8208;se a medica&#231;&#227;o mais frequente com bloqueadores&#8208;beta&#44; antagonistas do c&#225;lcio e IECA&#47;ARA&#44; a realiza&#231;&#227;o de coronariografia e angioplastia&#44; e &#224; aus&#234;ncia de doen&#231;a do tronco comum &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46; Os doentes que faleceram no internamento necessitaram mais frequentemente de terap&#234;utica com levosimendan&#44; inotr&#243;picos&#44; ventila&#231;&#227;o mec&#226;nica e <span class="elsevierStyleItalic">pacemaker</span> provis&#243;rio&#46; Tamb&#233;m apresentaram maior preval&#234;ncia de complica&#231;&#245;es isqu&#233;micas e hemorr&#225;gicas &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46; N&#227;o foi identificada associa&#231;&#227;o da MIH com a idade&#44; fatores de risco CV&#44; medica&#231;&#227;o pr&#233;via&#44; acesso vascular ou sistemas de encerramento arterial utilizados na coronariografia&#44; no tipo de <span class="elsevierStyleItalic">stent</span> utilizado na angioplastia ou na realiza&#231;&#227;o de cirurgia de revasculariza&#231;&#227;o mioc&#225;rdica&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">Em an&#225;lise multivariada&#44; foram preditores independentes de MIH a classe Killip &#224; admiss&#227;o &#62;<span class="elsevierStyleHsp" style=""></span>1&#44; fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo &#60;<span class="elsevierStyleHsp" style=""></span>30&#37; e a ocorr&#234;ncia de HM &#8211; a qual aumentou quase 11 vezes o risco de MIH &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; A realiza&#231;&#227;o de coronariografia nesta popula&#231;&#227;o mostrou ser protetora &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130"><span class="elsevierStyleItalic">Score</span> GRACE e Modelo Preditor de Mortalidade Intra&#8208;hospitalar para identifica&#231;&#227;o de mortalidade intra&#8208;hospitalar</span><p id="par0170" class="elsevierStylePara elsevierViewall">O <span class="elsevierStyleItalic">score</span> GRACE mostrou uma boa acuidade diagn&#243;stica para identificar os doentes que faleceram durante o internamento&#44; com uma &#225;rea debaixo da curva ROC &#40;AUC&#41; de 0&#44;75&#44; IC 95&#37; 0&#44;63&#8208;0&#44;87&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figura 1</a>&#41;&#46; O <span class="elsevierStyleItalic">Youden &#237;ndex</span> identificado para este <span class="elsevierStyleItalic">score</span> foi 170 &#40;sensibilidade 77&#37;&#44; especificidade 67&#37;&#41;&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">O MP&#8208;MIH apresentou uma boa calibra&#231;&#227;o para MIH&#44; de acordo com o teste de <span class="elsevierStyleItalic">Hosmer&#8208;Lemeshow</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;533&#41;&#46; A an&#225;lise de curvas ROC mostrou uma excelente capacidade discriminativa de MIH &#40;AUC 0&#44;81&#44; IC 95&#37; 0&#44;72&#8208;0&#44;90&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; sem que&#44; no entanto&#44; se tenha verificado diferen&#231;a significativa &#40;0&#44;06&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;239&#41; entre as AUC dos dois modelos &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figura 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Preditores de hemorragia <span class="elsevierStyleItalic">major</span> durante o internamento</span><p id="par0180" class="elsevierStylePara elsevierViewall">O <span class="elsevierStyleItalic">endpoint</span> HM associou&#8208;se a antecedentes de hemorragia ou de DPOC&#44; a classe <span class="elsevierStyleItalic">Killip</span> &#224; admiss&#227;o &#62;<span class="elsevierStyleHsp" style=""></span>1&#44; a valores mais elevados de creatinina m&#225;xima e a mais baixos de hemoglobina m&#237;nima&#44; a terap&#234;uticas durante o internamento com heparina n&#227;o&#8208;fracionada&#44; antiagregantes diferentes de AAS ou clopidogrel&#44; ou antagonistas da aldosterona&#46; Tamb&#233;m se associou a prolongamento do internamento e a uma taxa superior de MIH &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46; Em an&#225;lise univariada n&#227;o foi verificada associa&#231;&#227;o entre HM e idade&#44; g&#233;nero&#44; outros fatores de risco cardiovascular&#44; medica&#231;&#227;o pr&#233;via&#44; &#237;ndice de massa corporal&#44; valores &#224; admiss&#227;o de hemoglobina&#44; creatinina ou plaquetas&#44; medica&#231;&#227;o durante o internamento com inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a&#44; ou com a realiza&#231;&#227;o de coronariografia&#44; angioplastia&#44; cirurgia de revasculariza&#231;&#227;o mioc&#225;rdica&#44; quanto ao tipo de <span class="elsevierStyleItalic">stent</span> ou acesso vascular utilizado&#44; ou quanto ao uso de sistemas de encerramento arterial&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">Quando inclu&#237;das em an&#225;lise multivariada todas as associa&#231;&#245;es significativas previamente referidas&#44; apenas terap&#234;utica m&#233;dica administrada durante o internamento&#44; nomeadamente heparina n&#227;o&#8208;fracionada&#44; outros antiagregantes que n&#227;o AAS ou clopidogrel e antagonistas da aldosterona&#44; foram preditores independentes de HM &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46; A mesma an&#225;lise incluindo estes preditores independentes e os par&#226;metros inclu&#237;dos no <span class="elsevierStyleItalic">score</span> CRUSADE identificou como preditores de HM antecedentes de DPOC&#44; medica&#231;&#227;o com heparina n&#227;o&#8208;fracionada e com antagonistas da aldosterona &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46; Incluindo em an&#225;lise multivariada os preditores independentes iniciais e a terap&#234;utica com dupla antiagrega&#231;&#227;o ou com terap&#234;utica tripla&#44; separadamente&#44; foram obtidos valores marginalmente significativos para DPOC e heparina n&#227;o&#8208;fracionada&#44; tendo sido preditores de HM a terap&#234;utica com antiagregantes n&#227;o AAS&#47;clopidogrel e com antagonistas da aldosterona &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46; Em an&#225;lise semelhante incluindo a terap&#234;utica antiagregante tripla&#44; esta foi preditora independente de HM&#44; assim como a DPOC e a terap&#234;utica com antagonistas da aldosterona &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140"><span class="elsevierStyleItalic">Score</span> CRUSADE e Modelo Preditor de Hemorragia Major para identifica&#231;&#227;o de hemorragia <span class="elsevierStyleItalic">major</span></span><p id="par0190" class="elsevierStylePara elsevierViewall">Atrav&#233;s de an&#225;lise de curvas ROC&#44; o <span class="elsevierStyleItalic">score</span> CRUSADE mostrou n&#227;o ter acuidade diagn&#243;stica para a identifica&#231;&#227;o de HM nesta popula&#231;&#227;o &#40;AUC 0&#44;51&#44; IC 95&#37; 0&#44;30&#8208;0&#44;63&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;942&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Figura 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0195" class="elsevierStylePara elsevierViewall">O MP&#8208;HM apresentou uma boa calibra&#231;&#227;o no teste de <span class="elsevierStyleItalic">Hosmer&#8208;Lemeshow</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;111&#41; e&#44; em an&#225;lise de curvas ROC&#44; mostrou um bom poder discriminat&#243;rio de HM para a popula&#231;&#227;o em estudo &#40;AUC 0&#44;68&#44; IC 95&#37; 0&#44;52&#8208;0&#44;84&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;032&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Figura 3</a>&#41;&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discuss&#227;o</span><p id="par0200" class="elsevierStylePara elsevierViewall">Os dados apresentados sugerem que o <span class="elsevierStyleItalic">score</span> GRACE &#233; adequado para avalia&#231;&#227;o de risco de MIH em octogen&#225;rios com SCANST&#44; enquanto o CRUSADE parece ser desajustado para avalia&#231;&#227;o de risco hemorr&#225;gico nesta faixa et&#225;ria&#46; Do que &#233; nosso conhecimento&#44; este &#233; o primeiro estudo realizado at&#233; ao momento a avaliar a adequa&#231;&#227;o dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE a esta popula&#231;&#227;o&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">As comorbilidades e os fatores de risco cardiovascular verificados foram semelhantes aos publicados noutras s&#233;ries de SCANST em doentes idosos<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;9</span></a>&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">A incid&#234;ncia de terap&#234;utica antitromb&#243;tica nesta amostra atingiu valores id&#234;nticos aos apresentados num subestudo da iniciativa CRUSADE &#40;<span class="elsevierStyleItalic">Can Rapid risk stratification of Unstable angina patients Suppress Adverse outcomes with Early implementation of the ACC&#47;AHA guidelines</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#44; em doentes com SCANST e idade compreendida entre os 75 e os 89 anos&#44; com exce&#231;&#227;o de no CRUSADE haver uma frequ&#234;ncia maior de medica&#231;&#227;o com inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a &#40;29&#44;2 <span class="elsevierStyleItalic">versus</span> 5&#44;9&#37;&#41;&#46; A realiza&#231;&#227;o de coronariografia e angioplastia reportada nesse grupo de doentes do CRUSADE tamb&#233;m foi inferior &#224; verificada nesta popula&#231;&#227;o&#44; embora apenas tenham sido apresentados resultados para os procedimentos realizados nas primeiras 48<span class="elsevierStyleHsp" style=""></span>h ap&#243;s admiss&#227;o&#44; numa faixa et&#225;ria com limites diferentes<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; Uma an&#225;lise do registo <span class="elsevierStyleItalic">Acute Coronary Syndromes Israeli Survey</span><a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> publicou resultados para doentes com EAMNST com mais de 80 anos&#44; tendo sido verificada uma frequ&#234;ncia de coronariografia &#40;55&#37;&#41; ligeiramente inferior &#224; da nossa popula&#231;&#227;o &#40;59&#44;4&#37;&#41;&#44; em que 91&#37; dos doentes foram admitidos por EAMNST&#46; Ainda assim&#44; em 40&#37; destes idosos n&#227;o foi realizada coronariografia e 50&#37; n&#227;o foram submetidos a revasculariza&#231;&#227;o&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">A realiza&#231;&#227;o de coronariografia associou&#8208;se a um progn&#243;stico favor&#225;vel em termos de MIH&#44; mas n&#227;o se associou a HM&#46; A revasculariza&#231;&#227;o com angioplastia tamb&#233;m se associou a menor MIH&#44; embora de modo n&#227;o&#8208;independente&#46; Estes dados s&#227;o consistentes com os apresentados pelo subestudo do <span class="elsevierStyleItalic">Acute Coronary Syndromes Israeli Survey</span><a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> acima mencionado&#44; em que se observou uma redu&#231;&#227;o da mortalidade a um ano com procedimentos de revasculariza&#231;&#227;o &#40;HR 0&#44;5&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; redu&#231;&#227;o da mortalidade a um ano &#40;HR 0&#44;4&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; e a 30 dias &#40;HR 0&#44;38&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; com a realiza&#231;&#227;o de coronariografia nas primeiras 24<span class="elsevierStyleHsp" style=""></span>h de evolu&#231;&#227;o de EAMNST em doentes com mais de 80 anos&#46; Tamb&#233;m o subestudo do registo CRUSADE<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> concluiu que a ades&#227;o a terap&#234;uticas recomendadas pelas <span class="elsevierStyleItalic">guidelines</span>&#44; incluindo cateteriza&#231;&#227;o nas primeiras 48<span class="elsevierStyleHsp" style=""></span>h de evolu&#231;&#227;o&#44; se encontrava associada a redu&#231;&#227;o da MIH em doentes com ACSNST e idade superior a 75 anos&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">O valor preditivo superior da coronariografia face &#224; angioplastia verificado nesta popula&#231;&#227;o poder&#225; refletir as diferentes estrat&#233;gias de revasculariza&#231;&#227;o realizadas&#46; Por outro lado&#44; a angioplastia n&#227;o se associou &#224; ocorr&#234;ncia de HM&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Deve&#8208;se&#44; contudo&#44; ressalvar o poss&#237;vel vi&#233;s de sele&#231;&#227;o originado pelo <span class="elsevierStyleItalic">status</span> fisiol&#243;gico&#44; cognitivo e social dos idosos&#44; que poder&#225; ter contribu&#237;do para a sele&#231;&#227;o dos mais aptos e vi&#225;veis para a estrat&#233;gia invasiva&#44; mas que tem tamb&#233;m reconhecido impacto progn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; Estes dados salientam a import&#226;ncia do ajuste dos <span class="elsevierStyleItalic">scores</span> utilizados na estratifica&#231;&#227;o de risco &#224;s caracter&#237;sticas pr&#243;prias desta faixa et&#225;ria&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">A incid&#234;ncia de MIH e de HM encontrada no RNSCA foi inferior &#224; reportada noutros estudos com popula&#231;&#227;o id&#234;ntica&#44; nomeadamente no subestudo do registo CRUSADE<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> &#8211; o maior estudo realizado em idosos com SCANST &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;557&#41;&#44; em que se verificou uma MIH de 7&#44;8&#37; &#40;<span class="elsevierStyleItalic">versus</span> 6&#44;6&#37;&#41; e HM em 13&#44;1&#37; <span class="elsevierStyleItalic">&#40;versus</span> 2&#44;9&#37;&#41;&#46; Neste &#250;ltimo caso&#44; foi utilizada uma defini&#231;&#227;o de hemorragia mais abrangente&#44; tendo sido tamb&#233;m inclu&#237;dos outros crit&#233;rios que poder&#227;o justificar essa diferen&#231;a &#40;queda de hemat&#243;crito em &#8805;<span class="elsevierStyleHsp" style=""></span>12&#37;&#44; hemorragia retroperitoneal&#44; transfus&#227;o de gl&#243;bulos vermelhos em contexto de hemorragia documentada e com hemat&#243;crito basal &#60;<span class="elsevierStyleHsp" style=""></span>28&#37;&#44; ou transfus&#227;o com hemat&#243;crito basal &#8805;<span class="elsevierStyleHsp" style=""></span>28&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">A import&#226;ncia das comorbilidades no progn&#243;stico a curto prazo dos doentes com &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos foi bem evidenciada pelos resultados obtidos&#44; sobretudo o contributo da insufici&#234;ncia card&#237;aca como predisponente a MIH e HM&#44; e da DPOC para a HM&#46; Ambas se associam a um estado inflamat&#243;rio cr&#243;nico&#44; condicionando uma maior fragilidade fisiol&#243;gica e propiciando anemia&#46; No caso da DPOC&#44; poder&#227;o ainda contribuir para HM terap&#234;uticas frequentemente utilizadas neste contexto&#44; como a corticoterapia&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Os nossos resultados refor&#231;am tamb&#233;m a rela&#231;&#227;o estreita e independente da HM com a MIH&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">O risco acrescido de HM verificado para terap&#234;uticas como a heparina n&#227;o&#8208;fracionada&#44; antiagregantes n&#227;o&#8208;AAS&#47;clopidogrel&#44; antiagrega&#231;&#227;o tripla &#40;inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a associados a dupla antiagrega&#231;&#227;o&#41; ou antagonistas da aldosterona&#44; poder&#225; relacionar&#8208;se com sobredosagem dos mesmos&#46; Com efeito&#44; este tem sido um problema frequentemente reportado nos idosos&#44; associado &#224; deteriora&#231;&#227;o da fun&#231;&#227;o renal&#46; Tamb&#233;m nas terap&#234;uticas com ajuste de dose em fun&#231;&#227;o do peso corporal&#44; como a heparina n&#227;o&#8208;fracionada&#44; tem sido documentada sobredosagem associada a altera&#231;&#227;o da composi&#231;&#227;o corporal e dos n&#237;veis de prote&#237;nas nos idosos<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; No caso dos antitromb&#243;ticos&#44; a sobredosagem poder&#225; aumentar o risco de complica&#231;&#245;es hemorr&#225;gicas&#46; A associa&#231;&#227;o da HM com os antagonistas da aldosterona poder&#225; advir de m&#250;ltiplos fatores&#44; tais como o poss&#237;vel agravamento da fun&#231;&#227;o renal pelo f&#225;rmaco e a sua maior utiliza&#231;&#227;o em doentes com cl&#237;nica de insufici&#234;ncia card&#237;aca&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">A escolha das vari&#225;veis inclu&#237;das em cada um dos modelos criados prendeu&#8208;se com o objetivo destes poderem ser aplicados no momento da admiss&#227;o hospitalar&#46; Por esse motivo&#44; no MP&#8208;HM&#44; optou&#8208;se por incluir a vari&#225;vel creatinina &#224; admiss&#227;o&#44; apesar de a signific&#226;ncia estat&#237;stica ter sido verificada para a creatinina m&#225;xima&#44; face ao reduzido n&#250;mero de vari&#225;veis que seriam inclu&#237;das no modelo seguindo o crit&#233;rio inicial&#46; N&#227;o se incluiu a hemoglobina de admiss&#227;o pelo facto do seu valor m&#237;nimo&#44; que demonstrou associa&#231;&#227;o a HM&#44; refletir uma consequ&#234;ncia &#243;bvia da mesma&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">Segundo a nossa an&#225;lise&#44; o <span class="elsevierStyleItalic">score</span> GRACE discriminou de modo adequado os eventos de MIH nesta popula&#231;&#227;o&#44; sem diferen&#231;a significativa em rela&#231;&#227;o ao MP&#8208;MIH ajustado&#59; o seu <span class="elsevierStyleItalic">Youden &#237;ndex</span> foi superior ao ponto de corte de alto risco de MIH recomendado pelas <span class="elsevierStyleItalic">guidelines</span> da Sociedade Europeia de Cardiologia para doentes com