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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La insuficiencia card&#237;aca &#40;IC&#41; es una enfermedad cardiovascular cr&#243;nica frecuente pero muy grave<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; La prevalencia de la IC ronda el 2&#37; de la poblaci&#243;n adulta en los pa&#237;ses desarrollados<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Sin embargo&#44; se espera que la prevalencia aumente en los pr&#243;ximos a&#241;os&#44; debido principalmente al envejecimiento de la poblaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">3&#44;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La IC es una enfermedad progresiva y debilitante que se asocia con tasas de mortalidad elevadas<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">6</span></a>&#46; Es la causa principal de hospitalizaci&#243;n en Estados Unidos y en Europa<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">7</span></a>&#44; y el riesgo de muerte de los pacientes con IC aumenta con cada ingreso hospitalario<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">8</span></a>&#46; Adem&#225;s&#44; los s&#237;ntomas asociados a la IC repercuten negativamente en la calidad de vida<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2&#44;9</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A pesar de los tratamientos tradicionales de la IC&#44; como los inhibidores del sistema renina-angiotensina&#44; los betabloqueantes y los antagonistas de la aldosterona&#44; las tasas de mortalidad y hospitalizaci&#243;n siguen siendo inaceptablemente altas<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">10</span></a>&#46; Sin embargo&#44; en los &#250;ltimos a&#241;os los ensayos PARADIGM-HF y&#44; m&#225;s recientemente&#44; DAPA-HF y EMPEROR-Reduced han demostrado que la combinaci&#243;n sacubitrilo&#47;valsart&#225;n y algunos inhibidores del SGLT-2&#44; respectivamente&#44; tienen efectos positivos en la morbimortalidad de los pacientes con IC y fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo reducida &#40;ICFEr&#41;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">11&#8211;13</span></a>&#46; Por ello&#44; est&#225;n justificados nuevos estudios centrados en el perfil cl&#237;nico actual y el tratamiento de los pacientes con IC y su repercusi&#243;n en los resultados&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Los objetivos de este estudio eran describir la epidemiolog&#237;a&#44; las caracter&#237;sticas cl&#237;nicas y el manejo terap&#233;utico de la poblaci&#243;n con IC en una cohorte actual de pacientes espa&#241;oles&#44; estratificada en funci&#243;n de la presencia de diabetes tipo 2 &#40;DM2&#41;&#44; y determinar los eventos cardiovasculares tras un a&#241;o de seguimiento&#46; Se analiz&#243; lo mismo en una poblaci&#243;n que cumpl&#237;a los criterios de inclusi&#243;n m&#225;s relevantes del ensayo DAPA-HF<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">12</span></a> &#40;poblaci&#243;n similar a la de DAPA-HF&#41; y en pacientes que tomaban inhibidores del SGLT2 en el momento basal por DM2&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio observacional de cohortes&#44; que comprend&#237;a an&#225;lisis retrospectivos transversales y longitudinales utilizando datos secundarios registrados en historias cl&#237;nicas electr&#243;nicas de 7 regiones espa&#241;olas&#46; Las fuentes de datos fueron proporcionadas por la base de datos validada BIG-PAC&#44; representativa de la poblaci&#243;n espa&#241;ola<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">14</span></a>&#46; BIG-PAC conten&#237;a datos procedentes de centros de salud y hospitales de referencia del sistema nacional de salud espa&#241;ol&#46; Antes de exportarlos a BIG-PAC&#44; los datos se anonimizan y disocian de forma rigurosa&#44; lo que imposibilita la identificaci&#243;n individual<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">La fecha &#237;ndice &#40;1 de enero de 2019&#41; se eligi&#243; para caracterizar a la poblaci&#243;n m&#225;s reciente&#44; ya que 2019 era el &#250;ltimo a&#241;o completo en el momento de finalizar el protocolo&#46; En este an&#225;lisis no se observaron diferencias importantes entre los 2 a&#241;os evaluados &#40;2015 y 2019&#41;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Este estudio fue aprobado por el Comit&#233; de &#201;tica de la Investigaci&#243;n del Consorci Sanitari de Terrassa&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Se consider&#243; poblaci&#243;n con IC a los adultos con al menos un diagn&#243;stico de IC antes de la fecha &#237;ndice &#40;1 de enero de 2019&#41;&#46; Se consider&#243; con DM2 a los adultos con una receta de cualquier antidiab&#233;tico&#44; con diagn&#243;stico de DM2 o con HbA1c<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7&#37; antes de la fecha &#237;ndice&#46; La poblaci&#243;n similar a la del DAPA-HF incluy&#243; a los adultos con antecedentes de IC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>8 semanas&#44; tratamiento habitual de la IC&#44; clase de la NYHA<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>II en el a&#241;o previo a la fecha &#237;ndice y FE<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>40&#37;&#46; La poblaci&#243;n tratada con inhibidores del SGLT-2 estaba formada por los pacientes con DM2 tratados con esos f&#225;rmacos en el momento basal&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se hizo una b&#250;squeda de enfermedades concomitantes en todos los datos disponibles antes de la fecha &#237;ndice&#44; con la excepci&#243;n de la hipoglucemia grave&#44; que se consider&#243; solo en el a&#241;o anterior a la fecha &#237;ndice&#44; y del c&#225;ncer&#44; que se busc&#243; hasta 5 a&#241;os antes de la fecha &#237;ndice&#46; Se exigi&#243; un m&#237;nimo de un a&#241;o de datos antes de la fecha &#237;ndice&#46; Las comorbilidades eran cardiopat&#237;a isqu&#233;mica&#44; IC&#44; enfermedad renal cr&#243;nica &#40;ERC&#41;&#44; fibrilaci&#243;n auricular&#44; ictus&#44; arteriopat&#237;a perif&#233;rica &#40;AP&#41;&#44; hemorragia org&#225;nica importante espec&#237;fica&#44; complicaciones microvasculares&#44; hipoglucemia grave&#44; cetoacidosis y acidosis l&#225;ctica&#44; c&#225;ncer&#44; enfermedad pulmonar obstructiva cr&#243;nica y complicaciones en las extremidades inferiores&#46; Para el diagn&#243;stico de las comorbilidades se tuvieron en cuenta los c&#243;digos CIE-9 y CIE-10 &#40;<a href="https://eciemaps.mscbs.gob.es/">https&#58;&#47;&#47;eciemaps&#46;mscbs&#46;gob&#46;es</a>&#41; &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 1 suplementaria</a>&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Se registr&#243; la informaci&#243;n del tratamiento a partir de los registros de dispensaci&#243;n de medicamentos seg&#250;n el Sistema de clasificaci&#243;n anat&#243;mica&#44; terap&#233;utica y qu&#237;mica &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 1 suplementaria</a>&#41;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">17</span></a>&#46; Se registraron los tratamientos para la IC&#44; los anticoagulantes&#44; las estatinas&#44; los antiagregantes plaquetarios&#44; los antihipertensivos&#44; los nitratos y los antidiab&#233;ticos&#46; La prescripci&#243;n de un f&#225;rmaco a un enfermo concreto se bas&#243; &#250;nicamente en criterios m&#233;dicos &#40;pr&#225;ctica habitual&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se calcularon en la fecha &#237;ndice la prevalencia&#44; la incidencia y las caracter&#237;sticas basales &#40;poblaci&#243;n total con IC y por estado de DM2&#41;&#44; incluidas las caracter&#237;sticas demogr&#225;ficas&#44; las comorbilidades y los medicamentos&#46; Se calcul&#243; la incidencia como el n&#250;mero de pacientes diagnosticados durante el a&#241;o de inter&#233;s dividido entre el n&#250;mero de pacientes sin IC en la poblaci&#243;n al comienzo de 2019&#46; La prevalencia se calcul&#243; como todos los pacientes con diagn&#243;stico de IC al final de 2019 divididos entre todos los individuos de la poblaci&#243;n total&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Los eventos cardiovasculares se definieron como un diagn&#243;stico principal durante una visita o estancia hospitalaria ocurrida en cualquier momento de 2019 despu&#233;s de la fecha &#237;ndice &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 1 suplementaria</a>&#41;&#46; La mortalidad global se defini&#243; como la muerte por cualquier causa&#46; Se calcularon los eventos cardiovasculares &#40;infarto de miocardio &#91;IM&#93;&#44; ictus&#44; IC&#44; ERC definida como una filtraci&#243;n glomerular estimada<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> seg&#250;n la ecuaci&#243;n CKD-EPI&#44; y AP&#41; en las poblaciones total con IC&#44; similar DAPA-HF y con inhibidores SGLT2&#44; en funci&#243;n de la presencia de DM2&#44; y se estratificaron por edad y sexo&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se valoraron tambi&#233;n las variables siguientes en el grupo total con IC y en funci&#243;n de la presencia de DM2&#58; tasas de incidencia y hospitalizaci&#243;n&#44; tasas de reingreso hospitalario&#44; tasas de mortalidad&#44; tasas de mortalidad durante la hospitalizaci&#243;n y tasas de mortalidad despu&#233;s de la primera hospitalizaci&#243;n&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lisis estad&#237;stico</span><p id="par0070" class="elsevierStylePara elsevierViewall">Las variables categ&#243;ricas se describieron mediante sus frecuencias absolutas &#40;n&#41; y relativas &#40;&#37;&#41;&#44; y las variables continuas&#44; mediante la media y la desviaci&#243;n est&#225;ndar&#46; Las tasas de eventos se presentaron como episodios por 1&#46;000 pacientes-a&#241;o&#46; Las variables categ&#243;ricas se compararon con la prueba Chi-cuadrado o la prueba exacta de Fisher cuando proced&#237;a&#46; Para comparar 2 medias se utiliz&#243; la prueba <span class="elsevierStyleItalic">t</span> de Student&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se realizaron an&#225;lisis de los acontecimientos en la fecha &#237;ndice de 1 de enero de 2019 con un a&#241;o de seguimiento&#46; El tiempo hasta el primer evento se analiz&#243; con la prueba <span class="elsevierStyleItalic">t</span> de Student de contraste para muestras independientes&#46; Se aplic&#243; un nivel de significaci&#243;n estad&#237;stica de 0&#44;05 en todas las pruebas estad&#237;sticas&#46; Los datos se analizaron con el paquete estad&#237;stico SPSS v25&#46;0 &#40;SPSS Inc&#46;&#44; Chicago&#44; Illinois&#44; EE&#46; UU&#46;&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0080" class="elsevierStylePara elsevierViewall">En la fecha &#237;ndice se analizaron 21&#46;851 pacientes con IC &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; La incidencia de IC era de 2&#44;83 por 1&#46;000 pacientes-a&#241;o&#44; y la prevalencia del 1&#44;88&#37;&#46; En los pacientes con DM2&#44; la prevalencia de IC era unas 12 veces mayor que en los que no ten&#237;an DM2 &#40;16&#44;2&#37; y 1&#44;3&#37;&#44; respectivamente&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas cl&#237;nicas basales de la poblaci&#243;n con IC en funci&#243;n de la presencia o ausencia de DM2 se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La edad media global era 78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;3 a&#241;os&#44; y el 50&#44;9&#37; de los pacientes ten&#237;a ICFEr&#44; el 66&#44;1&#37; tomaba inhibidores del sistema renina-angiotensina&#44; el 69&#44;4&#37; betabloqueantes&#44; el 31&#44;2&#37; antagonistas de la aldosterona y el 7&#44;5&#37; sacubitrilo&#47;valsart&#225;n&#46; En total&#44; 7&#46;371 &#40;33&#44;7&#37;&#41; pacientes ten&#237;an DM2&#46; Los pacientes con DM2 ten&#237;an FE m&#225;s bajas &#40;42&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;6&#37; frente a 44&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; pasaban a clases funcionales de la NYHA peores &#40;clase funcional <span class="elsevierStyleSmallCaps">iii</span>-<span class="elsevierStyleSmallCaps">iv</span> de la NYHA&#44; 46&#44;9 frente a 38&#44;2&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ten&#237;an m&#225;s comorbilidades &#40;cardiopat&#237;a isqu&#233;mica&#58; 27&#44;8 frente a 18&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; ERC&#58; 37&#44;3 frente a 23&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; ictus&#58; 13&#44;3 frente a 9&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los pacientes con DM2 tomaban m&#225;s inhibidores del sistema renina-angiotensina &#40;70&#44;5 frente a 63&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y betabloqueantes &#40;74&#44;4 frente a 66&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; pero menos sacubitrilo&#47;valsart&#225;n &#40;5&#44;8 frente a 8&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Durante el a&#241;o de seguimiento&#44; el 29&#44;8&#37; de los pacientes present&#243; descompensaci&#243;n de la IC que determin&#243; la hospitalizaci&#243;n&#44; y el 12&#44;3&#37; falleci&#243;&#46; El acontecimiento que se produjo antes fue la ERC&#44; seguida de la hospitalizaci&#243;n por IC&#46; Las tasas de episodios fueron m&#225;s frecuentes en los pacientes con DM2 &#40;muerte por cualquier causa&#44; 14&#44;1 frente a 12&#44;6 episodios&#47;100 pacientes-a&#241;o&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#59; IM&#58; 8&#44;9 frente a 3&#44;1 episodios&#47;100 pacientes-a&#241;o&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; IC&#58; 