Letter to the Editor
Reply to letter “Beta-blockers in acute coronary syndrome patients: The concept of ‘gradient of benefit”’
Resposta à Carta «Beta-bloquantes no doente pós-SCA: o conceito de gradiente de benefício»
Lido
2244
Vezesque se leu este artigo
1000
Total PDF
1244
Total HTML
Compartilhar estatísticas
array:25 [ "pii" => "S0870255121003498" "issn" => "08702551" "doi" => "10.1016/j.repc.2021.07.007" "estado" => "S300" "fechaPublicacion" => "2021-10-01" "aid" => "1797" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2021;40:813-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S2174204921003202" "issn" => "21742049" "doi" => "10.1016/j.repce.2021.10.018" "estado" => "S300" "fechaPublicacion" => "2021-10-01" "aid" => "1797" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2021;40:813-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply to letter “Beta-blockers in acute coronary syndrome patients: The concept of ‘gradient of benefit”’" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "813" "paginaFinal" => "814" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Resposta à Carta «Beta-bloquantes no doente pós-SCA: o conceito de gradiente de benefício»" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1426 "Ancho" => 2021 "Tamanyo" => 86114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The gradient of benefit of beta-blockers (BB) according to the risk of future cardiovascular (CV) events and the risk of drug side effects in patients with ST-segment elevation myocardial infarction.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jesús Velásquez-Rodríguez, Manuel Martínez-Sellés" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Jesús" "apellidos" => "Velásquez-Rodríguez" ] 1 => array:2 [ "nombre" => "Manuel" "apellidos" => "Martínez-Sellés" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255121003498" "doi" => "10.1016/j.repc.2021.07.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003498?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204921003202?idApp=UINPBA00004E" "url" => "/21742049/0000004000000010/v1_202111300755/S2174204921003202/v1_202111300755/en/main.assets" ] ] "itemAnterior" => array:20 [ "pii" => "S0870255121003486" "issn" => "08702551" "doi" => "10.1016/j.repc.2021.05.009" "estado" => "S300" "fechaPublicacion" => "2021-10-01" "aid" => "1796" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2021;40:811-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Beta-blockers in acute coronary syndrome patients: The concept of ‘gradient of benefit’" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "811" "paginaFinal" => "812" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Betabloqueadores no doente pós SCA: o conceito de gradiente de benefício" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 971 "Ancho" => 2167 "Tamanyo" => 180474 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gradient of benefit for post-acute coronary syndrome patients. ACEi: angiotensin converting enzyme inhibitors; ACS: acute coronary syndrome; ARB: angiotensin receptor blockers; EF: ejection fraction; IH: in-hospital.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Fernando Montenegro Sá, João Morais" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Fernando Montenegro" "apellidos" => "Sá" ] 1 => array:2 [ "nombre" => "João" "apellidos" => "Morais" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204921003196" "doi" => "10.1016/j.repce.2021.10.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204921003196?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003486?idApp=UINPBA00004E" "url" => "/08702551/0000004000000010/v1_202110050607/S0870255121003486/v1_202110050607/en/main.assets" ] "asociados" => array:1 [ 0 => array:20 [ "pii" => "S0870255121003486" "issn" => "08702551" "doi" => "10.1016/j.repc.2021.05.009" "estado" => "S300" "fechaPublicacion" => "2021-10-01" "aid" => "1796" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Rev Port Cardiol. 2021;40:811-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Beta-blockers in acute coronary syndrome patients: The concept of ‘gradient of benefit’" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "811" "paginaFinal" => "812" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Betabloqueadores no doente pós SCA: o conceito de gradiente de benefício" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 971 "Ancho" => 2167 "Tamanyo" => 180474 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gradient of benefit for post-acute coronary syndrome patients. ACEi: angiotensin converting enzyme inhibitors; ACS: acute coronary syndrome; ARB: angiotensin receptor blockers; EF: ejection fraction; IH: in-hospital.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Fernando Montenegro Sá, João Morais" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Fernando Montenegro" "apellidos" => "Sá" ] 1 => array:2 [ "nombre" => "João" "apellidos" => "Morais" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204921003196" "doi" => "10.1016/j.repce.2021.10.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204921003196?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003486?idApp=UINPBA00004E" "url" => "/08702551/0000004000000010/v1_202110050607/S0870255121003486/v1_202110050607/en/main.assets" ] ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply to letter “Beta-blockers in acute coronary syndrome patients: The concept of ‘gradient of benefit”’" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "813" "paginaFinal" => "814" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jesús Velásquez-Rodríguez, Manuel Martínez-Sellés" "autores" => array:2 [ 0 => array:3 [ "nombre" => "Jesús" "apellidos" => "Velásquez-Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Manuel" "apellidos" => "Martínez-Sellés" "email" => array:1 [ 0 => "mmselles@secardiologia.