SCANST<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> e corresponder&#225; a um ajuste para a faixa et&#225;ria em avalia&#231;&#227;o&#46; Contudo&#44; o <span class="elsevierStyleItalic">score</span> CRUSADE&#44; tamb&#233;m recomendado pelas mesmas <span class="elsevierStyleItalic">guidelines</span>&#44; mostrou&#8208;se completamente desajustado &#224; predi&#231;&#227;o de HM nesta popula&#231;&#227;o&#46; Em parte&#44; este desajuste poderia ser explicado por se ter utilizado uma defini&#231;&#227;o de HM diferente da utilizada no estudo CRUSADE&#46; Ainda assim&#44; seria esperado que o <span class="elsevierStyleItalic">score</span> CRUSADE apresentasse alguma capacidade discriminativa para hemorragia grave&#44; como a HM definida pelos crit&#233;rios GUSTO&#44; o que n&#227;o se verificou&#46; Numa an&#225;lise do RNSCA apresentada no ESC Congress 2012<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#44; o <span class="elsevierStyleItalic">score</span> CUSADE mostrou uma capacidade discriminat&#243;ria bem superior &#224; verificada nesta an&#225;lise &#40;AUC 0&#44;755&#44; IC 95&#37; 0&#44;69&#8208;0&#44;82&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; contudo&#44; a idade m&#233;dia desta popula&#231;&#227;o era 66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13 anos&#46; Estes resultados p&#245;em em evid&#234;ncia a necessidade de novos <span class="elsevierStyleItalic">scores</span> para predi&#231;&#227;o de risco hemorr&#225;gico nos octogen&#225;rios&#46; O MP&#8208;HM criado poderia ser uma alternativa&#44; j&#225; que demonstrou uma boa acuidade diagn&#243;stica para HM&#46; Contudo&#44; tratando&#8208;se de um modelo ajustado a esta popula&#231;&#227;o&#44; teria de ser validado com outra amostra para garantir a extensibilidade destes resultados &#224; popula&#231;&#227;o geral de octogen&#225;rios com SCANST&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">Neste trabalho s&#227;o apresentados dados do mundo real&#44; com uma distribui&#231;&#227;o geogr&#225;fica alargada e um n&#250;mero significativo de doentes para a patologia e faixa et&#225;ria&#46; Contudo&#44; algumas limita&#231;&#245;es devem ser consideradas na interpreta&#231;&#227;o dos resultados&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Tratando&#8208;se de um estudo observacional&#44; tem de ser considerado um poss&#237;vel vi&#233;s de sele&#231;&#227;o das estrat&#233;gias terap&#234;uticas em fun&#231;&#227;o do <span class="elsevierStyleItalic">status</span> fisiol&#243;gico&#44; psicol&#243;gico&#44; cognitivo e meio social dos doentes&#44; que por sua vez tamb&#233;m s&#227;o fatores com impacto progn&#243;stico&#46; Uma das limita&#231;&#245;es inerentes a este trabalho prende&#8208;se com a falta de informa&#231;&#227;o relativa &#224; fragilidade dos doentes&#46; O RNSCA inclui informa&#231;&#227;o relativa a comorbilidades potencialmente associadas a maior fragilidade como dem&#234;ncia&#44; antecedentes de acidente vascular cerebral&#44; neoplasia&#44; insufici&#234;ncia renal&#44; DPOC&#44; contudo&#44; a fragilidade associada &#233; vari&#225;vel de acordo com a severidade da doen&#231;a&#46; Assim&#44; e &#224; semelhan&#231;a de outros estudos abordando esta tem&#225;tica&#44; n&#227;o se encontra adequadamente descriminada e definida a fragilidade nas suas diferentes vertentes&#58; debilidade fisiol&#243;gica&#44; cognitiva&#44; psicol&#243;gica ou social&#44; limita&#231;&#245;es funcionais e qualidade de vida&#44; que&#44; no entanto&#44; tem sido descrita como um fator de progn&#243;stico adverso mais importante nos idosos do que os fatores de risco cardiovascular cl&#225;ssicos ou as comorbilidades<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Estes dados seriam importantes na interpreta&#231;&#227;o das terap&#234;uticas efetuadas&#44; da HM e da MIH&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Apesar de se tratar de um estudo multic&#234;ntrico&#44; esta amostra baseia&#8208;se nos crit&#233;rios de admiss&#227;o do RNSCA&#58; apresenta&#231;&#227;o cl&#237;nica sugestiva em doentes com &#60;<span class="elsevierStyleHsp" style=""></span>48 horas de evolu&#231;&#227;o&#44; o que poder&#225; ter conduzido &#224; exclus&#227;o de idosos com apresenta&#231;&#227;o at&#237;pica&#44; frequente nesta faixa et&#225;ria e condicionadora de atraso no diagn&#243;stico&#46; Do mesmo modo&#44; apenas foram inclu&#237;dos os octogen&#225;rios com SCANST que sobreviveram at&#233; &#224; admiss&#227;o hospitalar&#44; impedindo&#44; assim&#44; que doentes mais graves pudessem ser inclu&#237;dos na an&#225;lise&#46; A participa&#231;&#227;o no RNSCA de apenas 14 centros portugueses tamb&#233;m n&#227;o garante a representatividade destes resultados &#224; popula&#231;&#227;o portuguesa de octogen&#225;rios com SCANST&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">Neste estudo s&#243; foi avaliada a MIH&#44; no entanto&#44; a mortalidade a longo prazo e a informa&#231;&#227;o relativa &#224; qualidade de vida ap&#243;s a alta seriam importantes na avalia&#231;&#227;o do risco&#8208;benef&#237;cio das diferentes terap&#234;uticas&#46; A MIH foi utilizada como <span class="elsevierStyleItalic">endpoint</span> para avalia&#231;&#227;o de risco isqu&#233;mico&#44; contudo&#44; tal como se verificou neste trabalho&#44; este <span class="elsevierStyleItalic">endpoint</span> reflete tamb&#233;m risco hemorr&#225;gico&#46; A avalia&#231;&#227;o do risco isqu&#233;mico seria mais correta utilizando um <span class="elsevierStyleItalic">endpoint</span> como enfarte fatal e n&#227;o&#8208;fatal&#44; mas tal implicaria um seguimento a longo prazo&#44; que limitaria ainda mais a dimens&#227;o da amostra&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conclus&#245;es</span><p id="par0280" class="elsevierStylePara elsevierViewall">Nos doentes com SCANST e idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos o <span class="elsevierStyleItalic">score</span> GRACE adequou&#8208;se &#224; predi&#231;&#227;o de MIH&#44; enquanto o CRUSADE se mostrou desajustado na avalia&#231;&#227;o de risco hemorr&#225;gico nesta faixa et&#225;ria&#46; A presen&#231;a de sinais de insufici&#234;ncia card&#237;aca &#224; admiss&#227;o&#44; uma fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo &#60;<span class="elsevierStyleHsp" style=""></span>30&#37; e a ocorr&#234;ncia de HM foram preditores independentes de MIH&#46; Os principais preditores de HM corresponderam a medica&#231;&#227;o institu&#237;da no internamento e a antecedentes de DPOC&#46; A realiza&#231;&#227;o de coronariografia associou&#8208;se a um progn&#243;stico favor&#225;vel durante o internamento em termos de MIH e n&#227;o aumentou o risco de HM&#46; Estes dados sugerem o benef&#237;cio de uma estrat&#233;gia invasiva em doentes selecionados&#44; bem como a necessidade de novos <span class="elsevierStyleItalic">scores</span> para avalia&#231;&#227;o do risco hemorr&#225;gico nestes doentes&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Responsabilidades &#233;ticas</span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Prote&#231;&#227;o de pessoas e animais</span><p id="par0285" class="elsevierStylePara elsevierViewall">Os autores declaram que para esta investiga&#231;&#227;o n&#227;o se realizaram experi&#234;ncias em seres humanos e&#47;ou animais&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Confidencialidade dos dados</span><p id="par0290" class="elsevierStylePara elsevierViewall">Os autores declaram ter seguido os protocolos do seu centro de trabalho acerca da publica&#231;&#227;o dos dados de pacientes&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Direito &#224; privacidade e consentimento escrito</span><p id="par0295" class="elsevierStylePara elsevierViewall">Os autores declaram ter recebido consentimento escrito dos pacientes e&#47;ou sujeitos mencionados no artigo&#46; O autor para correspond&#234;ncia deve estar na posse deste documento&#46;</p></span></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Conflito de interesses</span><p id="par0300" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A avalia&#231;&#227;o do risco isqu&#233;mico e hemorr&#225;gico &#233; fundamental na abordagem dos idosos com s&#237;ndromes coron&#225;rias agudas&#44; mas tem sido pouco estudada&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Este estudo pretende avaliar a adequa&#231;&#227;o dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE a doentes com s&#237;ndrome coron&#225;ria aguda sem supradesnivelamento&#8208;ST e idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos&#44; e identificar os principais preditores de mortalidade intra&#8208;hospitalar e hemorragia <span class="elsevierStyleItalic">major</span> nesta popula&#231;&#227;o&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Foram avaliados 544 doentes com idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos com s&#237;ndrome coron&#225;ria aguda sem supradesnivelamento&#8208;ST&#44; inclu&#237;dos no Registo Portugu&#234;s de S&#237;ndromes Coron&#225;rias Agudas&#46; Foram identificados os preditores de mortalidade intra&#8208;hospitalar e de hemorragia <span class="elsevierStyleItalic">major</span> durante o internamento&#46; Criaram&#8208;se modelos preditores destes <span class="elsevierStyleItalic">endpoints</span>&#44; posteriormente comparados com os <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE&#44; e avaliada a sua adequa&#231;&#227;o &#224; popula&#231;&#227;o em estudo&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A realiza&#231;&#227;o de coronariografia associou&#8208;se a redu&#231;&#227;o do risco de mortalidade intra&#8208;hospitalar e n&#227;o se associou a aumento do risco de hemorragia <span class="elsevierStyleItalic">major</span> &#40;OR 0&#44;2&#44; IC 95&#37; 0&#44;006&#8208;0&#44;49&#44; p &#61; 0&#44;001&#41;&#46; A hemorragia <span class="elsevierStyleItalic">major</span> foi preditora independente de mortalidade intra&#8208;hospitalar &#40;OR 10&#44;9&#44; IC 95&#37; 2&#44;36&#8208;50&#44;74&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; e associou&#8208;se a comorbilidades e &#224; terap&#234;utica farmacol&#243;gica institu&#237;da&#46; O <span class="elsevierStyleItalic">score</span> GRACE apresentou boa acuidade diagn&#243;stica para mortalidade intra&#8208;hospitalar &#40;AUC 0&#44;75&#44; IC 95&#37; 0&#44;63&#8208;0&#44;87&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; mas o CRUSADE mostrou fraca capacidade discriminat&#243;ria de hemorragia <span class="elsevierStyleItalic">major</span> &#40;AUC 0&#44;51&#44; IC 95&#37; 0&#44;30&#8208;0&#44;63&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;942&#41;&#44; contrariamente ao modelo preditor &#40;AUC 0&#44;68&#44; IC 95&#37; 0&#44;52&#8208;0&#44;84&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;032&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O <span class="elsevierStyleItalic">score</span> GRACE &#233; adequado para avalia&#231;&#227;o de risco nos octogen&#225;rios&#44; mas o CRUSADE &#233; desajustado&#44; sendo necess&#225;rios novos <span class="elsevierStyleItalic">scores</span> para a avalia&#231;&#227;o de risco hemorr&#225;gico nesta faixa et&#225;ria&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Assessment of ischemic and bleeding risk is critical for the management of elderly patients with acute coronary syndromes&#44; but it has been little studied&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">This study aims to assess the applicability of the GRACE and CRUSADE scores in patients aged &#8805;80 years with non&#8208;ST&#8208;elevation acute coronary syndrome &#40;NSTE&#8208;ACS&#41;&#44; and to identify the main predictors of in&#8208;hospital mortality and major bleeding in this population&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">We analyzed 544 patients aged &#8805;80 years with NSTE&#8208;ACS included in the Portuguese Registry on Acute Coronary Syndromes and identified the predictors of in&#8208;hospital mortality and major bleeding during hospitalization&#46; Prediction models were created for these endpoints&#44; then compared with the GRACE and CRUSADE scores&#44; and their applicability to the study population was assessed&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Use of coronary angiography was associated with reduced risk of in&#8208;hospital mortality&#44; without increasing risk of major bleeding &#40;OR 0&#46;2&#44; 95&#37; CI 0&#46;006&#8208;0&#46;49&#44; p&#61;0&#46;001&#41;&#46; Major bleeding was an independent predictor of in&#8208;hospital mortality &#40;OR 10&#46;9&#44; 95&#37; CI 2&#46;36&#8208;50&#46;74&#44; p&#61;0&#46;002&#41;&#44; and was associated with comorbidities and pharmacological therapy during hospitalization&#46; The GRACE score showed good diagnostic accuracy for in&#8208;hospital mortality &#40;AUC 0&#46;75&#44; 95&#37; CI 0&#46;63&#8208;0&#46;87&#44; p&#60;0&#46;001&#41;&#44; but the CRUSADE score had weak discriminatory capacity for major bleeding &#40;AUC 0&#46;51&#44; 95&#37; CI 0&#46;30&#8208;0&#46;63&#44; p&#61;0&#46;942&#41;&#44; unlike our prediction model &#40;AUC 0&#46;68&#44; 95&#37; CI 0&#46;52&#8211;0&#46;84&#44; p&#61;0032&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The GRACE score is suitable for risk assessment in octogenarians with NSTE&#8208;ACS&#44; but the CRUSADE score is inadequate&#44; and new scores are required to assess bleeding risk in this age&#8208;group&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Centro Nacional de Colec&#231;&#227;o de Dados em Cardiologia&#44; Sociedade Portuguesa de Cardiologia&#46;</p>"
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            "titulo" => "<span class="elsevierStyleSectionTitle" id="sect0075"><span class="elsevierStyleBold">Lista de Abreviaturas</span></span>"
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              0 => array:2 [
                "termino" => "AAS"
                "descripcion" => "<p id="par0005" class="elsevierStylePara elsevierViewall">&#193;cido acetilsalic&#237;lico</p>"
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              1 => array:2 [
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                "descripcion" => "<p id="par0010" class="elsevierStylePara elsevierViewall">Angina inst&#225;vel</p>"
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              2 => array:2 [
                "termino" => "AUC"
                "descripcion" => "<p id="par0015" class="elsevierStylePara elsevierViewall">&#193;rea debaixo da curva</p>"
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              3 => array:2 [
                "termino" => "DPOC"
                "descripcion" => "<p id="par0020" class="elsevierStylePara elsevierViewall">Doen&#231;a pulmonar obstrutiva cr&#243;nica</p>"
              ]
              4 => array:2 [
                "termino" => "EAMNST"
                "descripcion" => "<p id="par0025" class="elsevierStylePara elsevierViewall">Enfarte agudo do mioc&#225;rdio sem supradesnivelamento do segmento ST</p>"
              ]
              5 => array:2 [
                "termino" => "HM"
                "descripcion" => "<p id="par0030" class="elsevierStylePara elsevierViewall">Hemorragia major</p>"
              ]
              6 => array:2 [
                "termino" => "MIH"
                "descripcion" => "<p id="par0035" class="elsevierStylePara elsevierViewall">Mortalidade intra&#8208;hospitalar</p>"
              ]
              7 => array:2 [
                "termino" => "MP"
                "descripcion" => "<p id="par0040" class="elsevierStylePara elsevierViewall">Modelo predictor</p>"
              ]
              8 => array:2 [
                "termino" => "RNSCA"
                "descripcion" => "<p id="par0045" class="elsevierStylePara elsevierViewall">Registo Nacional de S&#237;ndromes Coron&#225;rias Agudas</p>"
              ]
              9 => array:2 [
                "termino" => "SCANST"
                "descripcion" => "<p id="par0050" class="elsevierStylePara elsevierViewall">S&#237;ndromes Coron&#225;rias Agudas sem supradesnivelamento do segmento ST</p>"
              ]
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      ]
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o da popula&#231;&#227;o total e dos doentes com eventos de acordo com a pontua&#231;&#227;o dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">HM&#58; hemorragia <span class="elsevierStyleItalic">major</span>&#59; MIH&#58; mortalidade intra&#8208;hospitalar&#46;</p>"
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      1 => array:7 [
        "identificador" => "fig0010"
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        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2071
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise de curvas ROC do GRACE e do MP&#8208;MIH para avalia&#231;&#227;o de mortalidade intra&#8208;hospitalar&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Diferen&#231;a&#58; diferen&#231;a entre as &#225;reas debaixo das duas curvas ROC&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2060
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise de curvas ROC do CRUSADE e do MP&#8208;HM para avalia&#231;&#227;o de hemorragia <span class="elsevierStyleItalic">major</span>&#46;</p>"