42&#44;9 frente a 34&#44;5 episodios&#47;100 pacientes-a&#241;o&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; ERC&#58; 17&#44;6 frente a 8&#44;6 episodios&#47;100 pacientes-a&#241;o&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41; y con la edad&#46; Mientras que las tasas de mortalidad &#40;13&#44;6 frente a 11&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y descompensaci&#243;n de la IC &#40;30&#44;8 frente a 28&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; fueron m&#225;s frecuentes en las mujeres&#44; el IM &#40;4 frente a 5&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y la AP &#40;1&#44;4 frente a 2&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; lo fueron en los varones &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">En cuanto a los resultados de la hospitalizaci&#243;n&#44; las tasas de hospitalizaci&#243;n alcanzaron el 30&#44;9&#37; al a&#241;o de seguimiento&#44; y el 8&#44;1&#37; de los pacientes fallecieron durante la hospitalizaci&#243;n&#46; Las tasas de hospitalizaci&#243;n y las de mortalidad durante la hospitalizaci&#243;n fueron m&#225;s frecuentes en los pacientes con DM2 &#40;incidencia y hospitalizaci&#243;n&#58; 34 frente a 29&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; mortalidad&#58; 13&#44;2 frente a 11&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis espec&#237;fico en la poblaci&#243;n similar a la del estudio DAPA-HF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;243&#41;&#46; En esta subpoblaci&#243;n&#44; la edad media era 78&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;0 a&#241;os&#44; y todos los pacientes ten&#237;an ICFEr&#46; La mayor&#237;a de los pacientes se situaron en la clase funcional <span class="elsevierStyleSmallCaps">ii</span> &#40;49&#44;7&#37;&#41; o <span class="elsevierStyleSmallCaps">iii</span> &#40;45&#44;4&#37;&#41; de la NYHA&#46; En total&#44; 1&#46;699 &#40;40&#37;&#41; pacientes ten&#237;an DM2&#46; Alrededor del 98&#44;2&#37; de los pacientes tomaba inhibidores del sistema renina-angiotensina&#44; el 100&#37; betabloqueantes&#44; el 20&#37; antagonistas de la aldosterona y el 3&#44;7&#37; sacubitrilo&#47;valsart&#225;n&#46; En comparaci&#243;n con los pacientes sin DM2&#44; quienes la sufr&#237;an estaban tomando m&#225;s sacubitrilo&#47;valsart&#225;n y digoxina &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 2 suplementaria</a>&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Durante el a&#241;o de seguimiento&#44; el 50&#44;3&#37; de los pacientes present&#243; descompensaci&#243;n de la IC que determin&#243; la hospitalizaci&#243;n&#44; y el 12&#44;2&#37; falleci&#243;&#46; El episodio que se produjo antes tambi&#233;n fue la ERC&#44; seguida de la hospitalizaci&#243;n por IC&#46; Las tasas de episodios fueron m&#225;s frecuentes en los pacientes con DM2 &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 3 suplementaria</a>&#41; y la mortalidad&#44; la IC y los resultados renales con la edad &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 4 suplementaria</a>&#41;&#46; Mientras que la descompensaci&#243;n de la IC fue m&#225;s frecuente en las mujeres&#44; el IM y la AP lo fueron en los varones &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 5 suplementaria</a>&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis espec&#237;fico de la poblaci&#243;n con inhibidores SGLT2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>797&#41;&#46; En esta subpoblaci&#243;n&#44; la edad media era 72&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;3 a&#241;os&#44; y el 46&#44;8&#37; de los pacientes sufr&#237;a ICFEr&#46; La mayor&#237;a de los pacientes se situaban en la clase funcional <span class="elsevierStyleSmallCaps">ii</span> &#40;40&#44;5&#37;&#41; o <span class="elsevierStyleSmallCaps">iii</span> &#40;42&#44;4&#37;&#41; de la NYHA&#46; Todos los pacientes ten&#237;an DM2&#46; El 68&#44;9&#37; de los pacientes tomaba inhibidores del sistema renina-angiotensina&#44; el 72&#44;5&#37; betabloqueantes&#44; el 46&#44;8&#37; antagonistas de la aldosterona y el 3&#44;6&#37; sacubitrilo&#47;valsart&#225;n &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 6 suplementaria</a>&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Durante el a&#241;o de seguimiento&#44; el 36&#44;4&#37; de los pacientes present&#243; descompensaci&#243;n de la IC que determin&#243; la hospitalizaci&#243;n&#44; y el 19&#37; falleci&#243; &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 7 suplementaria</a>&#41;&#46; La mortalidad aument&#243; con la edad &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 8 suplementaria</a>&#41;&#46; Las tasas de IC y AP fueron m&#225;s frecuentes en los varones &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 9 suplementaria</a>&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; la incidencia de IC fue de 2&#44;8 por 1&#46;000 personas-a&#241;o&#44; y la prevalencia del 1&#44;9&#37;&#46; Hay que se&#241;alar que la presencia de DM2 aumentaba notablemente el riesgo de IC&#46; A pesar de que estudios previos realizados en Espa&#241;a hab&#237;an mostrado una prevalencia m&#225;s alta de IC&#44; nuestros datos concuerdan con las cifras comunicadas en Europa y Estados Unidos<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;18&#8211;20</span></a>&#46; Por otro lado&#44; nuestro estudio mostr&#243; que el 51&#37; de los pacientes ten&#237;a ICFEr&#44; en consonancia con estudios previos<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">21&#44;22</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En cuanto a los tratamientos de la IC&#44; nuestro estudio mostr&#243; que hay mucho margen de mejora&#46; La prescripci&#243;n de los tratamientos recomendados por las directrices para la IC es esencial para mejorar la clase funcional&#44; pero&#44; sobre todo&#44; para reducir las hospitalizaciones por IC y la mortalidad<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2&#44;21&#44;23</span></a>&#46; Por desgracia&#44; aunque los pacientes ingresados en unidades espec&#237;ficas para la IC hacen un mayor uso de f&#225;rmacos para la IC basados en pruebas<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">24</span></a>&#44; la inmensa mayor&#237;a de los estudios realizados en otros contextos cl&#237;nicos han mostrado tasas de prescripci&#243;n m&#225;s bajas<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">25&#8211;27</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Hay que se&#241;alar que la menor prescripci&#243;n de los f&#225;rmacos recomendados por las directrices para la IC aumenta el uso de recursos sanitarios&#44; sobre todo de las hospitalizaciones iniciales y recurrentes<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">28</span></a>&#46; Por el contrario&#44; el aumento del cumplimiento de los f&#225;rmacos para la IC mejora los resultados cl&#237;nicos<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">29</span></a>&#46; Adem&#225;s&#44; tras un a&#241;o de seguimiento&#44; la complicaci&#243;n principal fue la hospitalizaci&#243;n por IC&#44; lo que subraya la importancia de prescribir los f&#225;rmacos con un efecto beneficioso demostrado no solo en la mortalidad&#44; sino tambi&#233;n en la morbilidad<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; el 12&#37; de los pacientes con IC fallecieron durante el seguimiento&#46; Aunque el pron&#243;stico de la IC ha mejorado en los &#250;ltimos decenios<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;30</span></a>&#44; las tasas de mortalidad siguen siendo altas<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">10</span></a>&#46; En un metaan&#225;lisis reciente se calcularon supervivencias a 1&#44; 5 y 10 a&#241;os del 87&#44; 57 y 35&#37;&#44; respectivamente&#44; en los pacientes con IC&#46; Hay que destacar que la mortalidad m&#225;s baja se dio en los estudios de atenci&#243;n secundaria&#44; lo que indica que la asistencia especializada&#44; junto con el mejor tratamiento de la IC&#44; mejora la supervivencia observada con la atenci&#243;n primaria<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En cuanto a los resultados de la hospitalizaci&#243;n&#44; el 8&#37; de los pacientes falleci&#243; durante la hospitalizaci&#243;n por IC&#46; Las tasas de mortalidad durante la hospitalizaci&#243;n fueron mayores en los pacientes con DM2&#46; Se ha calculado que la mortalidad a los 30 d&#237;as oscila entre el 5&#37; y el 20&#37;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;32</span></a>&#46; Lo m&#225;s notable es que la hospitalizaci&#243;n por IC es un factor predictivo independiente de aumento de la mortalidad por IC<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;33</span></a>&#46; Adem&#225;s&#44; el coste de la hospitalizaci&#243;n por IC es el principal determinante del coste sanitario total de la poblaci&#243;n con IC<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">5&#44;34</span></a>&#46; Es importante se&#241;alar que se espera que el n&#250;mero absoluto de hospitalizaciones por IC aumente en los pr&#243;ximos a&#241;os debido al envejecimiento de la poblaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">El ensayo PARADIGM-HF mostr&#243; que&#44; en comparaci&#243;n con el enalapril&#44; la combinaci&#243;n sacubitrilo&#47;valsart&#225;n reduc&#237;a notablemente el riesgo de hospitalizaci&#243;n por IC<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">11</span></a>&#44; y en el ensayo DAPA-HF la dapagliflozina redujo considerablemente el riesgo de un primer episodio de empeoramiento de la IC<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">12</span></a>&#46; Un estudio reciente ha mostrado que&#44; comparado con el tratamiento habitual&#44; el tratamiento farmacol&#243;gico modificador de la enfermedad integral temprano con sacubitrilo&#47;valsart&#225;n&#44; betabloqueantes&#44; antagonistas de la aldosterona y dapagliflozina disminuye significativamente la mortalidad cardiovascular o el ingreso hospitalario por IC en un 62&#37;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">35</span></a>&#46; En consecuencia&#44; es obligatoria la prescripci&#243;n de f&#225;rmacos que reduzcan tanto las hospitalizaciones por IC como la tasa de mortalidad para reducir la carga de IC&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; los pacientes con DM2 ten&#237;an m&#225;s procesos com&#243;rbidos&#44; as&#237; como m&#225;s resultados cardiovasculares y renales&#44; que los que no presentaban DM2&#46; Esto concuerda con los datos del registro RICA que mostraban que la DM2 era una enfermedad frecuente en los pacientes hospitalizados por IC y que su presencia era un factor predictivo independiente de mortalidad global y reingreso por IC<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">36</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Hay que destacar que la IC es una complicaci&#243;n precoz de los pacientes con DM2<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">37</span></a>&#46; Adem&#225;s&#44; muchos pacientes con DM2 tienen disfunci&#243;n ventricular izquierda asintom&#225;tica en los primeros a&#241;os tras el diagn&#243;stico de diabetes<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">38</span></a>&#46; Por ello&#44; el tratamiento temprano de los pacientes con DM2 con inhibidores SGLT2 puede retardar o incluso evitar la aparici&#243;n de IC<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">39&#44;40</span></a>&#46; En la poblaci&#243;n que recib&#237;a inhibidores SGLT2&#44; aunque la proporci&#243;n de pacientes que tomaban antagonistas de la aldosterona era mayor que en la poblaci&#243;n total con IC&#44; alrededor de un tercio de los pacientes no tomaban inhibidores del sistema renina-angiotensina y cerca del 30&#37; betabloqueantes&#44; lo que se traduc&#237;a en tasas altas de hospitalizaci&#243;n y fallecimiento por IC&#46; Hay que se&#241;alar que las tasas de mortalidad fueron mayores en la poblaci&#243;n tratada con inhibidores SGLT2 que en las poblaciones con IC y DM2 y similar a la del DAPA-HF&#44; lo que indica no solo un perfil cl&#237;nico peor con m&#225;s procesos com&#243;rbidos y peor clase funcional&#44; sino tambi&#233;n un uso tard&#237;o de estos f&#225;rmacos a pesar de su efecto beneficio demostrado en los resultados cardiovasculares<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">12&#44;40</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">En la poblaci&#243;n similar a la del estudio DAPA-HF&#44; aunque casi todos los pacientes estaban tomando inhibidores del sistema renina-angiotensina y betabloqueantes&#44; el 50&#37; sufri&#243; descompensaci&#243;n de la IC y el 12&#37; falleci&#243;&#46; En consecuencia&#44; es obligatorio optimizar la prescripci&#243;n de medicaci&#243;n cardioprotectora para reducir los resultados de la IC<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">39</span></a>&#46; De hecho&#44; se ha sugerido recientemente que puede ser m&#225;s importante priorizar el inicio del f&#225;rmaco antes del ajuste de la dosis en los pacientes con ICFEr<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">41</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Los resultados cardiovasculares y renales aumentaron significativamente con la edad&#44; y estudios anteriores tambi&#233;n han mostrado un riesgo alto de complicaciones en los pacientes de edad avanzada con IC<a class="elsevierStyleCrossRefs" href="#bib0435"><span class="elsevierStyleSup">42&#44;43</span></a>&#46; En especial&#44; en los pacientes mayores son