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidad Complutense, Universidad Europea, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Resposta à Carta «Beta-bloquantes no doente pós-SCA: o conceito de gradiente de benefício»" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1426 "Ancho" => 2021 "Tamanyo" => 86114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The gradient of benefit of beta-blockers (BB) according to the risk of future cardiovascular (CV) events and the risk of drug side effects in patients with ST-segment elevation myocardial infarction.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We would like to thank Fernando Montenegro Sá and João Morais for their interest in our paper.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> Beta-blockers are indicated after ST-segment elevation myocardial infarction (STEMI) in patients with left ventricular ejection fraction (LVEF) ≤40% (class I recommendation, level of evidence A) but in those with LVEF >40% the benefit is not clear (class IIa, level B).<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> We agree that in patients in the 40-50% range beta-blockers appear more likely to help than to harm, due to their moderate probability of future events. The gradient of benefit means that beta-blockers should probably not be used in very low risk STEMI,<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">3,4</span></a> in which the risk of cardiovascular events is extremely small in the near future. In addition, beta-blockers should be avoided in high-risk patients in whom side effects will probably occur, as in those with hypotension, acute heart failure,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a> or shock<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Further studies are needed to better identify STEMI patients who might benefit from beta-blockers, taking into consideration not only LVEF, but also other factors associated with prognosis that might improve with this treatment. For instance, endothelial dysfunction is common in STEMI<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> and beta-blockers improve microvascular function.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a> This is also the case with atrial fibrillation.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">9,10</span></a> Most studies of beta-blockers in STEMI were performed in an era when the rate of primary angioplasty was low and heart failure and mechanical complications were frequently seen.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">11</span></a> The current scenario is different and extrapolation of previous data could lead to overuse of these drugs. In the Description of Acute Myocardial Infarction: Management, New Therapies and Evolution (DIAMANTE) registry, 86% of our patients received beta-blockers.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> Finally, regarding dosage, Mars et al.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a> have recently shown that target dose is not associated with cardiovascular outcomes, and Goldberger et al.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a> even suggest that patients treated with 12.5-25% of the target dose may have enhanced survival compared with other doses.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1426 "Ancho" => 2021 "Tamanyo" => 86114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The gradient of benefit of beta-blockers (BB) according to the risk of future cardiovascular (CV) events and the risk of drug side effects in patients with ST-segment elevation myocardial infarction.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0070" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of left ventricular systolic function on the long-term benefit of beta-blockers after ST-segment elevation myocardial infarction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Velásquez-Rodríguez" 1 => "V. Bruña" 2 => "L. Vicent" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2021" "volumen" => "40" "paginaInicial" => "285" "paginaFinal" => "290" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0075" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "B. Ibanez" 1 => "S. James" 2 => "S. Agewall" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehx393" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2018" "volumen" => "39" "paginaInicial" => "119" "paginaFinal" => "177" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28886621" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0080" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Very low risk ST-segment elevation myocardial infarction? It exists and may be easily identified" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "F. Díez-Delhoyo" 1 => "M.J. Valero-Masa" 2 => "J. Velásquez-Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2016.11.276" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2017" "volumen" => "228" "paginaInicial" => "615" "paginaFinal" => "620" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27880927" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0085" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Short-term and long-term validation of the fastest score in patients with ST-elevation myocardial infarction after primary angioplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "B. Alvarez Alvarez" 1 => "A.B. Cid Alvarez" 2 => "A. Redondo Dieguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2018.07.108" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2018" "volumen" => "269" "paginaInicial" => "19" "paginaFinal" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30064924" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0090" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of high Killip class after ST segment elevation myocardial infarction in the era of primary reperfusion" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L. Vicent" 1 => "J. Velásquez-Rodríguez" 2 => "M.J. Valero-Masa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2017.07.038" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2017" "volumen" => "248" "paginaInicial" => "46" "paginaFinal" => "50" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28942880" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0095" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of in-hospital