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        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">AAS&#58; &#225;cido acetilsalic&#237;lico&#59; AIT&#58; acidente isqu&#233;mico transit&#243;rio&#59; AVC&#58; acidente vascular cerebral&#59; BNP&#58; pept&#237;deo natriur&#233;tico do tipo B&#59; DC&#58; doen&#231;a coron&#225;ria&#59; DPOC&#58; doen&#231;a pulmonar obstrutiva cr&#243;nica&#59; ECG&#58; eletrocardiograma&#59; IMC&#58; &#237;ndice de massa corporal&#59; MNM&#58; marcadores de necrose do mioc&#225;rdio&#59; NT&#8208;proBNP&#58; por&#231;&#227;o N&#8208;terminal do pro&#8208;BNP&#59; TA&#58; tens&#227;o arterial&#59; VM&#58; ventila&#231;&#227;o mec&#226;nica&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">As vari&#225;veis com distribui&#231;&#227;o n&#227;o&#8208;normal s&#227;o apresentadas como&#58; mediana &#40;percentil 25&#59; percentil 75&#41;&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">&#42; <span class="elsevierStyleItalic">Clearance</span> de creatinina estimado pela f&#243;rmula Cockcroft&#8208;Gault&#46;</p>"
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Descri&#231;&#227;o popula&#231;&#227;o&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>544</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Dados demogr&#225;ficos</td><td class="td" title="\n
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                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Apresenta&#231;&#227;o cl&#237;nica &#40;admiss&#227;o&#41;</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">Idade&#44; anos&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">84<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Insufici&#234;ncia card&#237;aca&#44; &#37; &#40;n&#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">35&#44;1&#37; &#40;191&#41;&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">Sexo masculino&#44; &#37; &#40;n&#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">53&#44;1&#37; &#40;289&#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">Paragem card&#237;aca&#44; &#37; &#40;n&#41;&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">1&#44;8&#37; &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC&#44; kg&#47;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequ&#234;ncia card&#237;aca&#44; bpm&nbsp;\t\t\t\t\t\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">81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fatores de risco cardiovascular&#44; &#37; &#40;n&#41;</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">TA sist&#243;lica&#44; mmHg&nbsp;\t\t\t\t\t\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">142<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertens&#227;o arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#44;7&#37; &#40;466&#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">ECG com infra&#8208;ST&#44; &#37; &#40;n&#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">43&#44;8&#37; &#40;238&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;2&#37; &#40;159&#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  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Par&#226;metros laboratoriais &#40;admiss&#227;o&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;1&#37; &#40;267&#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">Hemat&#243;crito&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Fumador&nbsp;\t\t\t\t\t\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">1&#44;5&#37; &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glicemia&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127 &#40;106&#59; 170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ex&#8208;fumador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;1&#37; &#40;66&#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">Creatinina&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#40;0&#44;9&#59; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hist&#243;ria familiar de DC&nbsp;\t\t\t\t\t\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&#44;6&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Clearance</span>&#44; mL&#47;min<span class="elsevierStyleSup">&#42;</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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;8 &#40;31&#44;8&#59; 55&#44;4&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antecedentes&#44; &#37; &#40;n&#41;</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">Eleva&#231;&#227;o MNM&#44; &#37; &#40;n&#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">20&#44;7&#37; &#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfarte&nbsp;\t\t\t\t\t\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">30&#37; &#40;163&#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">BNP&#44; pg&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127 &#40;106&#59; 170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Revasculariza&#231;&#227;o pr&#233;via&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;8&#37; &#40;124&#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">NT&#8208;proBNP&#44; pg&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;400 &#40;1&#46;714&#59; 12&#46;600&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AVC&#47;AIT&nbsp;\t\t\t\t\t\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">13&#44;4&#37; &#40;73&#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  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coronariografia e revasculariza&#231;&#227;o mioc&#225;rdica</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Doen&#231;a arterial perif&#233;rica&nbsp;\t\t\t\t\t\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">9&#44;6&#37; &#40;52&#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">Coronariografia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#44;4&#37; &#40;323&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insufici&#234;ncia renal cr&#243;nica&nbsp;\t\t\t\t\t\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">17&#44;8&#37; &#40;97&#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">Angioplastia&nbsp;\t\t\t\t\t\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">34&#44;7&#37; &#40;189&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DPOC&#44; &#37; &#40;n&#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">7&#44;9&#37; &#40;43&#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">Cirurgia &#40;revasculariza&#231;&#227;o&#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">14&#44;7&#37; &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemorragia&nbsp;\t\t\t\t\t\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">3&#44;5&#37; &#40;19&#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  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Outras terap&#234;uticas</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neoplasia&nbsp;\t\t\t\t\t\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">6&#44;8&#37; &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VM invasiva&nbsp;\t\t\t\t\t\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">1&#44;8&#37; &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dem&#234;ncia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;6&#37; &#40;25&#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">VM n&#227;o&#8208;invasiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;0&#37; &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insufici&#234;ncia card&#237;aca&nbsp;\t\t\t\t\t\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">17&#44;8&#37; &#40;97&#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"><span class="elsevierStyleItalic">Pacemaker</span> provis&#243;rio&nbsp;\t\t\t\t\t\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">1&#44;3&#37; &#40;7&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Scores</span> de risco</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">Bal&#227;o intra&#8208;a&#243;rtico&nbsp;\t\t\t\t\t\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&#44;4&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GRACE &#40;MIH&#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">161<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inotr&#243;picos&nbsp;\t\t\t\t\t\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">3&#44;9&#37; &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CRUSADE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Levosimendan&nbsp;\t\t\t\t\t\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&#44;9&#37; &#40;5&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diagn&#243;stico de admiss&#227;o</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">AAS&nbsp;\t\t\t\t\t\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">97&#44;6&#37; &#40;531&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfarte sem supra&#8208;ST&#44; &#37; &#40;n&#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">91&#37; &#40;495&#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">Clopidogrel&nbsp;\t\t\t\t\t\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">86&#44;9&#37; &#40;473&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Angina inst&#225;vel&#44; &#37; &#40;n&#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">9&#37; &#40;49&#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">Inibidores Gp <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;9&#37; &#40;32&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eventos &#40;internamento&#41;</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">Heparina n&#227;o&#8208;fraccionada&nbsp;\t\t\t\t\t\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">13&#44;6&#37; &#40;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemorragia <span class="elsevierStyleItalic">major</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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;9&#37; &#40;16&#41;&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">Enoxaparina&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">76&#44;3&#37; &#40;415&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Morte intra&#8208;hospitalar&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#44;6&#37; &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Fondaparinux&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#44;8&#37; &#40;75&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t" style="border-bottom: 2px solid black">Preditores de MIH &#8211; an&#225;lise univariada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">89<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TAS admiss&#227;o&#44; mmHg&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Classe Killip &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span> admiss&#227;o&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24&#44;6&#37; &#40;125&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">69&#44;4&#37; &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Infra&#8208;ST admiss&#227;o&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39&#44;5&#37; &#40;215&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">63&#44;9&#37; &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Eleva&#231;&#227;o isolada de troponina&#44; &#37; &#40;n&#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">18&#44;7&#37; &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;6&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinina admiss&#227;o&#44; mg&#47;dL&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&#44;41<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;34&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;57&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;022&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinina m&#225;xima&#44; mg&#47;dL&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&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;08&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;02&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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glicemia admiss&#227;o&#44; mg&#47;dL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;015&nbsp;\t\t\t\t\t\t\n
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                  \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
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bloqueador&#8208;beta&#44; &#37; &#40;n&#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">73&#44;8&#37; &#40;375&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">44&#44;4&#37; &#40;16&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IECA&#47;ARA&#44; &#37; &#40;n&#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">84&#44;2&#37; &#40;428&#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">58&#44;3&#37; &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antagonista do c&#225;lcio&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;8&#37; &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inotr&#243;pico&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;6&#37; &#40;13&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;2&#37; &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Levosimendan&#44; &#37; &#40;n&#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&#44;4&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;3&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronariografia&#44; &#37; &#40;n&#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">62&#44;2&#37; &#40;316&#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">19&#44;4&#37; &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\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">TC sem estenose significativa&#44; &#37; &#40;n&#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">45&#44;7&#37; &#40;232&#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">8&#44;3&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Angioplastia&#44; &#37; &#40;n&#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">36&#44;8&#37; &#40;187&#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">5&#44;6&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventila&#231;&#227;o mec&#226;nica invasiva&#44; &#37; &#40;n&#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">1&#44;2&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;1&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventila&#231;&#227;o mec&#226;nica n&#227;o invasiva&#44; &#37; &#40;n&#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">2&#44;4&#37; &#40;12&#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">27&#44;7&#37; &#40;10&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Pacemaker</span> provis&#243;rio&#44; &#37; &#40;n&#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&#44;8&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\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">Complica&#231;&#245;es &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fra&#231;&#227;o eje&#231;&#227;o VE &#60;<span class="elsevierStyleHsp" style=""></span>30&#37;&#44; &#37; &#40;n&#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">3&#44;1&#37; &#40;16&#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">30&#44;6&#37; &#40;11&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Insufici&#234;ncia card&#237;aca&#44; &#37; &#40;n&#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">26&#44;6&#37; &#40;135&#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">75&#37; &#40;27&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Complica&#231;&#227;o mec&#226;nica&#44; &#37; &#40;n&#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&#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">11&#44;1&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Re&#8208;enfarte&#44; &#37; &#40;n&#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">1&#44;4&#37; &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TV mantida&#44; &#37; &#40;n&#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&#44;6&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;9&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Paragem CR reanimada&#44; &#37; &#40;n&#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">1&#44;2&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;1&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemorragia <span class="elsevierStyleItalic">major</span>&#44; &#37; &#40;n&#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">2&#44;6&#37; &#40;13&#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">8&#44;3&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Vari&#225;veis associadas a mortalidade intra&#8208;hospitalar em an&#225;lise univariada</p>"
        ]
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      5 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">IC&#58; intervalo de confian&#231;a&#59; MIH&#58; mortalidade intra&#8208;hospitalar&#59; OR&#58; <span class="elsevierStyleItalic">Odds ratio</span>&#59; p&#58; signific&#226;ncia estat&#237;stica&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Preditores de MIH &#8211; an&#225;lise multivariada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobina m&#237;nima&#44; g&#47;dL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antagonista da aldosterona &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antagonista da aldosterona &#40;internamento&#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  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Preditores pr&#233;vios &#40;an&#225;lise multivariada&#41; &#43; terap&#234;utica tripla &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">0&#44;96&#8211;12&#44;24&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heparina n&#227;o&#8208;fracionada &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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Síndromes coronárias agudas sem supradesnivelamento‐ST nos octogenários: aplicabilidade dos scores GRACE e CRUSADE
Non‐ST‐elevation acute coronary syndromes in octogenarians: Applicability of the GRACE and CRUSADE scores
Ana Faustino
Autor para correspondência
anacatarina.faustino@gmail.com

Autor para correspondência.