beneficiosos los medicamentos para la IC respaldados por pruebas<a class="elsevierStyleCrossRefs" href="#bib0445"><span class="elsevierStyleSup">44&#44;45</span></a>&#46; En consecuencia&#44; tambi&#233;n debe optimizarse el tratamiento de la IC en esta poblaci&#243;n&#44; aunque con precauci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Limitaciones</span><p id="par0170" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio observacional de cohortes retrospectivo en el que se utilizaron datos secundarios procedentes de historias cl&#237;nicas electr&#243;nicas&#46; Estos estudios tienen algunas limitaciones&#44; por lo que solo puede aportarse una relaci&#243;n causal indirecta&#46; Adem&#225;s&#44; debido al dise&#241;o retrospectivo del estudio&#44; no se pudieron registrar algunos datos relevantes&#46; Asimismo&#44; la ausencia de clasificaci&#243;n de los pacientes en funci&#243;n de la FE dificulta la extrapolaci&#243;n de los patrones de tratamiento por grupos de FE&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Sin embargo&#44; el gran n&#250;mero de pacientes y la solidez de los datos pueden hacer posible la utilidad del estudio&#46; Por otro lado&#44; aunque los datos proced&#237;an de solo 7 regiones espa&#241;olas&#44; estudios previos han mostrado que estos datos son representativos de la poblaci&#243;n espa&#241;ola<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">14</span></a>&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusiones</span><p id="par0180" class="elsevierStylePara elsevierViewall">En Espa&#241;a&#44; la poblaci&#243;n con IC es mayor y tiene muchas comorbilidades&#44; y alrededor de la mitad de los pacientes sufren ICFEr&#46; Los pacientes con DM2 tienen m&#225;s procesos com&#243;rbidos y m&#225;s resultados cardiovasculares y renales que los pacientes sin DM2&#46; Por desgracia&#44; una proporci&#243;n importante de pacientes no toma f&#225;rmacos para la IC respaldados por pruebas&#44; lo que se traduce en tasas m&#225;s altas de resultados&#44; especialmente descompensaci&#243;n de la IC&#46; Esto ocurre en pacientes con y sin DM2&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Por lo tanto&#44; es fundamental mejorar el manejo de la IC&#44; sobre todo a trav&#233;s del uso de f&#225;rmacos que reduzcan la hospitalizaci&#243;n y la mortalidad por IC&#44; para disminuir la carga de IC&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Financiaci&#243;n</span><p id="par0190" class="elsevierStylePara elsevierViewall">Este estudio fue financiado por AstraZeneca&#46; La entidad financiadora no ha intervenido en el dise&#241;o&#44; la recogida de datos&#44; el an&#225;lisis&#44; la interpretaci&#243;n ni la redacci&#243;n del manuscrito&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0195" class="elsevierStylePara elsevierViewall">Los autores declararan no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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            1 => "Muerte"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las caracter&#237;sticas cl&#237;nicas y el manejo terap&#233;utico y determinar los eventos cardiovasculares tras un a&#241;o de seguimiento en una poblaci&#243;n contempor&#225;nea con insuficiencia card&#237;aca &#40;IC&#41; con y sin diabetes tipo 2 en Espa&#241;a&#46; Tambi&#233;n se analiz&#243; en la poblaci&#243;n DAPA-HF &#40;pacientes que cumplieron la mayor&#237;a de los criterios de inclusi&#243;n del estudio DAPA-HF&#41; y en los pacientes tratados basalmente con inhibidores SGLT2&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; retrospectivo&#44; poblacional&#44; empleando la base de datos BIG-PAC&#46; La fecha &#237;ndice fue 1 de enero de 2019&#46; Se seleccionaron sujetos<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>18 a&#241;os que recibieron tratamiento por IC en 2019&#46; Se analizaron los eventos durante 2019&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 21&#46;851 pacientes con IC &#40;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;3 a&#241;os&#59; 53&#37; varones&#59; 50&#44;9&#37; IC con fracci&#243;n de eyecci&#243;n reducida&#59; 44&#44;5&#37; en clase funcional NYHA II&#41;&#46; La prevalencia de IC fue del 1&#44;88&#37; y la incidencia 2&#44;83 por 1&#46;000 pacientes-a&#241;o&#46; El 66&#44;1&#37; tomaba inhibidores del sistema renina-angiotensina&#44; el 69&#44;4&#37; betabloqueantes&#44; el 31&#44;2&#37; antialdoster&#243;nicos y el 7&#44;5&#37; sacubitrilo&#47;valsart&#225;n&#46; Durante el a&#241;o de seguimiento&#44; el 29&#44;8&#37; fue hospitalizado por descompensaci&#243;n de la IC &#40;tiempo medio primer evento 120&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>72&#44;5 d&#237;as&#41;&#44; un 12&#44;3&#37; murieron&#44; un 8&#44;1&#37; murieron durante la hospitalizaci&#243;n&#46; Los eventos fueron m&#225;s frecuentes en los pacientes con diabetes tipo 2&#46; Las hospitalizaciones por IC fueron m&#225;s comunes en la poblaci&#243;n similar a DAPA-HF&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En Espa&#241;a&#44; la poblaci&#243;n con IC es anciana y tiene muchas comorbilidades&#46; Aproximadamente la mitad de los pacientes tienen IC con fracci&#243;n de eyecci&#243;n reducida&#46; Existe margen de mejora en el manejo de la IC&#44; en particular mediante el empleo de aquellos f&#225;rmacos que reducen tanto la hospitalizaci&#243;n por IC como la mortalidad&#44; para disminuir la carga de IC&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">This work aims to describe the clinical characteristics and therapeutic management and to determine cardiovascular outcomes after one year of follow-up in a contemporaneous population with heart failure &#40;HF&#41; with and without type 2 diabetes in Spain&#46; These factors were also analyzed in the DAPA-HF-like population &#40;patients who met most inclusion criteria of the DAPA-HF trial&#41; and in patients treated with SGLT2 inhibitors at baseline&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This work is an observational&#44; retrospective&#44; population-based study using the BIG-PAC database&#46; The index date was January 1&#44; 2019&#46; People aged<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>18 years who received care for HF in 2019 were selected&#46; Events that occurred in 2019 were analyzed&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We identified 21&#44;851 patients with HF &#40;age 78&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;3 years&#44; 53&#46;0&#37; men&#44; 50&#46;9&#37; with HF with reduced left ventricular ejection fraction&#44; 44&#46;5&#37; in NYHA functional class II&#41;&#46; HF prevalence was 1&#46;88&#37; and incidence was 2&#46;83 per 1&#44;000 person-years&#46; Regarding HF treatments&#44; 66&#46;1&#37; were taking renin-angiotensin system inhibitors&#44; 69&#46;4&#37; beta blockers&#44; 31&#46;2&#37; aldosterone antagonists&#44; and 7&#46;5&#37; sacubitril&#47;valsartan&#46; During the year of follow-up&#44; 29&#46;8&#37; had HF decompensation which led to hospitalization &#40;mean time to first event of 120&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>72&#46;5 days&#41;&#44; 12&#46;3&#37; died&#44; and 8&#46;1&#37; died during hospitalization&#46; Events were more common among patients with type 2 diabetes&#46; Hospitalizations for HF were more common in the DAPA-HF-like population&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In Spain&#44; the population with HF is elderly and has many comorbidities&#46; Approximately half of patients have HF with reduced left ventricular ejection fraction&#46; There is room for improvement in HF management&#44; particularly through the use of drugs that reduce both HF hospitalization and mortality&#44; in order to reduce the burden of HF&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>40&#37;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46;424 &#40;50&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>40-<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50&#37;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">755 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">798 &#40;11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;553 &#40;7&#44;9&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;665 &#40;44&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;458 &#40;35&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#46;123 &#40;41&#44;2&#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">&#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
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Datos de laboratorio</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">FGe&#44; mL&#47;min&#47;1&#44;73</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">77&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#44;1&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">72&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">HbA1c&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8&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">7&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8&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">&#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="5" align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Comorbilidades</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Enfermedad cardiovascular&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&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">2&#46;720 &#40;18&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;049 &#40;27&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;769 &#40;21&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Infarto de miocardio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;732 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;398 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;130 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>By-pass aortocoronario&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">196 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">184 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">380 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>ICP con endopr&#243;tesis&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">394 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">297 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">691 &#40;3&#44;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">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Angina inestable&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">576 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">458 &#40;6&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;034 &#40;4&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Angina de pecho&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">1&#46;022 &#40;7&#44;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
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                  \t\t\t\t">713 &#40;9&#44;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
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                  \t\t\t\t">1&#46;735 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ictus&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">1&#46;419 &#40;9&#44;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
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                  \t\t\t\t">982 &#40;13&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;401 &#40;11&#44;0&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ictus isqu&#233;mico&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">1&#46;073 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">765 &#40;10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;838 &#40;8&#44;4&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ictus hemorr&#225;gico&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">73 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">49 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">122 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;132&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Accidente isqu&#233;mico transitorio&nbsp;\t\t\t\t\t\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">387 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">274 &#40;3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">661 &#40;3&#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">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Fibrilaci&#243;n auricular&nbsp;\t\t\t\t\t\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">4&#46;742 &#40;32&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;504 &#40;34&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46;246 &#40;33&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;070&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Arteriopat&#237;a perif&#233;rica&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">600 &#40;4&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">450 &#40;6&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;050 &#40;4&#44;8&#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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Enfermedad renal cr&#243;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#46;392 &#40;23&#44;4&#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">2&#46;751 &#40;37&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46;143 &#40;28&#44;1&#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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Complicaciones microvasculares&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">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;094 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;094 &#40;14&#44;2&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Mono&#47;polineuropat&#237;a diab&#233;tica&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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">508 &#40;6&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">508 &#40;2&#44;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">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Complicaciones oculares de la diabetes&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">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#46;117 &#40;28&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;117 &#40;9&#44;7&#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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pie diab&#233;tico&#47;angiopat&#237;a perif&#233;rica&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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">380 &#40;5&#44;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