mortality among cardiogenic shock patients. Prognostic and therapeutic implications" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "X. Li" 1 => "I. Sousa-Casasnovas" 2 => "C. Devesa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2016.09.019" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2016" "volumen" => "224" "paginaInicial" => "114" "paginaFinal" => "118" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27648979" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0100" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of microvascular and endothelial dysfunction in the nonculprit territory in patients with acute myocardial infarction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "F. Díez-Delhoyo" 1 => "E. Gutiérrez-Ibañes" 2 => "R. Sanz-Ruiz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCINTERVENTIONS.118.007257" "Revista" => array:5 [ "tituloSerie" => "Circ Cardiovasc Interv" "fecha" => "2019" "volumen" => "12" "paginaInicial" => "e007257" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30722689" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0105" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beta-blockers and coronary flow reserve: the importance of a vasodilatory action" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Galderisi" 1 => "A. D’Errico" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2165/00003495-200868050-00002" "Revista" => array:6 [ "tituloSerie" => "Drugs" "fecha" => "2008" "volumen" => "68" "paginaInicial" => "579" "paginaFinal" => "590" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18370439" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0110" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic of interatrial block after an acute ST-segment elevation myocardial infarction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V. Bruña" 1 => "J. Velásquez-Rodríguez" 2 => "M.J. Valero-Masa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000499501" "Revista" => array:6 [ "tituloSerie" => "Cardiology" "fecha" => "2019" "volumen" => "142" "paginaInicial" => "109" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31117073" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0115" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of beta-blockers on the risk of atrial fibrillation in patients with acute myocardial infarction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A.E. Pesaro" 1 => "A. de Matos Soeiro" 2 => "C.V. Serrano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clinics (Sao Paulo)" "fecha" => "2010" "volumen" => "65" "paginaInicial" => "265" "paginaFinal" => "270" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0120" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Temporal trends in mechanical complications of acute myocardial infarction in the elderly" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Puerto" 1 => "A. Viana-Tejedor" 2 => "M. Martínez-Sellés" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2018.06.031" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2018" "volumen" => "72" "paginaInicial" => "959" "paginaFinal" => "966" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30139440" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0125" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between β-blocker dose and cardiovascular outcomes after myocardial infarction: insights from the SWEDEHEART registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Mars" 1 => "J. Wallert" 2 => "C. Held" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Heart J Acute Cardiovasc Care" "fecha" => "2021" "volumen" => "10" "paginaInicial" => "372" "paginaFinal" => "379" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0130" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "One-year landmark analysis of the effect of beta-blocker dose on survival after acute myocardial infarction" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "OBTAIN (Outcomes of Beta-Blocker Therapy After Myocardial Infarction) Investigators" "etal" => true "autores" => array:3 [ 0 => "J.J. Goldberger" 1 => "H. Subačius" 2 => "O.C. Marroquin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/JAHA.120.019017" "Revista" => array:5 [ "tituloSerie" => "J Am Heart Assoc" "fecha" => "2021" "volumen" => "10" "paginaInicial" => "e019017" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34227397" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004000000010/v1_202110050607/S0870255121003498/v1_202110050607/en/main.assets" "Apartado" => array:4 [ "identificador" => "55963" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Carta ao Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004000000010/v1_202110050607/S0870255121003498/v1_202110050607/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255121003498?idApp=UINPBA00004E" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 4 | 5 | 9 |
| 2024 Outubro | 38 | 31 | 69 |
| 2024 Setembro | 33 | 23 | 56 |
| 2024 Agosto | 49 | 25 | 74 |
| 2024 Julho | 40 | 23 | 63 |
| 2024 Junho | 36 | 20 | 56 |
| 2024 Maio | 36 | 18 | 54 |
| 2024 Abril | 32 | 21 | 53 |
| 2024 Maro | 28 | 15 | 43 |
| 2024 Fevereiro | 30 | 21 | 51 |
| 2024 Janeiro | 16 | 19 | 35 |
| 2023 Dezembro | 18 | 22 | 40 |
| 2023 Novembro | 28 | 29 | 57 |
| 2023 Outubro | 20 | 16 | 36 |
| 2023 Setembro | 23 | 18 | 41 |
| 2023 Agosto | 13 | 12 | 25 |
| 2023 Julho | 25 | 13 | 38 |
| 2023 Junho | 24 | 12 | 36 |
| 2023 Maio | 27 | 22 | 49 |
| 2023 Abril | 16 | 3 | 19 |
| 2023 Maro | 40 | 26 | 66 |
| 2023 Fevereiro | 31 | 18 | 49 |
| 2023 Janeiro | 14 | 17 | 31 |
| 2022 Dezembro | 38 | 28 | 66 |
| 2022 Novembro | 34 | 31 | 65 |
| 2022 Outubro | 42 | 25 | 67 |
| 2022 Setembro | 25 | 28 | 53 |
| 2022 Agosto | 21 | 25 | 46 |
| 2022 Julho | 31 | 49 | 80 |
| 2022 Junho | 27 | 30 | 57 |
| 2022 Maio | 22 | 30 | 52 |
| 2022 Abril | 30 | 31 | 61 |
| 2022 Maro | 28 | 37 | 65 |
| 2022 Fevereiro | 18 | 29 | 47 |
| 2022 Janeiro | 25 | 26 | 51 |
| 2021 Dezembro | 28 | 36 | 64 |
| 2021 Novembro | 40 | 30 | 70 |
| 2021 Outubro | 152 | 82 | 234 |
| 2021 Setembro | 44 | 44 | 88 |
| 2021 Agosto | 18 | 10 | 28 |
Mostrar tudo