, Paula Mota, Joana Silva, em nome dos Investigadores do Registo Nacional de Síndromes Coronárias Agudas da Sociedade Portuguesa de Cardiologia 1
Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra – Hospital Geral, Coimbra, Portugal
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os mais idosos ser&#227;o&#44; em teoria&#44; os que mais beneficiam das terap&#234;uticas com impacto progn&#243;stico<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#8211;11</span></a>&#46; Contudo&#44; esta faixa et&#225;ria apresenta caracter&#237;sticas pr&#243;prias&#44; como a presen&#231;a de m&#250;ltiplas comorbilidades&#44; redu&#231;&#227;o da capacidade para as atividades de vida di&#225;ria&#44; fragilidade fisiol&#243;gica&#44; psicol&#243;gica e cognitiva&#44; que influenciam o progn&#243;stico ap&#243;s SCANST e que limitam o benef&#237;cio de terap&#234;uticas mais agressivas<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Por outro lado&#44; nos idosos tamb&#233;m se encontra alterada a metaboliza&#231;&#227;o de f&#225;rmacos&#44; em virtude da deteriora&#231;&#227;o da fun&#231;&#227;o renal e hep&#225;tica&#44; intera&#231;&#227;o medicamentosa por polimedica&#231;&#227;o&#44; altera&#231;&#227;o da composi&#231;&#227;o corporal e comorbilidades&#46; 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provenientes de 14 hospitais portugueses&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A defini&#231;&#227;o de SCANST incluiu os diagn&#243;sticos de admiss&#227;o&#58; enfarte agudo do mioc&#225;rdio sem supradesnivelamento do segmento ST &#40;EAMNST&#58; aus&#234;ncia de supradesnivelamento persistente &#91;&#60; 30 minutos&#93; do segmento ST associada a eleva&#231;&#227;o dos marcadores de necrose mioc&#225;rdica &#91;troponina ou CK&#8208;mb&#93; em contexto cl&#237;nico sugestivo de isquemia mioc&#225;rdica&#41;&#44; e angina inst&#225;vel &#40;AI&#58; cl&#237;nica sugestiva de angor ou equivalente anginoso&#44; associada ou n&#227;o a altera&#231;&#245;es electrocardiogr&#225;ficas indicativas de isquemia&#44; na aus&#234;ncia de eleva&#231;&#227;o de biomarcadores de necrose do mioc&#225;rdio&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">O RNSCA<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> &#233; um estudo observacional com inclus&#227;o cont&#237;nua e prospetiva de doentes adultos &#40;&#62;<span class="elsevierStyleHsp" style=""></span>18 anos&#41; com o diagn&#243;stico de s&#237;ndrome coron&#225;ria aguda com &#60;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>h de evolu&#231;&#227;o&#46; Foram exclu&#237;dos deste registo enfartes dos tipos 4&#44; 5 e 2 &#40;classifica&#231;&#227;o de acordo com a redefini&#231;&#227;o do enfarte do mioc&#225;rdio de 2007 da <span class="elsevierStyleItalic">Joint ESC&#47;ACCF&#47;AHA&#47;WHF Task Force</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleItalic">&#46;</span> Informa&#231;&#227;o adicional em rela&#231;&#227;o ao protocolo deste registo pode ser consultada no s&#237;tio da Sociedade Portuguesa de Cardiologia<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Colheita de dados</span><p id="par0100" class="elsevierStylePara elsevierViewall">De entre as vari&#225;veis existentes no RNSCA&#44; foram avaliadas as seguintes&#44; que foram inclu&#237;das na an&#225;lise univari&#225;vel&#58; dados demogr&#225;ficos &#40;idade&#44; g&#233;nero&#44; &#237;ndice de massa corporal&#41;&#59; fatores de risco cardiovascular &#40;definidos por hist&#243;ria conhecida de hipertens&#227;o arterial&#44; diabetes&#44; dislipidemia&#44; tabagismo atual &#91;se consumo at&#233; 30 dias antes da admiss&#227;o&#93;&#44; e hist&#243;ria familiar de doen&#231;a coron&#225;ria&#41;&#59; antecedentes pessoais cardiovasculares &#40;antecedentes de enfarte agudo do mioc&#225;rdio&#44; insufici&#234;ncia card&#237;aca&#44; acidente vascular cerebral&#47;acidente isqu&#233;mico transit&#243;rio&#41; e antecedentes n&#227;o&#8208;cardiovasculares &#40;neoplasia&#44; hemorragia &#91;clinicamente significativa ou que tenha colocado a vida em risco&#93;&#44; dem&#234;ncia&#44; doen&#231;a pulmonar obstrutiva cr&#243;nica &#91;DPOC&#93;&#44; insufici&#234;ncia renal cr&#243;nica &#91;definida como hist&#243;ria pr&#233;via ou presen&#231;a de pelo menos um dos seguintes crit&#233;rios&#58; creatinina pr&#233;via ao internamento &#62; 2 mg&#47;dL&#44; di&#225;lise ou transplante renal&#93;&#41;&#59; medica&#231;&#227;o pr&#233;via &#224; admiss&#227;o &#40;antiagregantes &#91;aspirina&#44; clopidogrel&#44; ambos&#44; outros&#93;&#59; anticoagulantes &#91;antagonistas da vitamina K&#44; outros&#93;&#41;&#59; dados relativos &#224; admiss&#227;o hospitalar &#40;local&#44; forma de transporte para o hospital&#44; cl&#237;nica&#44; tens&#227;o arterial&#44; frequ&#234;ncia card&#237;aca&#44; classe Killip<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#44; infradesnivelamento do segmento ST no eletrocardiograma&#44; e avalia&#231;&#227;o anal&#237;tica &#224; admiss&#227;o &#91;eleva&#231;&#227;o isolada de troponina&#44; valor de hemoglobina&#44; hemat&#243;crito&#44; plaquetas&#44; glicemia&#44; HbA1c e creatinina&#93;&#41;&#46; O valor do hemat&#243;crito foi calculado a partir da hemoglobina&#44; de acordo com a equa&#231;&#227;o descrita por Bain e Bates<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> &#40;hemat&#243;crito &#61; hemoglobina &#91;g&#47;dl&#93; &#215; 3&#41;&#46; O valor do <span class="elsevierStyleItalic">clearance</span> de creatinina foi estimado atrav&#233;s da f&#243;rmula de Cockcroft&#8208;Gault<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; Foram ainda avaliados dados relativos ao internamento&#44; tais como a dura&#231;&#227;o&#44; vari&#225;veis anal&#237;ticas &#40;hemoglobina m&#237;nima&#44; creatinina m&#225;xima&#41;&#44; medica&#231;&#227;o administrada &#40;antiagregantes&#58; &#225;cido acetilsalic&#237;lico &#91;AAS&#93;&#41;&#44; clopidogrel&#44; outros n&#227;o&#8208;AAS&#47;clopidogrel&#59; anticoagulantes&#58; heparina n&#227;o fracionada&#44; enoxaparina&#44; fondaparinux&#44; antagonistas da vitamina K&#44; outros&#59; inibidores da glicoprote&#237;na IIb&#47;IIIa&#44; bloqueador&#8208;beta&#44; inibidor do enzima de convers&#227;o da angiotensina ou antagonista dos recetores de angiotensina&#44; estatina&#44; nitratos&#44; antagonistas do c&#225;lcio&#44; ivabradina&#44; antagonistas da aldosterona&#44; diur&#233;ticos&#44; antiarr&#237;tmicos&#44; insulina&#44; antidiab&#233;ticos orais&#44; inotr&#243;picos&#44; levosimendan&#41;&#44; realiza&#231;&#227;o de coronariografia&#44; acesso vascular&#44; uso de sistemas de encerramento arterial&#44; art&#233;ria <span class="elsevierStyleItalic">culprit</span>&#44; n&#250;mero de vasos com estenose &#8805; 50&#37;&#44; angioplastia&#44; tipo de <span class="elsevierStyleItalic">stent</span> utilizado&#44; revasculariza&#231;&#227;o cir&#250;rgica&#44; fun&#231;&#227;o ventricular esquerda&#44; tratamentos como implanta&#231;&#227;o de <span class="elsevierStyleItalic">pacemaker</span> provis&#243;rio&#44; bal&#227;o intra&#8208;a&#243;rtico&#44; ventila&#231;&#227;o mec&#226;nica invasiva e n&#227;o invasiva&#44; e ainda complica&#231;&#245;es verificadas durante o internamento &#40;re&#8208;enfarte&#44; complica&#231;&#245;es mec&#226;nicas&#44; arritmias&#44; paragem cardiorrespirat&#243;ria reanimada&#44; acidente vascular cerebral&#44; insufici&#234;ncia card&#237;aca&#44; HM e morte&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Os <span class="elsevierStyleItalic">scores</span> GRACE<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> &#40;avalia&#231;&#227;o de MIH&#41; e CRUSADE<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> foram calculados para todos os doentes&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Esclarecimentos adicionais no que respeita &#224; defini&#231;&#227;o das diferentes vari&#225;veis podem ser obtidos por consulta do s&#237;tio da Sociedade Portuguesa de Cardiologia<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105"><span class="elsevierStyleItalic">Endpoints</span> do estudo</span><p id="par0115" class="elsevierStylePara elsevierViewall">Os <span class="elsevierStyleItalic">endpoints</span> deste estudo corresponderam &#224; avalia&#231;&#227;o de MIH e HM&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">A MIH foi definida como morte de qualquer causa ocorrida durante o internamento por SCANST&#46; A HM foi definida como ocorr&#234;ncia durante o internamento de hemorragia intracraniana ou hemorragia com compromisso hemodin&#226;mico requerendo interven&#231;&#227;o &#40;crit&#233;rios <span class="elsevierStyleItalic">Global Use of Strategies to Open Occluded Arteries</span><a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> &#8211; GUSTO&#41;&#46; A sele&#231;&#227;o dos crit&#233;rios GUSTO para defini&#231;&#227;o de HM deveu&#8208;se ao facto de ser esta a classifica&#231;&#227;o utilizada no RNSCA&#46; Contudo&#44; os autores consideram que se trata tamb&#233;m da classifica&#231;&#227;o mais adequada &#224; popula&#231;&#227;o e aos objetivos do estudo&#44; uma vez que importa identificar a hemorragia suficientemente grave para justificar a n&#227;o utiliza&#231;&#227;o de terap&#234;uticas efetivas na redu&#231;&#227;o das complica&#231;&#245;es isqu&#233;micas&#44; mas que aumentam o risco hemorr&#225;gico no SCA&#46;</p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lise estat&#237;stica</span><p id="par0125" class="elsevierStylePara elsevierViewall">Foi realizada uma caracteriza&#231;&#227;o global da amostra considerando todos os par&#226;metros avaliados&#46; As vari&#225;veis categ&#243;ricas foram caracterizadas por frequ&#234;ncias absolutas e relativas&#44; e as vari&#225;veis cont&#237;nuas recorrendo &#224; m&#233;dia e desvio padr&#227;o&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Foram determinados os preditores independentes de cada um dos <span class="elsevierStyleItalic">endpoints</span> considerados&#44; MIH e HM&#44; tendo&#8208;se realizado uma an&#225;lise univari&#225;vel em que se testou a associa&#231;&#227;o entre o <span class="elsevierStyleItalic">endpoint</span> e cada um dos potenciais preditores&#46; No caso das vari&#225;veis categ&#243;ricas recorreu&#8208;se ao teste Qui&#8208;Quadrado e no caso de vari&#225;veis cont&#237;nuas recorreu&#8208;se ao teste T&#46; Sempre que os pressupostos de utiliza&#231;&#227;o do teste T n&#227;o eram satisfeitos utilizou&#8208;se o teste Mann&#8208;Whitney&#46; A normalidade da distribui&#231;&#227;o dos valores das vari&#225;veis cont&#237;nuas e a igualdade das suas vari&#226;ncias foram testadas usando o teste Kolmogorov&#8208;Smirnov e o teste de Levene&#44; respetivamente&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Foram aplicadas t&#233;cnicas de regress&#227;o log&#237;stica para identificar os preditores independentes de MIH e HM tendo em conta todas as vari&#225;veis com signific&#226;ncia estat&#237;stica &#40;m&#233;todo <span class="elsevierStyleItalic">Stepwise Forward</span> com teste raz&#227;o de verosimilhan&#231;as&#41;&#46; As vari&#225;veis identificadas como preditoras independentes de HM foram adicionalmente avaliadas por regress&#227;o log&#237;stica &#40;m&#233;todo <span class="elsevierStyleItalic">Stepwise Forward</span> com teste raz&#227;o de verosimilhan&#231;as&#41;&#44; incluindo&#8208;se no modelo as vari&#225;veis utilizadas no <span class="elsevierStyleItalic">score</span> CRUSADE&#44; e separadamente vari&#225;veis relativas &#224; medica&#231;&#227;o realizada durante o internamento&#58; dupla antiagrega&#231;&#227;o&#44; ou a associa&#231;&#227;o desta a anticoagulantes &#40;terap&#234;utica tripla&#41; ou a inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">II</span>a &#40;antiagrega&#231;&#227;o tripla&#41;&#46; Os valores p de entrada e sa&#237;da do modelo considerados foram 0&#44;10 e 0&#44;15&#44; respetivamente&#46; O risco de ocorr&#234;ncia de cada <span class="elsevierStyleItalic">endpoint</span> associado a cada preditor foi estimado por interm&#233;dio do <span class="elsevierStyleItalic">Odds rtio</span> e respetivo intervalo de confian&#231;a &#40;IC&#41; a 95&#37;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Por regress&#227;o log&#237;stica &#40;m&#233;todo <span class="elsevierStyleItalic">enter</span>&#41; foram criados MP de MIH e de HM com base em vari&#225;veis presentes &#224; admiss&#227;o hospitalar&#44; com signific&#226;ncia estat&#237;stica para cada <span class="elsevierStyleItalic">endpoint</span> ou que adicionalmente apresentavam interesse cl&#237;nico&#58; MP&#8208;MIH &#8211; fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo &#60;<span class="elsevierStyleHsp" style=""></span>30&#37;&#44; classe Killip &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span>&#44; infradesnivelamento do segmento ST no eletrocardiograma&#44; tens&#227;o arterial sist&#243;lica&#44; frequ&#234;ncia card&#237;aca&#44; glicemia&#44; creatinina&#44; eleva&#231;&#227;o isolada de troponina&#59; MP&#8208;MH &#8211; antecedentes de hemorragia&#44; antecedentes de DPOC&#44; classe Killip &#224; admiss&#227;o &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span> e creatinina &#224; admiss&#227;o&#46; A calibra&#231;&#227;o dos modelos foi avaliada atrav&#233;s do teste de Hosmer&#8208;Lemeshow&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">A partir dos coeficientes de regress&#227;o estimados foram determinados os valores preditos de cada modelo para posterior avalia&#231;&#227;o da sua capacidade discriminat&#243;ria&#44; que foi feita estimando a &#225;rea sob as curvas ROC &#40;<span class="elsevierStyleItalic">Receiver Operating Characteristic Curve</span>&#41;&#44; para al&#233;m da determina&#231;&#227;o da sensibilidade e especificidade&#46; Estas curvas avaliam a capacidade de um modelo atribuir uma probabilidade mais elevada de eventos aos doentes que atingiram o <span class="elsevierStyleItalic">endpoint</span> em estudo&#46; Desta forma avaliou&#8208;se a acuidade diagn&#243;stica do <span class="elsevierStyleItalic">score</span> GRACE e do MP&#8208;MIH para MIH&#44; e do <span class="elsevierStyleItalic">score</span> CRUSADE e do MP&#8208;HM para HM&#46; A compara&#231;&#227;o das curvas ROC para MIH e para HM foi feita com recurso ao software MedCalc para Windows vers&#227;o 9&#46;2&#46;0&#46;1&#46; A restante an&#225;lise estat&#237;stica foi realizada usando o software SPSS vers&#227;o 19&#44; com o teste definido por Hanley e McNeil &#40;1982&#44; 1983&#41;&#46; O n&#237;vel de signific&#226;ncia utilizado nesta an&#225;lise foi de 5&#37;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Caracteriza&#231;&#227;o da popula&#231;&#227;o</span><p id="par0150" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas dos 544 doentes avaliados s&#227;o apresentadas na <a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#46; A idade m&#237;nima inclu&#237;da na amostra foi de 80 anos&#44; enquanto a m&#225;xima foi de 92 anos&#44; com uma m&#233;dia de 84 anos&#46; O diagn&#243;stico de admiss&#227;o foi EAMNST em 91&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>495&#41; dos doentes&#44; e AI em 