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                  \t\t\t\t">380 &#40;1&#44;7&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Nefropat&#237;a diab&#233;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">655 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">655 &#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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hipoglucemia grave&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">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">629 &#40;8&#44;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
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                  \t\t\t\t">629 &#40;2&#44;9&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cetoacidosis&#47;acidosis l&#225;ctica&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&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55 &#40;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55 &#40;0&#44;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">&#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="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Otras comorbilidades&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>C&#225;ncer&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">1&#46;534 &#40;10&#44;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">883 &#40;12&#44;0&#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">2&#46;417 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Enfermedad pulmonar obstructiva 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
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                  \t\t\t\t">2&#46;244 &#40;15&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;503 &#40;20&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;747 &#40;17&#44;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">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Amputaciones de miembros inferiores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">36 &#40;0&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">115 &#40;1&#44;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">151 &#40;0&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hemorragia organoespec&#237;fica grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">383 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">246 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">629 &#40;2&#44;9&#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;004&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
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Tratamientos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Medicamentos para la insuficiencia card&#237;aca&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14&#46;480 &#40;100&#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">7&#46;371 &#40;100&#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">21&#46;851 &#40;100&#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="left" valign="\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inhibidores del sistema renina-angiotensina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">9&#46;253 &#40;63&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;193 &#40;70&#44;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
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                  \t\t\t\t">14&#46;446 &#40;66&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inhibidores de la enzima convertidora de la angiotensina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4&#46;421 &#40;30&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;419 &#40;32&#44;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
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                  \t\t\t\t">6&#46;840 &#40;31&#44;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
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antagonistas de los receptores de angiotensina&nbsp;\t\t\t\t\t\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">4&#46;832 &#40;33&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;774 &#40;37&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46;606 &#40;34&#44;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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Betabloqueantes&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">9&#46;678 &#40;66&#44;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
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                  \t\t\t\t">5&#46;482 &#40;74&#44;4&#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">15&#46;160 &#40;69&#44;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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Diur&#233;ticos del asa&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">10&#46;018 &#40;69&#44;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
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                  \t\t\t\t">5&#46;662 &#40;76&#44;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
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                  \t\t\t\t">15&#46;680 &#40;71&#44;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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antagonistas de la aldosterona&nbsp;\t\t\t\t\t\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">4&#46;493 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#46;323 &#40;31&#44;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
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                  \t\t\t\t">6&#46;816 &#40;31&#44;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
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                  \t\t\t\t">0&#44;463&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Sacubitrilo&#47;valsart&#225;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;202 &#40;8&#44;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
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                  \t\t\t\t">430 &#40;5&#44;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">1&#46;632 &#40;7&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Digoxina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;105 &#40;7&#44;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="left" valign="\n
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                  \t\t\t\t">571 &#40;7&#44;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
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                  \t\t\t\t">1&#46;676 &#40;7&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;762&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="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Otra medicaci&#243;n cardiovascular&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#193;cido acetilsalic&#237;lico en dosis bajas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;947 &#40;20&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;230 &#40;30&#44;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">5&#46;177 &#40;23&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antagonistas del receptor P2Y12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;284 &#40;8&#44;9&#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">853 &#40;11&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;137 &#40;9&#44;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
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Estatinas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;325 &#40;50&#44;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="left" valign="\n
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                  \t\t\t\t">4&#46;573 &#40;62&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11&#46;898 &#40;54&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antihipertensivos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;709 &#40;18&#44;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="left" valign="\n
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                  \t\t\t\t">1&#46;892 &#40;25&#44;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="left" valign="\n
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                  \t\t\t\t">4&#46;601 &#40;21&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>AC dihidropirid&#237;nicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;641 &#40;11&#44;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">1&#46;434 &#40;19&#44;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="left" valign="\n
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                  \t\t\t\t">3&#46;075 &#40;14&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tiazidas&nbsp;\t\t\t\t\t\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">835 &#40;5&#44;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
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                  \t\t\t\t">379 &#40;5&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;214 &#40;5&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;057&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>AC no dihidropirid&#237;nicos&nbsp;\t\t\t\t\t\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">417 &#40;2&#44;9&#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">232 &#40;3&#44;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="left" valign="\n
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                  \t\t\t\t">649 &#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">0&#44;271&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Nitratos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;477 &#40;10&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">934 &#40;12&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;411 &#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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Warfarina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;685 &#40;18&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;411 &#40;19&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;096 &#40;18&#44;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">0&#44;283&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Antidiab&#233;ticos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;733 &#40;91&#44;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">6&#46;733 &#40;30&#44;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">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Metformina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;993 &#40;67&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;993 &#40;22&#44;9&#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
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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-with-role" title="\n
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                  \t\t\t\t">442 &#40;3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">618 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">466 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">765 &#40;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Insuficiencia card&#237;aca&#44; n &#40;&#37;&#41;</span>&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 ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">124&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>73&#44;8&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="elsevierStyleItalic">Enfermedad renal cr&#243;nica</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">117&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>60&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">107&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>60&#44;1&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="elsevierStyleItalic">Arteriopat&#237;a perif&#233;rica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">224 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">221 &#40;3&#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"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
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Características clínicas, manejo y riesgo de complicaciones a un año en pacientes con insuficiencia cardíaca con y sin diabetes tipo 2 en España
Clinical characteristics, management, and one-year risk of complications among patients with heart failure with and without type 2 diabetes in Spain
C. Escobara,
Corresponding author
escobar_cervantes_carlos@hotmail.com

Autor para correspondencia.