9&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>49&#41;&#46; A <a class="elsevierStyleCrossRef" href="#fig0005">Figura 1</a> apresenta a distribui&#231;&#227;o da popula&#231;&#227;o e dos doentes com MIH e HM pelos diferentes grupos de risco dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE&#44; respetivamente&#46; Na popula&#231;&#227;o em estudo&#44; 93&#44;6&#37; dos doentes que atingiram o <span class="elsevierStyleItalic">endpoint</span> MIH foram classificados no grupo de alto risco pelo <span class="elsevierStyleItalic">score</span> GRACE&#59; j&#225; o <span class="elsevierStyleItalic">score</span> CRUSADE classificou apenas 53&#44;9&#37; dos doentes com HM na classe de risco alto ou muito alto &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figura 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">Cerca de 98&#37; dos doentes foram medicados com AAS&#44; 86&#44;9&#37; com clopidogrel e 5&#44;9&#37; com inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a&#46; A enoxaparina foi o anticoagulante mais frequentemente utilizado&#46; Foi realizada coronariografia em 59&#44;4&#37; dos doentes&#44; angioplastia em 34&#44;7&#37; e cirurgia de revasculariza&#231;&#227;o em 14&#44;7&#37;&#46; Esta popula&#231;&#227;o apresentou um <span class="elsevierStyleItalic">score</span> GRACE de 161<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27 e CRUSADE de 44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46; A dura&#231;&#227;o mediana do internamento foi de cinco dias &#40;P25&#58; 3&#59; P75&#58; 8&#41;&#44; tendo sido observado o <span class="elsevierStyleItalic">endpoint</span> MI em 6&#44;6&#37; e HM em 2&#44;9&#37; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Preditores de mortalidade intra&#8208;hospitalar</span><p id="par0160" class="elsevierStylePara elsevierViewall">Em an&#225;lise univariada&#44; a MIH associou&#8208;se a valores mais elevados de frequ&#234;ncia card&#237;aca e creatinina &#224; admiss&#227;o&#44; creatinina m&#225;xima&#44; presen&#231;a &#224; admiss&#227;o de classe Killip &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span>&#44; infradesnivelamento do segmento ST&#44; eleva&#231;&#227;o n&#227;o isolada de troponina e valores mais baixos de tens&#227;o arterial sist&#243;lica &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46; A sobreviv&#234;ncia durante o internamento associou&#8208;se a medica&#231;&#227;o mais frequente com bloqueadores&#8208;beta&#44; antagonistas do c&#225;lcio e IECA&#47;ARA&#44; a realiza&#231;&#227;o de coronariografia e angioplastia&#44; e &#224; aus&#234;ncia de doen&#231;a do tronco comum &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46; Os doentes que faleceram no internamento necessitaram mais frequentemente de terap&#234;utica com levosimendan&#44; inotr&#243;picos&#44; ventila&#231;&#227;o mec&#226;nica e <span class="elsevierStyleItalic">pacemaker</span> provis&#243;rio&#46; Tamb&#233;m apresentaram maior preval&#234;ncia de complica&#231;&#245;es isqu&#233;micas e hemorr&#225;gicas &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46; N&#227;o foi identificada associa&#231;&#227;o da MIH com a idade&#44; fatores de risco CV&#44; medica&#231;&#227;o pr&#233;via&#44; acesso vascular ou sistemas de encerramento arterial utilizados na coronariografia&#44; no tipo de <span class="elsevierStyleItalic">stent</span> utilizado na angioplastia ou na realiza&#231;&#227;o de cirurgia de revasculariza&#231;&#227;o mioc&#225;rdica&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">Em an&#225;lise multivariada&#44; foram preditores independentes de MIH a classe Killip &#224; admiss&#227;o &#62;<span class="elsevierStyleHsp" style=""></span>1&#44; fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo &#60;<span class="elsevierStyleHsp" style=""></span>30&#37; e a ocorr&#234;ncia de HM &#8211; a qual aumentou quase 11 vezes o risco de MIH &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; A realiza&#231;&#227;o de coronariografia nesta popula&#231;&#227;o mostrou ser protetora &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130"><span class="elsevierStyleItalic">Score</span> GRACE e Modelo Preditor de Mortalidade Intra&#8208;hospitalar para identifica&#231;&#227;o de mortalidade intra&#8208;hospitalar</span><p id="par0170" class="elsevierStylePara elsevierViewall">O <span class="elsevierStyleItalic">score</span> GRACE mostrou uma boa acuidade diagn&#243;stica para identificar os doentes que faleceram durante o internamento&#44; com uma &#225;rea debaixo da curva ROC &#40;AUC&#41; de 0&#44;75&#44; IC 95&#37; 0&#44;63&#8208;0&#44;87&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figura 1</a>&#41;&#46; O <span class="elsevierStyleItalic">Youden &#237;ndex</span> identificado para este <span class="elsevierStyleItalic">score</span> foi 170 &#40;sensibilidade 77&#37;&#44; especificidade 67&#37;&#41;&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">O MP&#8208;MIH apresentou uma boa calibra&#231;&#227;o para MIH&#44; de acordo com o teste de <span class="elsevierStyleItalic">Hosmer&#8208;Lemeshow</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;533&#41;&#46; A an&#225;lise de curvas ROC mostrou uma excelente capacidade discriminativa de MIH &#40;AUC 0&#44;81&#44; IC 95&#37; 0&#44;72&#8208;0&#44;90&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; sem que&#44; no entanto&#44; se tenha verificado diferen&#231;a significativa &#40;0&#44;06&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;239&#41; entre as AUC dos dois modelos &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figura 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Preditores de hemorragia <span class="elsevierStyleItalic">major</span> durante o internamento</span><p id="par0180" class="elsevierStylePara elsevierViewall">O <span class="elsevierStyleItalic">endpoint</span> HM associou&#8208;se a antecedentes de hemorragia ou de DPOC&#44; a classe <span class="elsevierStyleItalic">Killip</span> &#224; admiss&#227;o &#62;<span class="elsevierStyleHsp" style=""></span>1&#44; a valores mais elevados de creatinina m&#225;xima e a mais baixos de hemoglobina m&#237;nima&#44; a terap&#234;uticas durante o internamento com heparina n&#227;o&#8208;fracionada&#44; antiagregantes diferentes de AAS ou clopidogrel&#44; ou antagonistas da aldosterona&#46; Tamb&#233;m se associou a prolongamento do internamento e a uma taxa superior de MIH &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46; Em an&#225;lise univariada n&#227;o foi verificada associa&#231;&#227;o entre HM e idade&#44; g&#233;nero&#44; outros fatores de risco cardiovascular&#44; medica&#231;&#227;o pr&#233;via&#44; &#237;ndice de massa corporal&#44; valores &#224; admiss&#227;o de hemoglobina&#44; creatinina ou plaquetas&#44; medica&#231;&#227;o durante o internamento com inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a&#44; ou com a realiza&#231;&#227;o de coronariografia&#44; angioplastia&#44; cirurgia de revasculariza&#231;&#227;o mioc&#225;rdica&#44; quanto ao tipo de <span class="elsevierStyleItalic">stent</span> ou acesso vascular utilizado&#44; ou quanto ao uso de sistemas de encerramento arterial&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">Quando inclu&#237;das em an&#225;lise multivariada todas as associa&#231;&#245;es significativas previamente referidas&#44; apenas terap&#234;utica m&#233;dica administrada durante o internamento&#44; nomeadamente heparina n&#227;o&#8208;fracionada&#44; outros antiagregantes que n&#227;o AAS ou clopidogrel e antagonistas da aldosterona&#44; foram preditores independentes de HM &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46; A mesma an&#225;lise incluindo estes preditores independentes e os par&#226;metros inclu&#237;dos no <span class="elsevierStyleItalic">score</span> CRUSADE identificou como preditores de HM antecedentes de DPOC&#44; medica&#231;&#227;o com heparina n&#227;o&#8208;fracionada e com antagonistas da aldosterona &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46; Incluindo em an&#225;lise multivariada os preditores independentes iniciais e a terap&#234;utica com dupla antiagrega&#231;&#227;o ou com terap&#234;utica tripla&#44; separadamente&#44; foram obtidos valores marginalmente significativos para DPOC e heparina n&#227;o&#8208;fracionada&#44; tendo sido preditores de HM a terap&#234;utica com antiagregantes n&#227;o AAS&#47;clopidogrel e com antagonistas da aldosterona &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46; Em an&#225;lise semelhante incluindo a terap&#234;utica antiagregante tripla&#44; esta foi preditora independente de HM&#44; assim como a DPOC e a terap&#234;utica com antagonistas da aldosterona &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140"><span class="elsevierStyleItalic">Score</span> CRUSADE e Modelo Preditor de Hemorragia Major para identifica&#231;&#227;o de hemorragia <span class="elsevierStyleItalic">major</span></span><p id="par0190" class="elsevierStylePara elsevierViewall">Atrav&#233;s de an&#225;lise de curvas ROC&#44; o <span class="elsevierStyleItalic">score</span> CRUSADE mostrou n&#227;o ter acuidade diagn&#243;stica para a identifica&#231;&#227;o de HM nesta popula&#231;&#227;o &#40;AUC 0&#44;51&#44; IC 95&#37; 0&#44;30&#8208;0&#44;63&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;942&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Figura 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0195" class="elsevierStylePara elsevierViewall">O MP&#8208;HM apresentou uma boa calibra&#231;&#227;o no teste de <span class="elsevierStyleItalic">Hosmer&#8208;Lemeshow</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;111&#41; e&#44; em an&#225;lise de curvas ROC&#44; mostrou um bom poder discriminat&#243;rio de HM para a popula&#231;&#227;o em estudo &#40;AUC 0&#44;68&#44; IC 95&#37; 0&#44;52&#8208;0&#44;84&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;032&#59; <a class="elsevierStyleCrossRef" href="#fig0015">Figura 3</a>&#41;&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discuss&#227;o</span><p id="par0200" class="elsevierStylePara elsevierViewall">Os dados apresentados sugerem que o <span class="elsevierStyleItalic">score</span> GRACE &#233; adequado para avalia&#231;&#227;o de risco de MIH em octogen&#225;rios com SCANST&#44; enquanto o CRUSADE parece ser desajustado para avalia&#231;&#227;o de risco hemorr&#225;gico nesta faixa et&#225;ria&#46; Do que &#233; nosso conhecimento&#44; este &#233; o primeiro estudo realizado at&#233; ao momento a avaliar a adequa&#231;&#227;o dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE a esta popula&#231;&#227;o&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">As comorbilidades e os fatores de risco cardiovascular verificados foram semelhantes aos publicados noutras s&#233;ries de SCANST em doentes idosos<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;9</span></a>&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">A incid&#234;ncia de terap&#234;utica antitromb&#243;tica nesta amostra atingiu valores id&#234;nticos aos apresentados num subestudo da iniciativa CRUSADE &#40;<span class="elsevierStyleItalic">Can Rapid risk stratification of Unstable angina patients Suppress Adverse outcomes with Early implementation of the ACC&#47;AHA guidelines</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#44; em doentes com SCANST e idade compreendida entre os 75 e os 89 anos&#44; com exce&#231;&#227;o de no CRUSADE haver uma frequ&#234;ncia maior de medica&#231;&#227;o com inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a &#40;29&#44;2 <span class="elsevierStyleItalic">versus</span> 5&#44;9&#37;&#41;&#46; A realiza&#231;&#227;o de coronariografia e angioplastia reportada nesse grupo de doentes do CRUSADE tamb&#233;m foi inferior &#224; verificada nesta popula&#231;&#227;o&#44; embora apenas tenham sido apresentados resultados para os procedimentos realizados nas primeiras 48<span class="elsevierStyleHsp" style=""></span>h ap&#243;s admiss&#227;o&#44; numa faixa et&#225;ria com limites diferentes<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; Uma an&#225;lise do registo <span class="elsevierStyleItalic">Acute Coronary Syndromes Israeli Survey</span><a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> publicou resultados para doentes com EAMNST com mais de 80 anos&#44; tendo sido verificada uma frequ&#234;ncia de coronariografia &#40;55&#37;&#41; ligeiramente inferior &#224; da nossa popula&#231;&#227;o &#40;59&#44;4&#37;&#41;&#44; em que 91&#37; dos doentes foram admitidos por EAMNST&#46; Ainda assim&#44; em 40&#37; destes idosos n&#227;o foi realizada coronariografia e 50&#37; n&#227;o foram submetidos a revasculariza&#231;&#227;o&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">A realiza&#231;&#227;o de coronariografia associou&#8208;se a um progn&#243;stico favor&#225;vel em termos de MIH&#44; mas n&#227;o se associou a HM&#46; A revasculariza&#231;&#227;o com angioplastia tamb&#233;m se associou a menor MIH&#44; embora de modo n&#227;o&#8208;independente&#46; Estes dados s&#227;o consistentes com os apresentados pelo subestudo do <span class="elsevierStyleItalic">Acute Coronary Syndromes Israeli Survey</span><a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> acima mencionado&#44; em que se observou uma redu&#231;&#227;o da mortalidade a um ano com procedimentos de revasculariza&#231;&#227;o &#40;HR 0&#44;5&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; redu&#231;&#227;o da mortalidade a um ano &#40;HR 0&#44;4&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; e a 30 dias &#40;HR 0&#44;38&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; com a realiza&#231;&#227;o de coronariografia nas primeiras 24<span class="elsevierStyleHsp" style=""></span>h de evolu&#231;&#227;o de EAMNST em doentes com mais de 80 anos&#46; Tamb&#233;m o subestudo do registo CRUSADE<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> concluiu que a ades&#227;o a terap&#234;uticas recomendadas pelas <span class="elsevierStyleItalic">guidelines</span>&#44; incluindo cateteriza&#231;&#227;o nas primeiras 48<span class="elsevierStyleHsp" style=""></span>h de evolu&#231;&#227;o&#44; se encontrava associada a redu&#231;&#227;o da MIH em doentes com ACSNST e idade superior a 75 anos&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">O valor preditivo superior da coronariografia face &#224; angioplastia verificado nesta popula&#231;&#227;o poder&#225; refletir as diferentes estrat&#233;gias de revasculariza&#231;&#227;o realizadas&#46; Por outro lado&#44; a angioplastia n&#227;o se associou &#224; ocorr&#234;ncia de HM&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Deve&#8208;se&#44; contudo&#44; ressalvar o poss&#237;vel vi&#233;s de sele&#231;&#227;o originado pelo <span class="elsevierStyleItalic">status</span> fisiol&#243;gico&#44; cognitivo e social dos idosos&#44; que poder&#225; ter contribu&#237;do para a sele&#231;&#227;o dos mais aptos e vi&#225;veis para a estrat&#233;gia invasiva&#44; mas que tem tamb&#233;m reconhecido impacto progn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; Estes dados salientam a import&#226;ncia do ajuste dos <span class="elsevierStyleItalic">scores</span> utilizados na estratifica&#231;&#227;o de risco &#224;s caracter&#237;sticas pr&#243;prias