, L. Varelab, B. Palaciosb, M. Capelb, A. Sicras-Mainarc, A. Sicras-Navarroc, A. Hormigod, R. Alcázare, N. Manitof, M. Botanag
a Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España
b Departamento médico, AstraZeneca, España
c Investigación sobre economía y resultados de la salud, Atrys Health, Barcelona, España
d Centro de Salud de Atención Primaria Puerta Blanca, Málaga, España
e Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
f Unidad de Insuficiencia Cardíaca Avanzada y Trasplante Cardíaco, Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, España
g Servicio de Endocrinología, Hospital Universitario Lucus Augusti, Lugo, España
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo de la poblaci&#243;n moderna &#40;2019&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">IC&#58; insuficiencia card&#237;aca&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">&#42;</span>La poblaci&#243;n con IC se defini&#243; como todos los pacientes<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>18 a&#241;os con al menos un diagn&#243;stico de IC antes de la fecha &#237;ndice &#40;1 de enero de 2019&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La insuficiencia card&#237;aca &#40;IC&#41; es una enfermedad cardiovascular cr&#243;nica frecuente pero muy grave<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; La prevalencia de la IC ronda el 2&#37; de la poblaci&#243;n adulta en los pa&#237;ses desarrollados<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Sin embargo&#44; se espera que la prevalencia aumente en los pr&#243;ximos a&#241;os&#44; debido principalmente al envejecimiento de la poblaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">3&#44;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La IC es una enfermedad progresiva y debilitante que se asocia con tasas de mortalidad elevadas<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">6</span></a>&#46; Es la causa principal de hospitalizaci&#243;n en Estados Unidos y en Europa<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">7</span></a>&#44; y el riesgo de muerte de los pacientes con IC aumenta con cada ingreso hospitalario<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">8</span></a>&#46; Adem&#225;s&#44; los s&#237;ntomas asociados a la IC repercuten negativamente en la calidad de vida<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2&#44;9</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A pesar de los tratamientos tradicionales de la IC&#44; como los inhibidores del sistema renina-angiotensina&#44; los betabloqueantes y los antagonistas de la aldosterona&#44; las tasas de mortalidad y hospitalizaci&#243;n siguen siendo inaceptablemente altas<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">10</span></a>&#46; Sin embargo&#44; en los &#250;ltimos a&#241;os los ensayos PARADIGM-HF y&#44; m&#225;s recientemente&#44; DAPA-HF y EMPEROR-Reduced han demostrado que la combinaci&#243;n sacubitrilo&#47;valsart&#225;n y algunos inhibidores del SGLT-2&#44; respectivamente&#44; tienen efectos positivos en la morbimortalidad de los pacientes con IC y fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo reducida &#40;ICFEr&#41;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">11&#8211;13</span></a>&#46; Por ello&#44; est&#225;n justificados nuevos estudios centrados en el perfil cl&#237;nico actual y el tratamiento de los pacientes con IC y su repercusi&#243;n en los resultados&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Los objetivos de este estudio eran describir la epidemiolog&#237;a&#44; las caracter&#237;sticas cl&#237;nicas y el manejo terap&#233;utico de la poblaci&#243;n con IC en una cohorte actual de pacientes espa&#241;oles&#44; estratificada en funci&#243;n de la presencia de diabetes tipo 2 &#40;DM2&#41;&#44; y determinar los eventos cardiovasculares tras un a&#241;o de seguimiento&#46; Se analiz&#243; lo mismo en una poblaci&#243;n que cumpl&#237;a los criterios de inclusi&#243;n m&#225;s relevantes del ensayo DAPA-HF<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">12</span></a> &#40;poblaci&#243;n similar a la de DAPA-HF&#41; y en pacientes que tomaban inhibidores del SGLT2 en el momento basal por DM2&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio observacional de cohortes&#44; que comprend&#237;a an&#225;lisis retrospectivos transversales y longitudinales utilizando datos secundarios registrados en historias cl&#237;nicas electr&#243;nicas de 7 regiones espa&#241;olas&#46; Las fuentes de datos fueron proporcionadas por la base de datos validada BIG-PAC&#44; representativa de la poblaci&#243;n espa&#241;ola<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">14</span></a>&#46; BIG-PAC conten&#237;a datos procedentes de centros de salud y hospitales de referencia del sistema nacional de salud espa&#241;ol&#46; Antes de exportarlos a BIG-PAC&#44; los datos se anonimizan y disocian de forma rigurosa&#44; lo que imposibilita la identificaci&#243;n individual<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">La fecha &#237;ndice &#40;1 de enero de 2019&#41; se eligi&#243; para caracterizar a la poblaci&#243;n m&#225;s reciente&#44; ya que 2019 era el &#250;ltimo a&#241;o completo en el momento de finalizar el protocolo&#46; En este an&#225;lisis no se observaron diferencias importantes entre los 2 a&#241;os evaluados &#40;2015 y 2019&#41;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Este estudio fue aprobado por el Comit&#233; de &#201;tica de la Investigaci&#243;n del Consorci Sanitari de Terrassa&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Se consider&#243; poblaci&#243;n con IC a los adultos con al menos un diagn&#243;stico de IC antes de la fecha &#237;ndice &#40;1 de enero de 2019&#41;&#46; Se consider&#243; con DM2 a los adultos con una receta de cualquier antidiab&#233;tico&#44; con diagn&#243;stico de DM2 o con HbA1c<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7&#37; antes de la fecha &#237;ndice&#46; La poblaci&#243;n similar a la del DAPA-HF incluy&#243; a los adultos con antecedentes de IC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>8 semanas&#44; tratamiento habitual de la IC&#44; clase de la NYHA<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>II en el a&#241;o previo a la fecha &#237;ndice y FE<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>40&#37;&#46; La poblaci&#243;n tratada con inhibidores del SGLT-2 estaba formada por los pacientes con DM2 tratados con esos f&#225;rmacos en el momento basal&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se hizo una b&#250;squeda de enfermedades concomitantes en todos los datos disponibles antes de la fecha &#237;ndice&#44; con la excepci&#243;n de la hipoglucemia grave&#44; que se consider&#243; solo en el a&#241;o anterior a la fecha &#237;ndice&#44; y del c&#225;ncer&#44; que se busc&#243; hasta 5 a&#241;os antes de la fecha &#237;ndice&#46; Se exigi&#243; un m&#237;nimo de un a&#241;o de datos antes de la fecha &#237;ndice&#46; Las comorbilidades eran cardiopat&#237;a isqu&#233;mica&#44; IC&#44; enfermedad renal cr&#243;nica &#40;ERC&#41;&#44; fibrilaci&#243;n auricular&#44; ictus&#44; arteriopat&#237;a perif&#233;rica &#40;AP&#41;&#44; hemorragia org&#225;nica importante espec&#237;fica&#44; complicaciones microvasculares&#44; hipoglucemia grave&#44; cetoacidosis y acidosis l&#225;ctica&#44; c&#225;ncer&#44; enfermedad pulmonar obstructiva cr&#243;nica y complicaciones en las extremidades inferiores&#46; Para el diagn&#243;stico de las comorbilidades se tuvieron en cuenta los c&#243;digos CIE-9 y CIE-10 &#40;<a href="https://eciemaps.mscbs.gob.es/">https&#58;&#47;&#47;eciemaps&#46;mscbs&#46;gob&#46;es</a>&#41; &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 1 suplementaria</a>&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Se registr&#243; la informaci&#243;n del tratamiento a partir de los registros de dispensaci&#243;n de medicamentos seg&#250;n el Sistema de clasificaci&#243;n anat&#243;mica&#44; terap&#233;utica y qu&#237;mica &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 1 suplementaria</a>&#41;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">17</span></a>&#46; Se registraron los tratamientos para la IC&#44; los anticoagulantes&#44; las estatinas&#44; los antiagregantes plaquetarios&#44; los antihipertensivos&#44; los nitratos y los antidiab&#233;ticos&#46; La prescripci&#243;n de un f&#225;rmaco a un enfermo concreto se bas&#243; &#250;nicamente en criterios m&#233;dicos &#40;pr&#225;ctica habitual&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se calcularon en la fecha &#237;ndice la prevalencia&#44; la incidencia y las caracter&#237;sticas basales &#40;poblaci&#243;n total con IC y por estado de DM2&#41;&#44; incluidas las caracter&#237;sticas demogr&#225;ficas&#44; las comorbilidades y los medicamentos&#46; Se calcul&#243; la incidencia como el n&#250;mero de pacientes diagnosticados durante el a&#241;o de inter&#233;s dividido entre el n&#250;mero de pacientes sin IC en la poblaci&#243;n al comienzo de 2019&#46; La prevalencia se calcul&#243; como todos los pacientes con diagn&#243;stico de IC al final de 2019 divididos entre todos los individuos de la poblaci&#243;n total&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Los eventos cardiovasculares se definieron como un diagn&#243;stico principal durante una visita o estancia hospitalaria ocurrida en cualquier momento de 2019 despu&#233;s de la fecha &#237;ndice &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 1 suplementaria</a>&#41;&#46; La mortalidad global se defini&#243; como la muerte por cualquier causa&#46; Se calcularon los eventos cardiovasculares &#40;infarto de miocardio &#91;IM&#93;&#44; ictus&#44; IC&#44; ERC definida como una filtraci&#243;n glomerular estimada<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> seg&#250;n la ecuaci&#243;n CKD-EPI&#44; y AP&#41; en las poblaciones total con IC&#44; similar DAPA-HF y con inhibidores SGLT2&#44; en funci&#243;n de la presencia de DM2&#44; y se estratificaron por edad y sexo&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se valoraron tambi&#233;n las variables siguientes en el grupo total con IC y en funci&#243;n de la presencia de DM2&#58; tasas de incidencia y hospitalizaci&#243;n&#44; tasas de reingreso hospitalario&#44; tasas de mortalidad&#44; tasas de mortalidad durante la hospitalizaci&#243;n y tasas de mortalidad despu&#233;s de la primera hospitalizaci&#243;n&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lisis estad&#237;stico</span><p id="par0070" class="elsevierStylePara elsevierViewall">Las variables categ&#243;ricas se describieron mediante sus frecuencias absolutas &#40;n&#41; y relativas &#40;&#37;&#41;&#44; y las variables continuas&#44; mediante la media y la desviaci&#243;n est&#225;ndar&#46; Las tasas de eventos se presentaron como episodios por 1&#46;000 pacientes-a&#241;o&#46; Las variables categ&#243;ricas se compararon con la prueba Chi-cuadrado o la prueba exacta de Fisher cuando proced&#237;a&#46; Para comparar 2 medias se utiliz&#243; la prueba <span class="elsevierStyleItalic">t</span> de Student&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se realizaron an&#225;lisis de los acontecimientos en la fecha &#237;ndice de 1 de enero de 2019 con un a&#241;o de seguimiento&#46; El tiempo hasta el primer evento se analiz&#243; con la prueba <span class="elsevierStyleItalic">t</span> de Student de contraste para muestras