desta faixa et&#225;ria&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">A incid&#234;ncia de MIH e de HM encontrada no RNSCA foi inferior &#224; reportada noutros estudos com popula&#231;&#227;o id&#234;ntica&#44; nomeadamente no subestudo do registo CRUSADE<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> &#8211; o maior estudo realizado em idosos com SCANST &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;557&#41;&#44; em que se verificou uma MIH de 7&#44;8&#37; &#40;<span class="elsevierStyleItalic">versus</span> 6&#44;6&#37;&#41; e HM em 13&#44;1&#37; <span class="elsevierStyleItalic">&#40;versus</span> 2&#44;9&#37;&#41;&#46; Neste &#250;ltimo caso&#44; foi utilizada uma defini&#231;&#227;o de hemorragia mais abrangente&#44; tendo sido tamb&#233;m inclu&#237;dos outros crit&#233;rios que poder&#227;o justificar essa diferen&#231;a &#40;queda de hemat&#243;crito em &#8805;<span class="elsevierStyleHsp" style=""></span>12&#37;&#44; hemorragia retroperitoneal&#44; transfus&#227;o de gl&#243;bulos vermelhos em contexto de hemorragia documentada e com hemat&#243;crito basal &#60;<span class="elsevierStyleHsp" style=""></span>28&#37;&#44; ou transfus&#227;o com hemat&#243;crito basal &#8805;<span class="elsevierStyleHsp" style=""></span>28&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">A import&#226;ncia das comorbilidades no progn&#243;stico a curto prazo dos doentes com &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos foi bem evidenciada pelos resultados obtidos&#44; sobretudo o contributo da insufici&#234;ncia card&#237;aca como predisponente a MIH e HM&#44; e da DPOC para a HM&#46; Ambas se associam a um estado inflamat&#243;rio cr&#243;nico&#44; condicionando uma maior fragilidade fisiol&#243;gica e propiciando anemia&#46; No caso da DPOC&#44; poder&#227;o ainda contribuir para HM terap&#234;uticas frequentemente utilizadas neste contexto&#44; como a corticoterapia&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Os nossos resultados refor&#231;am tamb&#233;m a rela&#231;&#227;o estreita e independente da HM com a MIH&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">O risco acrescido de HM verificado para terap&#234;uticas como a heparina n&#227;o&#8208;fracionada&#44; antiagregantes n&#227;o&#8208;AAS&#47;clopidogrel&#44; antiagrega&#231;&#227;o tripla &#40;inibidores da glicoprote&#237;na <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a associados a dupla antiagrega&#231;&#227;o&#41; ou antagonistas da aldosterona&#44; poder&#225; relacionar&#8208;se com sobredosagem dos mesmos&#46; Com efeito&#44; este tem sido um problema frequentemente reportado nos idosos&#44; associado &#224; deteriora&#231;&#227;o da fun&#231;&#227;o renal&#46; Tamb&#233;m nas terap&#234;uticas com ajuste de dose em fun&#231;&#227;o do peso corporal&#44; como a heparina n&#227;o&#8208;fracionada&#44; tem sido documentada sobredosagem associada a altera&#231;&#227;o da composi&#231;&#227;o corporal e dos n&#237;veis de prote&#237;nas nos idosos<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; No caso dos antitromb&#243;ticos&#44; a sobredosagem poder&#225; aumentar o risco de complica&#231;&#245;es hemorr&#225;gicas&#46; A associa&#231;&#227;o da HM com os antagonistas da aldosterona poder&#225; advir de m&#250;ltiplos fatores&#44; tais como o poss&#237;vel agravamento da fun&#231;&#227;o renal pelo f&#225;rmaco e a sua maior utiliza&#231;&#227;o em doentes com cl&#237;nica de insufici&#234;ncia card&#237;aca&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">A escolha das vari&#225;veis inclu&#237;das em cada um dos modelos criados prendeu&#8208;se com o objetivo destes poderem ser aplicados no momento da admiss&#227;o hospitalar&#46; Por esse motivo&#44; no MP&#8208;HM&#44; optou&#8208;se por incluir a vari&#225;vel creatinina &#224; admiss&#227;o&#44; apesar de a signific&#226;ncia estat&#237;stica ter sido verificada para a creatinina m&#225;xima&#44; face ao reduzido n&#250;mero de vari&#225;veis que seriam inclu&#237;das no modelo seguindo o crit&#233;rio inicial&#46; N&#227;o se incluiu a hemoglobina de admiss&#227;o pelo facto do seu valor m&#237;nimo&#44; que demonstrou associa&#231;&#227;o a HM&#44; refletir uma consequ&#234;ncia &#243;bvia da mesma&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">Segundo a nossa an&#225;lise&#44; o <span class="elsevierStyleItalic">score</span> GRACE discriminou de modo adequado os eventos de MIH nesta popula&#231;&#227;o&#44; sem diferen&#231;a significativa em rela&#231;&#227;o ao MP&#8208;MIH ajustado&#59; o seu <span class="elsevierStyleItalic">Youden &#237;ndex</span> foi superior ao ponto de corte de alto risco de MIH recomendado pelas <span class="elsevierStyleItalic">guidelines</span> da Sociedade Europeia de Cardiologia para doentes com SCANST<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> e corresponder&#225; a um ajuste para a faixa et&#225;ria em avalia&#231;&#227;o&#46; Contudo&#44; o <span class="elsevierStyleItalic">score</span> CRUSADE&#44; tamb&#233;m recomendado pelas mesmas <span class="elsevierStyleItalic">guidelines</span>&#44; mostrou&#8208;se completamente desajustado &#224; predi&#231;&#227;o de HM nesta popula&#231;&#227;o&#46; Em parte&#44; este desajuste poderia ser explicado por se ter utilizado uma defini&#231;&#227;o de HM diferente da utilizada no estudo CRUSADE&#46; Ainda assim&#44; seria esperado que o <span class="elsevierStyleItalic">score</span> CRUSADE apresentasse alguma capacidade discriminativa para hemorragia grave&#44; como a HM definida pelos crit&#233;rios GUSTO&#44; o que n&#227;o se verificou&#46; Numa an&#225;lise do RNSCA apresentada no ESC Congress 2012<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#44; o <span class="elsevierStyleItalic">score</span> CUSADE mostrou uma capacidade discriminat&#243;ria bem superior &#224; verificada nesta an&#225;lise &#40;AUC 0&#44;755&#44; IC 95&#37; 0&#44;69&#8208;0&#44;82&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; contudo&#44; a idade m&#233;dia desta popula&#231;&#227;o era 66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13 anos&#46; Estes resultados p&#245;em em evid&#234;ncia a necessidade de novos <span class="elsevierStyleItalic">scores</span> para predi&#231;&#227;o de risco hemorr&#225;gico nos octogen&#225;rios&#46; O MP&#8208;HM criado poderia ser uma alternativa&#44; j&#225; que demonstrou uma boa acuidade diagn&#243;stica para HM&#46; Contudo&#44; tratando&#8208;se de um modelo ajustado a esta popula&#231;&#227;o&#44; teria de ser validado com outra amostra para garantir a extensibilidade destes resultados &#224; popula&#231;&#227;o geral de octogen&#225;rios com SCANST&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">Neste trabalho s&#227;o apresentados dados do mundo real&#44; com uma distribui&#231;&#227;o geogr&#225;fica alargada e um n&#250;mero significativo de doentes para a patologia e faixa et&#225;ria&#46; Contudo&#44; algumas limita&#231;&#245;es devem ser consideradas na interpreta&#231;&#227;o dos resultados&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Tratando&#8208;se de um estudo observacional&#44; tem de ser considerado um poss&#237;vel vi&#233;s de sele&#231;&#227;o das estrat&#233;gias terap&#234;uticas em fun&#231;&#227;o do <span class="elsevierStyleItalic">status</span> fisiol&#243;gico&#44; psicol&#243;gico&#44; cognitivo e meio social dos doentes&#44; que por sua vez tamb&#233;m s&#227;o fatores com impacto progn&#243;stico&#46; Uma das limita&#231;&#245;es inerentes a este trabalho prende&#8208;se com a falta de informa&#231;&#227;o relativa &#224; fragilidade dos doentes&#46; O RNSCA inclui informa&#231;&#227;o relativa a comorbilidades potencialmente associadas a maior fragilidade como dem&#234;ncia&#44; antecedentes de acidente vascular cerebral&#44; neoplasia&#44; insufici&#234;ncia renal&#44; DPOC&#44; contudo&#44; a fragilidade associada &#233; vari&#225;vel de acordo com a severidade da doen&#231;a&#46; Assim&#44; e &#224; semelhan&#231;a de outros estudos abordando esta tem&#225;tica&#44; n&#227;o se encontra adequadamente descriminada e definida a fragilidade nas suas diferentes vertentes&#58; debilidade fisiol&#243;gica&#44; cognitiva&#44; psicol&#243;gica ou social&#44; limita&#231;&#245;es funcionais e qualidade de vida&#44; que&#44; no entanto&#44; tem sido descrita como um fator de progn&#243;stico adverso mais importante nos idosos do que os fatores de risco cardiovascular cl&#225;ssicos ou as comorbilidades<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Estes dados seriam importantes na interpreta&#231;&#227;o das terap&#234;uticas efetuadas&#44; da HM e da MIH&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Apesar de se tratar de um estudo multic&#234;ntrico&#44; esta amostra baseia&#8208;se nos crit&#233;rios de admiss&#227;o do RNSCA&#58; apresenta&#231;&#227;o cl&#237;nica sugestiva em doentes com &#60;<span class="elsevierStyleHsp" style=""></span>48 horas de evolu&#231;&#227;o&#44; o que poder&#225; ter conduzido &#224; exclus&#227;o de idosos com apresenta&#231;&#227;o at&#237;pica&#44; frequente nesta faixa et&#225;ria e condicionadora de atraso no diagn&#243;stico&#46; Do mesmo modo&#44; apenas foram inclu&#237;dos os octogen&#225;rios com SCANST que sobreviveram at&#233; &#224; admiss&#227;o hospitalar&#44; impedindo&#44; assim&#44; que doentes mais graves pudessem ser inclu&#237;dos na an&#225;lise&#46; A participa&#231;&#227;o no RNSCA de apenas 14 centros portugueses tamb&#233;m n&#227;o garante a representatividade destes resultados &#224; popula&#231;&#227;o portuguesa de octogen&#225;rios com SCANST&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">Neste estudo s&#243; foi avaliada a MIH&#44; no entanto&#44; a mortalidade a longo prazo e a informa&#231;&#227;o relativa &#224; qualidade de vida ap&#243;s a alta seriam importantes na avalia&#231;&#227;o do risco&#8208;benef&#237;cio das diferentes terap&#234;uticas&#46; A MIH foi utilizada como <span class="elsevierStyleItalic">endpoint</span> para avalia&#231;&#227;o de risco isqu&#233;mico&#44; contudo&#44; tal como se verificou neste trabalho&#44; este <span class="elsevierStyleItalic">endpoint</span> reflete tamb&#233;m risco hemorr&#225;gico&#46; A avalia&#231;&#227;o do risco isqu&#233;mico seria mais correta utilizando um <span class="elsevierStyleItalic">endpoint</span> como enfarte fatal e n&#227;o&#8208;fatal&#44; mas tal implicaria um seguimento a longo prazo&#44; que limitaria ainda mais a dimens&#227;o da amostra&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conclus&#245;es</span><p id="par0280" class="elsevierStylePara elsevierViewall">Nos doentes com SCANST e idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos o <span class="elsevierStyleItalic">score</span> GRACE adequou&#8208;se &#224; predi&#231;&#227;o de MIH&#44; enquanto o CRUSADE se mostrou desajustado na avalia&#231;&#227;o de risco hemorr&#225;gico nesta faixa et&#225;ria&#46; A presen&#231;a de sinais de insufici&#234;ncia card&#237;aca &#224; admiss&#227;o&#44; uma fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo &#60;<span class="elsevierStyleHsp" style=""></span>30&#37; e a ocorr&#234;ncia de HM foram preditores independentes de MIH&#46; Os principais preditores de HM corresponderam a medica&#231;&#227;o institu&#237;da no internamento e a antecedentes de DPOC&#46; A realiza&#231;&#227;o de coronariografia associou&#8208;se a um progn&#243;stico favor&#225;vel durante o internamento em termos de MIH e n&#227;o aumentou o risco de HM&#46; Estes dados sugerem o benef&#237;cio de uma estrat&#233;gia invasiva em doentes selecionados&#44; bem como a necessidade de novos <span class="elsevierStyleItalic">scores</span> para avalia&#231;&#227;o do risco hemorr&#225;gico nestes doentes&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Responsabilidades &#233;ticas</span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Prote&#231;&#227;o de pessoas e animais</span><p id="par0285" class="elsevierStylePara elsevierViewall">Os autores declaram que para esta investiga&#231;&#227;o n&#227;o se realizaram experi&#234;ncias em seres humanos e&#47;ou animais&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Confidencialidade dos dados</span><p id="par0290" class="elsevierStylePara elsevierViewall">Os autores declaram ter seguido os protocolos do seu centro de trabalho acerca da publica&#231;&#227;o dos dados de pacientes&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Direito &#224; privacidade e consentimento escrito</span><p id="par0295" class="elsevierStylePara elsevierViewall">Os autores declaram ter recebido consentimento escrito dos pacientes e&#47;ou sujeitos mencionados no artigo&#46; O autor para correspond&#234;ncia deve estar na posse deste documento&#46;</p></span></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Conflito de interesses</span><p id="par0300" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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            3 => "Octogen&#225;rios"