independientes&#46; Se aplic&#243; un nivel de significaci&#243;n estad&#237;stica de 0&#44;05 en todas las pruebas estad&#237;sticas&#46; Los datos se analizaron con el paquete estad&#237;stico SPSS v25&#46;0 &#40;SPSS Inc&#46;&#44; Chicago&#44; Illinois&#44; EE&#46; UU&#46;&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0080" class="elsevierStylePara elsevierViewall">En la fecha &#237;ndice se analizaron 21&#46;851 pacientes con IC &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; La incidencia de IC era de 2&#44;83 por 1&#46;000 pacientes-a&#241;o&#44; y la prevalencia del 1&#44;88&#37;&#46; En los pacientes con DM2&#44; la prevalencia de IC era unas 12 veces mayor que en los que no ten&#237;an DM2 &#40;16&#44;2&#37; y 1&#44;3&#37;&#44; respectivamente&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas cl&#237;nicas basales de la poblaci&#243;n con IC en funci&#243;n de la presencia o ausencia de DM2 se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La edad media global era 78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;3 a&#241;os&#44; y el 50&#44;9&#37; de los pacientes ten&#237;a ICFEr&#44; el 66&#44;1&#37; tomaba inhibidores del sistema renina-angiotensina&#44; el 69&#44;4&#37; betabloqueantes&#44; el 31&#44;2&#37; antagonistas de la aldosterona y el 7&#44;5&#37; sacubitrilo&#47;valsart&#225;n&#46; En total&#44; 7&#46;371 &#40;33&#44;7&#37;&#41; pacientes ten&#237;an DM2&#46; Los pacientes con DM2 ten&#237;an FE m&#225;s bajas &#40;42&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;6&#37; frente a 44&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; pasaban a clases funcionales de la NYHA peores &#40;clase funcional <span class="elsevierStyleSmallCaps">iii</span>-<span class="elsevierStyleSmallCaps">iv</span> de la NYHA&#44; 46&#44;9 frente a 38&#44;2&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ten&#237;an m&#225;s comorbilidades &#40;cardiopat&#237;a isqu&#233;mica&#58; 27&#44;8 frente a 18&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; ERC&#58; 37&#44;3 frente a 23&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; ictus&#58; 13&#44;3 frente a 9&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los pacientes con DM2 tomaban m&#225;s inhibidores del sistema renina-angiotensina &#40;70&#44;5 frente a 63&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y betabloqueantes &#40;74&#44;4 frente a 66&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; pero menos sacubitrilo&#47;valsart&#225;n &#40;5&#44;8 frente a 8&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Durante el a&#241;o de seguimiento&#44; el 29&#44;8&#37; de los pacientes present&#243; descompensaci&#243;n de la IC que determin&#243; la hospitalizaci&#243;n&#44; y el 12&#44;3&#37; falleci&#243;&#46; El acontecimiento que se produjo antes fue la ERC&#44; seguida de la hospitalizaci&#243;n por IC&#46; Las tasas de episodios fueron m&#225;s frecuentes en los pacientes con DM2 &#40;muerte por cualquier causa&#44; 14&#44;1 frente a 12&#44;6 episodios&#47;100 pacientes-a&#241;o&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#59; IM&#58; 8&#44;9 frente a 3&#44;1 episodios&#47;100 pacientes-a&#241;o&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; IC&#58; 42&#44;9 frente a 34&#44;5 episodios&#47;100 pacientes-a&#241;o&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; ERC&#58; 17&#44;6 frente a 8&#44;6 episodios&#47;100 pacientes-a&#241;o&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41; y con la edad&#46; Mientras que las tasas de mortalidad &#40;13&#44;6 frente a 11&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y descompensaci&#243;n de la IC &#40;30&#44;8 frente a 28&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; fueron m&#225;s frecuentes en las mujeres&#44; el IM &#40;4 frente a 5&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y la AP &#40;1&#44;4 frente a 2&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; lo fueron en los varones &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">En cuanto a los resultados de la hospitalizaci&#243;n&#44; las tasas de hospitalizaci&#243;n alcanzaron el 30&#44;9&#37; al a&#241;o de seguimiento&#44; y el 8&#44;1&#37; de los pacientes fallecieron durante la hospitalizaci&#243;n&#46; Las tasas de hospitalizaci&#243;n y las de mortalidad durante la hospitalizaci&#243;n fueron m&#225;s frecuentes en los pacientes con DM2 &#40;incidencia y hospitalizaci&#243;n&#58; 34 frente a 29&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; mortalidad&#58; 13&#44;2 frente a 11&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis espec&#237;fico en la poblaci&#243;n similar a la del estudio DAPA-HF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;243&#41;&#46; En esta subpoblaci&#243;n&#44; la edad media era 78&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;0 a&#241;os&#44; y todos los pacientes ten&#237;an ICFEr&#46; La mayor&#237;a de los pacientes se situaron en la clase funcional <span class="elsevierStyleSmallCaps">ii</span> &#40;49&#44;7&#37;&#41; o <span class="elsevierStyleSmallCaps">iii</span> &#40;45&#44;4&#37;&#41; de la NYHA&#46; En total&#44; 1&#46;699 &#40;40&#37;&#41; pacientes ten&#237;an DM2&#46; Alrededor del 98&#44;2&#37; de los pacientes tomaba inhibidores del sistema renina-angiotensina&#44; el 100&#37; betabloqueantes&#44; el 20&#37; antagonistas de la aldosterona y el 3&#44;7&#37; sacubitrilo&#47;valsart&#225;n&#46; En comparaci&#243;n con los pacientes sin DM2&#44; quienes la sufr&#237;an estaban tomando m&#225;s sacubitrilo&#47;valsart&#225;n y digoxina &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 2 suplementaria</a>&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Durante el a&#241;o de seguimiento&#44; el 50&#44;3&#37; de los pacientes present&#243; descompensaci&#243;n de la IC que determin&#243; la hospitalizaci&#243;n&#44; y el 12&#44;2&#37; falleci&#243;&#46; El episodio que se produjo antes tambi&#233;n fue la ERC&#44; seguida de la hospitalizaci&#243;n por IC&#46; Las tasas de episodios fueron m&#225;s frecuentes en los pacientes con DM2 &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 3 suplementaria</a>&#41; y la mortalidad&#44; la IC y los resultados renales con la edad &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 4 suplementaria</a>&#41;&#46; Mientras que la descompensaci&#243;n de la IC fue m&#225;s frecuente en las mujeres&#44; el IM y la AP lo fueron en los varones &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 5 suplementaria</a>&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis espec&#237;fico de la poblaci&#243;n con inhibidores SGLT2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>797&#41;&#46; En esta subpoblaci&#243;n&#44; la edad media era 72&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;3 a&#241;os&#44; y el 46&#44;8&#37; de los pacientes sufr&#237;a ICFEr&#46; La mayor&#237;a de los pacientes se situaban en la clase funcional <span class="elsevierStyleSmallCaps">ii</span> &#40;40&#44;5&#37;&#41; o <span class="elsevierStyleSmallCaps">iii</span> &#40;42&#44;4&#37;&#41; de la NYHA&#46; Todos los pacientes ten&#237;an DM2&#46; El 68&#44;9&#37; de los pacientes tomaba inhibidores del sistema renina-angiotensina&#44; el 72&#44;5&#37; betabloqueantes&#44; el 46&#44;8&#37; antagonistas de la aldosterona y el 3&#44;6&#37; sacubitrilo&#47;valsart&#225;n &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 6 suplementaria</a>&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Durante el a&#241;o de seguimiento&#44; el 36&#44;4&#37; de los pacientes present&#243; descompensaci&#243;n de la IC que determin&#243; la hospitalizaci&#243;n&#44; y el 19&#37; falleci&#243; &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 7 suplementaria</a>&#41;&#46; La mortalidad aument&#243; con la edad &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 8 suplementaria</a>&#41;&#46; Las tasas de IC y AP fueron m&#225;s frecuentes en los varones &#40;<a class="elsevierStyleCrossRef" href="#sec0055">tabla 9 suplementaria</a>&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; la incidencia de IC fue de 2&#44;8 por 1&#46;000 personas-a&#241;o&#44; y la prevalencia del 1&#44;9&#37;&#46; Hay que se&#241;alar que la presencia de DM2 aumentaba notablemente el riesgo de IC&#46; A pesar de que estudios previos realizados en Espa&#241;a hab&#237;an mostrado una prevalencia m&#225;s alta de IC&#44; nuestros datos concuerdan con las cifras comunicadas en Europa y Estados Unidos<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;18&#8211;20</span></a>&#46; Por otro lado&#44; nuestro estudio mostr&#243; que el 51&#37; de los pacientes ten&#237;a ICFEr&#44; en consonancia con estudios previos<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">21&#44;22</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En cuanto a los tratamientos de la IC&#44; nuestro estudio mostr&#243; que hay mucho margen de mejora&#46; La prescripci&#243;n de los tratamientos recomendados por las directrices para la IC es esencial para mejorar la clase funcional&#44; pero&#44; sobre todo&#44; para reducir las hospitalizaciones por IC y la mortalidad<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2&#44;21&#44;23</span></a>&#46; Por desgracia&#44; aunque los pacientes ingresados en unidades espec&#237;ficas para la IC hacen un mayor uso de f&#225;rmacos para la IC basados en pruebas<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">24</span></a>&#44; la inmensa mayor&#237;a de los estudios realizados en otros contextos cl&#237;nicos han mostrado tasas de prescripci&#243;n m&#225;s bajas<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">25&#8211;27</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Hay que se&#241;alar que la menor prescripci&#243;n de los f&#225;rmacos recomendados por las directrices para la IC aumenta el uso de recursos sanitarios&#44; sobre todo de las hospitalizaciones iniciales y recurrentes<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">28</span></a>&#46; Por el contrario&#44; el aumento del cumplimiento de los f&#225;rmacos para la IC mejora los resultados cl&#237;nicos<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">29</span></a>&#46; Adem&#225;s&#44; tras un a&#241;o de seguimiento&#44; la complicaci&#243;n principal fue la hospitalizaci&#243;n por IC&#44; lo que subraya la importancia de prescribir los f&#225;rmacos con un efecto beneficioso demostrado no solo en la mortalidad&#44; sino tambi&#233;n en la morbilidad<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; el 12&#37; de los pacientes con IC fallecieron durante el seguimiento&#46; Aunque el pron&#243;stico de la IC ha mejorado en los &#250;ltimos decenios<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;30</span></a>&#44; las tasas de mortalidad siguen siendo altas<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">10</span></a>&#46; En un metaan&#225;lisis reciente se calcularon supervivencias a 1&#44; 5 y 10 a&#241;os del 87&#44; 57 y 35&#37;&#44; respectivamente&#44; en los pacientes con IC&#46; Hay que destacar que la mortalidad m&#225;s baja se dio en los estudios de atenci&#243;n secundaria&#44; lo que indica que la asistencia especializada&#44; junto con el mejor tratamiento de la IC&#44; mejora la supervivencia observada con la atenci&#243;n primaria<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En cuanto a los resultados de la hospitalizaci&#243;n&#44; el 8&#37; de los pacientes falleci&#243; durante la hospitalizaci&#243;n por IC&#46; Las tasas de mortalidad durante la hospitalizaci&#243;n fueron mayores en los pacientes con DM2&#46; Se ha calculado que la mortalidad a los 30 d&#237;as oscila entre el 5&#37; y el 20&#37;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;32</span></a>&#46; Lo m&#225;s notable es que la hospitalizaci&#243;n por IC es un factor predictivo independiente de aumento de la mortalidad por IC<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">10&#44;33</span></a>&#46; Adem&#225;s&#44; el coste de la hospitalizaci&#243;n por IC es el principal determinante del coste sanitario total de la poblaci&#243;n con IC<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">5&#44;34</span></a>&#46; Es importante se&#241;alar que se espera que el n&#250;mero absoluto de hospitalizaciones por IC aumente en los pr&#243;ximos a&#241;os debido al envejecimiento de la poblaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">El ensayo PARADIGM-HF mostr&#243; que&#44; en comparaci&#243;n con el enalapril&#44; la combinaci&#243;n sacubitrilo&#47;valsart&#225;n reduc&#237;a notablemente el riesgo de hospitalizaci&#243;n por IC<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">11</span></a>&#44; y en el ensayo DAPA-HF la dapagliflozina redujo considerablemente el riesgo de un primer episodio de empeoramiento de la IC<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">12</span></a>&#46; Un estudio reciente ha mostrado que&#44; comparado con el tratamiento habitual&#44; el tratamiento farmacol&#243;gico modificador de la enfermedad integral temprano con sacubitrilo&#47;valsart&#225;n&#44; betabloqueantes&#44; antagonistas de la aldosterona y dapagliflozina disminuye significativamente la mortalidad cardiovascular o el ingreso hospitalario por IC en un 62&#37;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">35</span></a>&#46; En consecuencia&#44; es obligatoria la prescripci&#243;n de f&#225;rmacos que reduzcan tanto las hospitalizaciones por IC como la tasa de mortalidad para reducir la carga de IC&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; los pacientes con DM2 ten&#237;an m&#225;s procesos com&#243;rbidos&#44; as&#237; como m&#225;s resultados cardiovasculares y renales&#44; que los que no presentaban DM2&#46; Esto concuerda con los datos del registro RICA que mostraban que la DM2 era una enfermedad frecuente en los pacientes hospitalizados por IC y que su presencia era un factor predictivo independiente de mortalidad global y reingreso por IC<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">36</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Hay que destacar que la IC es una complicaci&#243;n precoz de los pacientes con DM2<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">37</span></a>&#46; Adem&#225;s&#44; muchos pacientes con DM2 tienen disfunci&#243;n ventricular izquierda asintom&#225;tica en los primeros a&#241;os tras el diagn&#243;stico de diabetes<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">38</span></a>&#46; Por ello&#44; el tratamiento temprano de los pacientes con DM2 con inhibidores SGLT2 puede retardar o incluso evitar la aparici&#243;n de IC<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">39&#44;40</span></a>&#46; En la poblaci&#243;n que recib&#237;a inhibidores SGLT2&#44; aunque la proporci&#243;n de pacientes que tomaban antagonistas de la aldosterona era mayor que en la poblaci&#243;n total con IC&#44; alrededor de un tercio de los pacientes no tomaban inhibidores del sistema renina-angiotensina y cerca del 30&#37; betabloqueantes&#44; lo que se traduc&#237;a en tasas altas de hospitalizaci&#243;n y fallecimiento por IC&#46; Hay que se&#241;alar que las tasas de mortalidad fueron mayores en la poblaci&#243;n tratada con inhibidores SGLT2 que en las poblaciones con IC y DM2 y similar a la del DAPA-HF&#44; lo que indica no solo un perfil cl&#237;nico peor con m&#225;s procesos com&#243;rbidos y peor clase funcional&#44; sino tambi&#233;n un uso tard&#237;o de estos f&#225;rmacos a pesar de su efecto beneficio demostrado en los resultados cardiovasculares<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">12&#44;40</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">En la poblaci&#243;n similar a la del estudio DAPA-HF&#44; aunque casi todos los pacientes estaban tomando inhibidores del sistema renina-angiotensina y betabloqueantes&#44; el 50&#37; sufri&#243; descompensaci&#243;n de la IC y el 12&#37; falleci&#243;&#46; En consecuencia&#44; es obligatorio optimizar la prescripci&#243;n de medicaci&#243;n cardioprotectora para reducir los resultados de la IC<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">39</span></a>&#46; De hecho&#44; se ha sugerido recientemente que puede ser m&#225;s importante priorizar el inicio del f&#225;rmaco antes del ajuste de la dosis en los pacientes con ICFEr<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">41</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Los resultados cardiovasculares y renales aumentaron significativamente con la edad&#44; y estudios anteriores tambi&#233;n han mostrado un riesgo alto de complicaciones en los pacientes de edad avanzada con IC<a class="elsevierStyleCrossRefs" href="#bib0435"><span class="elsevierStyleSup">42&#44;43</span></a>&#46; En especial&#44; en los pacientes mayores son beneficiosos los medicamentos para la IC respaldados por pruebas<a class="elsevierStyleCrossRefs" href="#bib0445"><span class="elsevierStyleSup">44&#44;45</span></a>&#46; En consecuencia&#44; tambi&#233;n debe optimizarse el tratamiento de la IC en esta poblaci&#243;n&#44; aunque con precauci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Limitaciones</span><p id="par0170" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio observacional de cohortes retrospectivo en el que se utilizaron datos secundarios procedentes de historias cl&#237;nicas electr&#243;nicas&#46; Estos estudios tienen algunas limitaciones&#44; por lo que solo puede aportarse una relaci&#243;n causal indirecta&#46; Adem&#225;s&#44; debido al dise&#241;o retrospectivo del estudio&#44; no se pudieron registrar algunos datos relevantes&#46; Asimismo&#44; la ausencia de clasificaci&#243;n de los pacientes en funci&#243;n de la FE dificulta la extrapolaci&#243;n de los patrones de tratamiento por grupos de FE&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Sin embargo&#44; el gran n&#250;mero de pacientes y la solidez de los datos pueden hacer posible la utilidad del estudio&#46; Por otro lado&#44; aunque los datos proced&#237;an de solo 7 regiones espa&#241;olas&#44; estudios previos han mostrado que estos datos son representativos de la poblaci&#243;n espa&#241;ola<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">14</span></a>&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusiones</span><p id="par0180" class="elsevierStylePara elsevierViewall">En Espa&#241;a&#44; la poblaci&#243;n con IC es mayor y tiene muchas comorbilidades&#44; y alrededor de la mitad de los pacientes sufren ICFEr&#46; Los pacientes con DM2 tienen m&#225;s procesos com&#243;rbidos y m&#225;s resultados cardiovasculares y renales que los pacientes sin DM2&#46; Por desgracia&#44; una proporci&#243;n importante de pacientes no toma f&#225;rmacos para la IC respaldados por pruebas&#44; lo que se traduce en tasas m&#225;s altas de resultados&#44; especialmente descompensaci&#243;n de la IC&#46; Esto ocurre en pacientes con y sin DM2&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Por lo tanto&#44; es fundamental mejorar el manejo de la IC&#44; sobre todo a trav&#233;s del uso de f&#225;rmacos que reduzcan la hospitalizaci&#243;n y la mortalidad por IC&#44; para disminuir la carga de IC&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Financiaci&#243;n</span><p id="par0190" class="elsevierStylePara elsevierViewall">Este estudio fue financiado por AstraZeneca&#46; La entidad financiadora no ha intervenido en el dise&#241;o&#44; la recogida de datos&#44; el an&#225;lisis&#44; la interpretaci&#243;n ni la redacci&#243;n del manuscrito&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0195" class="elsevierStylePara elsevierViewall">Los autores declararan no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las caracter&#237;sticas cl&#237;nicas y el manejo terap&#233;utico y determinar los eventos cardiovasculares tras un a&#241;o de seguimiento en una poblaci&#243;n contempor&#225;nea con insuficiencia card&#237;aca &#40;IC&#41; con y sin diabetes tipo 2 en Espa&#241;a&#46; Tambi&#233;n se analiz&#243; en la poblaci&#243;n DAPA-HF &#40;pacientes que cumplieron la mayor&#237;a de los criterios de inclusi&#243;n del estudio DAPA-HF&#41; y en los pacientes tratados basalmente con inhibidores SGLT2&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; retrospectivo&#44; poblacional&#44; empleando la base de datos BIG-PAC&#46; La fecha &#237;ndice fue 1 de enero de 2019&#46; Se seleccionaron sujetos<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>18 a&#241;os que recibieron tratamiento por IC en 2019&#46; Se analizaron los eventos durante 2019&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 21&#46;851 pacientes con IC &#40;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;3 a&#241;os&#59; 53&#37; varones&#59; 50&#44;9&#37; IC con fracci&#243;n de eyecci&#243;n reducida&#59; 44&#44;5&#37; en clase funcional NYHA II&#41;&#46; La prevalencia de IC fue del 1&#44;88&#37; y la incidencia 2&#44;83 por 1&#46;000 pacientes-a&#241;o&#46; El 66&#44;1&#37; tomaba inhibidores del sistema renina-angiotensina&#44; el 69&#44;4&#37; betabloqueantes&#44; el 31&#44;2&#37; antialdoster&#243;nicos y el 7&#44;5&#37; sacubitrilo&#47;valsart&#225;n&#46; Durante el a&#241;o de seguimiento&#44; el 29&#44;8&#37; fue hospitalizado por descompensaci&#243;n de la IC &#40;tiempo medio primer evento 120&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>72&#44;5 d&#237;as&#41;&#44; un 12&#44;3&#37; murieron&#44; un 8&#44;1&#37; murieron durante la hospitalizaci&#243;n&#46; Los eventos fueron m&#225;s frecuentes en los pacientes con diabetes tipo 2&#46; Las hospitalizaciones por IC fueron m&#225;s comunes en la poblaci&#243;n similar a DAPA-HF&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En Espa&#241;a&#44; la poblaci&#243;n con IC es anciana y tiene muchas comorbilidades&#46; Aproximadamente la mitad de los pacientes tienen IC con fracci&#243;n de eyecci&#243;n reducida&#46; Existe margen de mejora en el manejo de la IC&#44; en particular mediante el empleo de aquellos f&#225;rmacos que reducen tanto la hospitalizaci&#243;n por IC como la mortalidad&#44; para disminuir la carga de IC&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">This work aims to describe the clinical characteristics and therapeutic management and to determine cardiovascular outcomes after one year of follow-up in a contemporaneous population with heart failure &#40;HF&#41; with and without type 2 diabetes in Spain&#46; These factors were also analyzed in the DAPA-HF-like population &#40;patients who met most inclusion criteria of the DAPA-HF trial&#41; and in patients treated with SGLT2 inhibitors at baseline&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This work is an observational&#44; retrospective&#44; population-based study using the BIG-PAC database&#46; The index date was January 1&#44; 2019&#46; People aged<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>18 years who received care for HF in 2019 were selected&#46; Events that occurred in 2019 were analyzed&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We identified 21&#44;851 patients with HF &#40;age 78&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;3 years&#44; 53&#46;0&#37; men&#44; 50&#46;9&#37; with HF with reduced left ventricular ejection fraction&#44; 44&#46;5&#37; in NYHA functional class II&#41;&#46; HF prevalence was 1&#46;88&#37; and incidence was 2&#46;83 per 1&#44;000 person-years&#46; Regarding HF treatments&#44; 66&#46;1&#37; were taking renin-angiotensin system inhibitors&#44; 69&#46;4&#37; beta blockers&#44; 31&#46;2&#37; aldosterone antagonists&#44; and 7&#46;5&#37; sacubitril&#47;valsartan&#46; During the year of follow-up&#44; 29&#46;8&#37; had HF decompensation which led to hospitalization &#40;mean time to first event of 120&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>72&#46;5 days&#41;&#44; 12&#46;3&#37; died&#44; and 8&#46;1&#37; died during hospitalization&#46; Events were more common among patients with type 2 diabetes&#46; Hospitalizations for HF were more common in the DAPA-HF-like population&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In Spain&#44; the population with HF is elderly and has many comorbidities&#46; Approximately half of patients have HF with reduced left ventricular ejection fraction&#46; There is room for improvement in HF management&#44; particularly through the use of drugs that reduce both HF hospitalization and mortality&#44; in order to reduce the burden of HF&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objective"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