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    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A avalia&#231;&#227;o do risco isqu&#233;mico e hemorr&#225;gico &#233; fundamental na abordagem dos idosos com s&#237;ndromes coron&#225;rias agudas&#44; mas tem sido pouco estudada&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Este estudo pretende avaliar a adequa&#231;&#227;o dos <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE a doentes com s&#237;ndrome coron&#225;ria aguda sem supradesnivelamento&#8208;ST e idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos&#44; e identificar os principais preditores de mortalidade intra&#8208;hospitalar e hemorragia <span class="elsevierStyleItalic">major</span> nesta popula&#231;&#227;o&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Foram avaliados 544 doentes com idade &#8805;<span class="elsevierStyleHsp" style=""></span>80 anos com s&#237;ndrome coron&#225;ria aguda sem supradesnivelamento&#8208;ST&#44; inclu&#237;dos no Registo Portugu&#234;s de S&#237;ndromes Coron&#225;rias Agudas&#46; Foram identificados os preditores de mortalidade intra&#8208;hospitalar e de hemorragia <span class="elsevierStyleItalic">major</span> durante o internamento&#46; Criaram&#8208;se modelos preditores destes <span class="elsevierStyleItalic">endpoints</span>&#44; posteriormente comparados com os <span class="elsevierStyleItalic">scores</span> GRACE e CRUSADE&#44; e avaliada a sua adequa&#231;&#227;o &#224; popula&#231;&#227;o em estudo&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A realiza&#231;&#227;o de coronariografia associou&#8208;se a redu&#231;&#227;o do risco de mortalidade intra&#8208;hospitalar e n&#227;o se associou a aumento do risco de hemorragia <span class="elsevierStyleItalic">major</span> &#40;OR 0&#44;2&#44; IC 95&#37; 0&#44;006&#8208;0&#44;49&#44; p &#61; 0&#44;001&#41;&#46; A hemorragia <span class="elsevierStyleItalic">major</span> foi preditora independente de mortalidade intra&#8208;hospitalar &#40;OR 10&#44;9&#44; IC 95&#37; 2&#44;36&#8208;50&#44;74&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; e associou&#8208;se a comorbilidades e &#224; terap&#234;utica farmacol&#243;gica institu&#237;da&#46; O <span class="elsevierStyleItalic">score</span> GRACE apresentou boa acuidade diagn&#243;stica para mortalidade intra&#8208;hospitalar &#40;AUC 0&#44;75&#44; IC 95&#37; 0&#44;63&#8208;0&#44;87&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; mas o CRUSADE mostrou fraca capacidade discriminat&#243;ria de hemorragia <span class="elsevierStyleItalic">major</span> &#40;AUC 0&#44;51&#44; IC 95&#37; 0&#44;30&#8208;0&#44;63&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;942&#41;&#44; contrariamente ao modelo preditor &#40;AUC 0&#44;68&#44; IC 95&#37; 0&#44;52&#8208;0&#44;84&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;032&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O <span class="elsevierStyleItalic">score</span> GRACE &#233; adequado para avalia&#231;&#227;o de risco nos octogen&#225;rios&#44; mas o CRUSADE &#233; desajustado&#44; sendo necess&#225;rios novos <span class="elsevierStyleItalic">scores</span> para a avalia&#231;&#227;o de risco hemorr&#225;gico nesta faixa et&#225;ria&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Assessment of ischemic and bleeding risk is critical for the management of elderly patients with acute coronary syndromes&#44; but it has been little studied&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">This study aims to assess the applicability of the GRACE and CRUSADE scores in patients aged &#8805;80 years with non&#8208;ST&#8208;elevation acute coronary syndrome &#40;NSTE&#8208;ACS&#41;&#44; and to identify the main predictors of in&#8208;hospital mortality and major bleeding in this population&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">We analyzed 544 patients aged &#8805;80 years with NSTE&#8208;ACS included in the Portuguese Registry on Acute Coronary Syndromes and identified the predictors of in&#8208;hospital mortality and major bleeding during hospitalization&#46; Prediction models were created for these endpoints&#44; then compared with the GRACE and CRUSADE scores&#44; and their applicability to the study population was assessed&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Use of coronary angiography was associated with reduced risk of in&#8208;hospital mortality&#44; without increasing risk of major bleeding &#40;OR 0&#46;2&#44; 95&#37; CI 0&#46;006&#8208;0&#46;49&#44; p&#61;0&#46;001&#41;&#46; Major bleeding was an independent predictor of in&#8208;hospital mortality &#40;OR 10&#46;9&#44; 95&#37; CI 2&#46;36&#8208;50&#46;74&#44; p&#61;0&#46;002&#41;&#44; and was associated with comorbidities and pharmacological therapy during hospitalization&#46; The GRACE score showed good diagnostic accuracy for in&#8208;hospital mortality &#40;AUC 0&#46;75&#44; 95&#37; CI 0&#46;63&#8208;0&#46;87&#44; p&#60;0&#46;001&#41;&#44; but the CRUSADE score had weak discriminatory capacity for major bleeding &#40;AUC 0&#46;51&#44; 95&#37; CI 0&#46;30&#8208;0&#46;63&#44; p&#61;0&#46;942&#41;&#44; unlike our prediction model &#40;AUC 0&#46;68&#44; 95&#37; CI 0&#46;52&#8211;0&#46;84&#44; p&#61;0032&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The GRACE score is suitable for risk assessment in octogenarians with NSTE&#8208;ACS&#44; but the CRUSADE score is inadequate&#44; and new scores are required to assess bleeding risk in this age&#8208;group&#46;</p>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">AAS&#58; &#225;cido acetilsalic&#237;lico&#59; AIT&#58; acidente isqu&#233;mico transit&#243;rio&#59; AVC&#58; acidente vascular cerebral&#59; BNP&#58; pept&#237;deo natriur&#233;tico do tipo B&#59; DC&#58; doen&#231;a coron&#225;ria&#59; DPOC&#58; doen&#231;a pulmonar obstrutiva cr&#243;nica&#59; ECG&#58; eletrocardiograma&#59; IMC&#58; &#237;ndice de massa corporal&#59; MNM&#58; marcadores de necrose do mioc&#225;rdio&#59; NT&#8208;proBNP&#58; por&#231;&#227;o N&#8208;terminal do pro&#8208;BNP&#59; TA&#58; tens&#227;o arterial&#59; VM&#58; ventila&#231;&#227;o mec&#226;nica&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">As vari&#225;veis com distribui&#231;&#227;o n&#227;o&#8208;normal s&#227;o apresentadas como&#58; mediana &#40;percentil 25&#59; percentil 75&#41;&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">&#42; <span class="elsevierStyleItalic">Clearance</span> de creatinina estimado pela f&#243;rmula Cockcroft&#8208;Gault&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Descri&#231;&#227;o popula&#231;&#227;o&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>544</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Dados demogr&#225;ficos</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Apresenta&#231;&#227;o cl&#237;nica &#40;admiss&#227;o&#41;</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade&#44; anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insufici&#234;ncia card&#237;aca&#44; &#37; &#40;n&#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">35&#44;1&#37; &#40;191&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo masculino&#44; &#37; &#40;n&#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">53&#44;1&#37; &#40;289&#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">Paragem card&#237;aca&#44; &#37; &#40;n&#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">1&#44;8&#37; &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC&#44; kg&#47;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequ&#234;ncia card&#237;aca&#44; bpm&nbsp;\t\t\t\t\t\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">81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fatores de risco cardiovascular&#44; &#37; &#40;n&#41;</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">TA sist&#243;lica&#44; mmHg&nbsp;\t\t\t\t\t\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">142<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertens&#227;o arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#44;7&#37; &#40;466&#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">ECG com infra&#8208;ST&#44; &#37; &#40;n&#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">43&#44;8&#37; &#40;238&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;2&#37; &#40;159&#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  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Par&#226;metros laboratoriais &#40;admiss&#227;o&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;1&#37; &#40;267&#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">Hemat&#243;crito&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fumador&nbsp;\t\t\t\t\t\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">1&#44;5&#37; &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glicemia&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127 &#40;106&#59; 170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ex&#8208;fumador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;1&#37; &#40;66&#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">Creatinina&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#40;0&#44;9&#59; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hist&#243;ria familiar de DC&nbsp;\t\t\t\t\t\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&#44;6&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Clearance</span>&#44; mL&#47;min<span class="elsevierStyleSup">&#42;</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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;8 &#40;31&#44;8&#59; 55&#44;4&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antecedentes&#44; &#37; &#40;n&#41;</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">Eleva&#231;&#227;o MNM&#44; &#37; &#40;n&#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">20&#44;7&#37; &#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfarte&nbsp;\t\t\t\t\t\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">30&#37; &#40;163&#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">BNP&#44; pg&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127 &#40;106&#59; 170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Revasculariza&#231;&#227;o pr&#233;via&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;8&#37; &#40;124&#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">NT&#8208;proBNP&#44; pg&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;400 &#40;1&#46;714&#59; 12&#46;600&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AVC&#47;AIT&nbsp;\t\t\t\t\t\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">13&#44;4&#37; &#40;73&#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  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coronariografia e revasculariza&#231;&#227;o mioc&#225;rdica</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Doen&#231;a arterial perif&#233;rica&nbsp;\t\t\t\t\t\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">9&#44;6&#37; &#40;52&#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">Coronariografia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#44;4&#37; &#40;323&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insufici&#234;ncia renal cr&#243;nica&nbsp;\t\t\t\t\t\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">17&#44;8&#37; &#40;97&#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">Angioplastia&nbsp;\t\t\t\t\t\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">34&#44;7&#37; &#40;189&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DPOC&#44; &#37; &#40;n&#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">7&#44;9&#37; &#40;43&#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">Cirurgia &#40;revasculariza&#231;&#227;o&#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">14&#44;7&#37; &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemorragia&nbsp;\t\t\t\t\t\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">3&#44;5&#37; &#40;19&#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  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Outras terap&#234;uticas</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neoplasia&nbsp;\t\t\t\t\t\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">6&#44;8&#37; &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VM invasiva&nbsp;\t\t\t\t\t\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">1&#44;8&#37; &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dem&#234;ncia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;6&#37; &#40;25&#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">VM n&#227;o&#8208;invasiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;0&#37; &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insufici&#234;ncia card&#237;aca&nbsp;\t\t\t\t\t\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">17&#44;8&#37; &#40;97&#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"><span class="elsevierStyleItalic">Pacemaker</span> provis&#243;rio&nbsp;\t\t\t\t\t\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">1&#44;3&#37; &#40;7&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Scores</span> de risco</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">Bal&#227;o intra&#8208;a&#243;rtico&nbsp;\t\t\t\t\t\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&#44;4&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GRACE &#40;MIH&#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">161<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inotr&#243;picos&nbsp;\t\t\t\t\t\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">3&#44;9&#37; &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CRUSADE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Levosimendan&nbsp;\t\t\t\t\t\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&#44;9&#37; &#40;5&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diagn&#243;stico de admiss&#227;o</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">AAS&nbsp;\t\t\t\t\t\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">97&#44;6&#37; &#40;531&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfarte sem supra&#8208;ST&#44; &#37; &#40;n&#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">91&#37; &#40;495&#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">Clopidogrel&nbsp;\t\t\t\t\t\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">86&#44;9&#37; &#40;473&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Angina inst&#225;vel&#44; &#37; &#40;n&#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">9&#37; &#40;49&#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">Inibidores Gp <span class="elsevierStyleSmallCaps">II</span>b&#47;<span class="elsevierStyleSmallCaps">III</span>a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;9&#37; &#40;32&#41;&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eventos &#40;internamento&#41;</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">Heparina n&#227;o&#8208;fraccionada&nbsp;\t\t\t\t\t\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">13&#44;6&#37; &#40;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemorragia <span class="elsevierStyleItalic">major</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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;9&#37; &#40;16&#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">Enoxaparina&nbsp;\t\t\t\t\t\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">76&#44;3&#37; &#40;415&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morte intra&#8208;hospitalar&nbsp;\t\t\t\t\t\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">6&#44;6&#37; &#40;36&#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">Fondaparinux&nbsp;\t\t\t\t\t\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">13&#44;8&#37; &#40;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas basais da popula&#231;&#227;o em estudo</p>"
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">CR&#58; cardiorrespirat&#243;ria&#59; FC&#58; frequ&#234;ncia card&#237;aca&#59; MIH&#58; mortalidade intra&#8208;hospitalar&#59; TAS&#58; tens&#227;o arterial sist&#243;lica&#59; TC&#58; tronco comum&#46;</p>"
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            0 => array:2 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Preditores de MIH &#8211; an&#225;lise univariada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">MIH<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">MIH<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Avalia&#231;&#227;o cl&#237;nica e laboratorial</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>FC admiss&#227;o&#44; bpm&nbsp;\t\t\t\t\t\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">81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&nbsp;\t\t\t\t\t\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">89<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&nbsp;\t\t\t\t\t\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&#44;021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TAS admiss&#227;o&#44; mmHg&nbsp;\t\t\t\t\t\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">144<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&nbsp;\t\t\t\t\t\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">121<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Classe Killip &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span> admiss&#227;o&#44; &#37; &#40;n&#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">24&#44;6&#37; &#40;125&#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">69&#44;4&#37; &#40;25&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Infra&#8208;ST admiss&#227;o&#44; &#37; &#40;n&#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">39&#44;5&#37; &#40;215&#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">63&#44;9&#37; &#40;23&#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&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Eleva&#231;&#227;o isolada de troponina&#44; &#37; &#40;n&#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">18&#44;7&#37; &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;6&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinina admiss&#227;o&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;41<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;34&nbsp;\t\t\t\t\t\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">1&#44;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinina m&#225;xima&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glicemia admiss&#227;o&#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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">148<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>70&nbsp;\t\t\t\t\t\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">178<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>132&nbsp;\t\t\t\t\t\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&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " 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">Terap&#234;utica &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bloqueador&#8208;beta&#44; &#37; &#40;n&#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">73&#44;8&#37; &#40;375&#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">44&#44;4&#37; &#40;16&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IECA&#47;ARA&#44; &#37; &#40;n&#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">84&#44;2&#37; &#40;428&#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">58&#44;3&#37; &#40;21&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antagonista do c&#225;lcio&#44; &#37; &#40;n&#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">15&#44;7&#37; &#40;80&#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">2&#44;8&#37; &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inotr&#243;pico&#44; &#37; &#40;n&#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">2&#44;6&#37; &#40;13&#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">22&#44;2&#37; &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Levosimendan&#44; &#37; &#40;n&#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&#44;4&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;3&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronariografia&#44; &#37; &#40;n&#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">62&#44;2&#37; &#40;316&#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">19&#44;4&#37; &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\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">TC sem estenose significativa&#44; &#37; &#40;n&#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">45&#44;7&#37; &#40;232&#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">8&#44;3&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Angioplastia&#44; &#37; &#40;n&#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">36&#44;8&#37; &#40;187&#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">5&#44;6&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventila&#231;&#227;o mec&#226;nica invasiva&#44; &#37; &#40;n&#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">1&#44;2&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;1&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventila&#231;&#227;o mec&#226;nica n&#227;o invasiva&#44; &#37; &#40;n&#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">2&#44;4&#37; &#40;12&#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">27&#44;7&#37; &#40;10&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Pacemaker</span> provis&#243;rio&#44; &#37; &#40;n&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\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">Complica&#231;&#245;es &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fra&#231;&#227;o eje&#231;&#227;o VE &#60;<span class="elsevierStyleHsp" style=""></span>30&#37;&#44; &#37; &#40;n&#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">3&#44;1&#37; &#40;16&#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">30&#44;6&#37; &#40;11&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Insufici&#234;ncia card&#237;aca&#44; &#37; &#40;n&#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">26&#44;6&#37; &#40;135&#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">75&#37; &#40;27&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Complica&#231;&#227;o mec&#226;nica&#44; &#37; &#40;n&#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&#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">11&#44;1&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Re&#8208;enfarte&#44; &#37; &#40;n&#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">1&#44;4&#37; &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TV mantida&#44; &#37; &#40;n&#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&#44;6&#37; &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;9&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Paragem CR reanimada&#44; &#37; &#40;n&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;1&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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"><span class="elsevierStyleHsp" style=""></span>Hemorragia <span class="elsevierStyleItalic">major</span>&#44; &#37; &#40;n&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6&#37; &#40;13&#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">8&#44;3&#37; &#40;3&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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" style="border-bottom: 2px solid black">p&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">3&#44;5&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">1&#44;41&#8211;8&#44;87&nbsp;\t\t\t\t\t\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&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Fra&#231;&#227;o de eje&#231;&#227;o do VE &#60;<span class="elsevierStyleHsp" style=""></span>30&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;17&#8211;50&#44;74&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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  " align="char" valign="\n
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                  \t\t\t\t">10&#44;9&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">2&#44;36&#8211;50&#44;74&nbsp;\t\t\t\t\t\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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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  " align="char" valign="\n
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                  \t\t\t\t">0&#44;2&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&#44;006&#8211;0&#44;49&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Vari&#225;veis associadas a mortalidade intra&#8208;hospitalar em an&#225;lise multivariada</p>"
        ]
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                  \t\t\t\t\tvoid\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" style="border-bottom: 2px solid black">Preditores de HM &#8211; an&#225;lise univariada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes</span></td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>DPOC&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#44;4&#37; &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25&#37; &#40;4&#41;&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&#44;011&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemorragia&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#44;2&#37; &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#44;5&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;039&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Avalia&#231;&#227;o cl&#237;nica e laboratorial &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Classe Killip &#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">I</span> admiss&#227;o&#44; &#37; &#40;n&#41;&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">10&#37; &#40;53&#41;&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">31&#44;2&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Creatinina m&#225;xima&#44; mg&#47;dL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;08&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;20&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;037&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobina m&#237;nima&#44; g&#47;dL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;022&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Terap&#234;utica &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heparina n&#227;o&#8208;fracionada&#44; &#37; &#40;n&#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">13&#44;1&#37; &#40;69&#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">31&#44;2&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antiagregantes n&#227;o&#8208;AAS&#47;clopidogrel&#44; &#37; &#40;n&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1&#37; &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#44;5&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;007&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antagonista da aldosterona&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;1&#37; &#40;64&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;5&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dias de internamento&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">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Complica&#231;&#245;es &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Morte intra&#8208;hospitalar&#44; &#37; &#40;n&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;25&#37; &#40;33&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;8&#37; &#40;3&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;048&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Preditores de HM &#8211; an&#225;lise multivariada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">IC 95&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Associa&#231;&#245;es significativas &#40;an&#225;lise univariada&#41;</span></td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Heparina n&#227;o&#8208;fracionada &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;02&#8211;10&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antiagregantes n&#227;o&#8208;AAS&#47;clopidogrel &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Preditores pr&#233;vios &#40;an&#225;lise multivariada&#41; &#43; par&#226;metros do score CRUSADE</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heparina n&#227;o&#8208;fracionada &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;047&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">0&#44;008&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Preditores pr&#233;vios &#40;an&#225;lise multivariada&#41; &#43; dupla anti&#8208;agrega&#231;&#227;o &#40;internamento&#41;</span></td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Antiagregantes n&#227;o&#8208;AAS&#47;clopidogrel &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;031&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;014&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Preditores pr&#233;vios &#40;an&#225;lise multivariada&#41; &#43; terap&#234;utica tripla &#40;internamento&#41;</span></td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Heparina n&#227;o&#8208;fracionada &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antiagregantes n&#227;o&#8208;AAS&#47;clopidogrel &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;031&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antagonista da aldosterona &#40;internamento&#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</td></tr><tr title="table-row"><td class="td" title="\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">Preditores pr&#233;vios &#40;an&#225;lise multivariada&#41; &#43; tripla antiagrega&#231;&#227;o &#40;internamento&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DPOC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antagonista da aldosterona &#40;internamento&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tripla antiagrega&#231;&#227;o &#40;internamento&#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">16&#44;6&nbsp;\t\t\t\t\t\t\n
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Informação do artigo
ISSN: 08702551
Idioma original: Português
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 17 7 24
2024 Outubro 56 22 78
2024 Setembro 68 26 94
2024 Agosto 43 27 70
2024 Julho 34 31 65
2024 Junho 70 25 95
2024 Maio 38 21 59
2024 Abril 30 24 54
2024 Maro 43 22 65
2024 Fevereiro 31 17 48
2024 Janeiro 40 29 69
2023 Dezembro 24 18 42
2023 Novembro 39 29 68
2023 Outubro 29 13 42
2023 Setembro 28 22 50
2023 Agosto 33 18 51
2023 Julho 31 15 46
2023 Junho 33 11 44
2023 Maio 55 31 86
2023 Abril 27 8 35
2023 Maro 51 23 74
2023 Fevereiro 42 16 58
2023 Janeiro 29 15 44
2022 Dezembro 43 29 72
2022 Novembro 68 28 96
2022 Outubro 43 35 78
2022 Setembro 50 38 88
2022 Agosto 56 32 88
2022 Julho 55 46 101
2022 Junho 46 30 76
2022 Maio 53 32 85
2022 Abril 39 33 72
2022 Maro 69 39 108
2022 Fevereiro 61 40 101
2022 Janeiro 51 31 82
2021 Dezembro 59 30 89
2021 Novembro 54 33 87
2021 Outubro 59 38 97
2021 Setembro 38 31 69
2021 Agosto 42 51 93
2021 Julho 32 29 61
2021 Junho 62 17 79
2021 Maio 69 24 93
2021 Abril 69 18 87
2021 Maro 65 15 80
2021 Fevereiro 79 24 103
2021 Janeiro 46 13 59
2020 Dezembro 27 9 36
2020 Novembro 47 16 63
2020 Outubro 23 28 51
2020 Setembro 35 27 62
2020 Agosto 39 11 50
2020 Julho 38 7 45
2020 Junho 40 13 53
2020 Maio 42 9 51
2020 Abril 38 22 60
2020 Maro 55 5 60
2020 Fevereiro 95 19 114
2020 Janeiro 45 6 51
2019 Dezembro 33 5 38
2019 Novembro 38 8 46
2019 Outubro 43 5 48
2019 Setembro 36 8 44
2019 Agosto 26 10 36
2019 Julho 38 8 46
2019 Junho 49 6 55
2019 Maio 28 9 37
2019 Abril 25 15 40
2019 Maro 32 14 46
2019 Fevereiro 29 6 35
2019 Janeiro 30 5 35
2018 Dezembro 83 14 97
2018 Novembro 114 6 120
2018 Outubro 229 23 252
2018 Setembro 58 10 68
2018 Agosto 40 8 48
2018 Julho 36 11 47
2018 Junho 31 8 39
2018 Maio 85 16 101
2018 Abril 67 14 81
2018 Maro 73 8 81
2018 Fevereiro 68 4 72
2018 Janeiro 68 13 81
2017 Dezembro 74 23 97
2017 Novembro 43 19 62
2017 Outubro 48 18 66
2017 Setembro 52 16 68
2017 Agosto 42 6 48
2017 Julho 22 12 34
2017 Junho 34 22 56
2017 Maio 55 11 66
2017 Abril 33 5 38
2017 Maro 47 11 58
2017 Fevereiro 64 9 73
2017 Janeiro 63 12 75
2016 Dezembro 32 18 50
2016 Novembro 27 10 37
2016 Outubro 36 5 41
2016 Setembro 62 11 73
2016 Agosto 27 5 32
2016 Julho 19 10 29
2016 Junho 2 6 8
2016 Maio 3 0 3
2016 Abril 34 5 39
2016 Maro 49 14 63
2016 Fevereiro 82 14 96
2016 Janeiro 51 9 60
2015 Dezembro 63 10 73
2015 Novembro 55 12 67
2015 Outubro 43 10 53
2015 Setembro 48 10 58
2015 Agosto 51 14 65
2015 Julho 47 11 58
2015 Junho 34 7 41
2015 Maio 46 13 59
2015 Abril 44 7 51
2015 Maro 23 10 33
2015 Fevereiro 32 11 43
2015 Janeiro 30 16 46
2014 Dezembro 37 17 54
2014 Novembro 110 72 182
2014 Outubro 17 8 25
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