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        ]
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    "apendice" => array:1 [
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          0 => array:4 [
            "apendice" => "<p id="par0205" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Anexo A"
            "titulo" => "Material adicional"
            "identificador" => "sec0055"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1702
            "Ancho" => 1250
            "Tamanyo" => 141527
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo de la poblaci&#243;n moderna &#40;2019&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">IC&#58; insuficiencia card&#237;aca&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">&#42;</span>La poblaci&#243;n con IC se defini&#243; como todos los pacientes<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>18 a&#241;os con al menos un diagn&#243;stico de IC antes de la fecha &#237;ndice &#40;1 de enero de 2019&#41;&#46;</p>"
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        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "identificador" => "at1"
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">AC&#58; antagonistas del calcio&#59; By-pass aortocoronario&#58; revascularizaci&#243;n quir&#250;rgica&#59; DM2&#58; diabetes tipo 2&#59; DPP4&#58; dipeptidil peptidasa 4&#59; FGe&#58; filtraci&#243;n glomerular estimada&#59; GLP-1&#58; p&#233;ptido glucagonoide 1&#59; IC&#58; insuficiencia card&#237;aca&#59; ICP&#58; intervenci&#243;n coronaria percut&#225;nea&#59; SGLT-2&#58; cotransportador 2 de sodio-glucosa&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sin DM2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#46;480&#59; 66&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Con DM2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7371&#59; 33&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#46;851&#59; 100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Datos biodemogr&#225;ficos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Edad&#44; a&#241;os</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78&#44;3<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">77&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;3&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">78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>85 a&#241;os&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">5&#46;827 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;157 &#40;42&#44;8&#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">8&#46;984 &#40;41&#44;1&#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">7&#46;566 &#40;52&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;024 &#40;54&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&#46;590 &#40;53&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">128&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">131&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;019 &#40;13&#44;9&#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">762 &#40;10&#44;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">2&#46;781 &#40;12&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#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><span class="elsevierStyleHsp" style=""></span>IV&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">821 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>40&#37;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46;424 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>40-<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50&#37;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">798 &#40;11&#44;6&#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><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;665 &#40;44&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Datos de laboratorio</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">FGe&#44; mL&#47;min&#47;1&#44;73</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">HbA1c&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Comorbilidades</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Enfermedad cardiovascular&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&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">2&#46;720 &#40;18&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;049 &#40;27&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;769 &#40;21&#44;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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Infarto de miocardio&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">1&#46;732 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;398 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;130 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>By-pass aortocoronario&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">196 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">184 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">380 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>ICP con endopr&#243;tesis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">394 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">297 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">691 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Angina inestable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">576 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">458 &#40;6&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;034 &#40;4&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Angina de pecho&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">1&#46;022 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">713 &#40;9&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;735 &#40;7&#44;9&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ictus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;419 &#40;9&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">982 &#40;13&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;401 &#40;11&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ictus isqu&#233;mico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;073 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">765 &#40;10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;838 &#40;8&#44;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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ictus hemorr&#225;gico&nbsp;\t\t\t\t\t\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">73 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">49 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">122 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;132&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Accidente isqu&#233;mico transitorio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">387 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">274 &#40;3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">661 &#40;3&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Fibrilaci&#243;n auricular&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">4&#46;742 &#40;32&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;504 &#40;34&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46;246 &#40;33&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;070&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Arteriopat&#237;a perif&#233;rica&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">600 &#40;4&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">450 &#40;6&#44;1&#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">1&#46;050 &#40;4&#44;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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Enfermedad renal cr&#243;nica&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">3&#46;392 &#40;23&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;751 &#40;37&#44;3&#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">6&#46;143 &#40;28&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Complicaciones microvasculares&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3&#46;094 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3&#46;094 &#40;14&#44;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="left" valign="\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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Mono&#47;polineuropat&#237;a diab&#233;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">508 &#40;6&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">508 &#40;2&#44;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
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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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Complicaciones oculares de la 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="left" valign="\n
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                  \t\t\t\t">2&#46;117 &#40;28&#44;7&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pie diab&#233;tico&#47;angiopat&#237;a perif&#233;rica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">380 &#40;5&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">380 &#40;1&#44;7&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Nefropat&#237;a diab&#233;tica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">655 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">655 &#40;3&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hipoglucemia grave&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&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">629 &#40;8&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">629 &#40;2&#44;9&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cetoacidosis&#47;acidosis l&#225;ctica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55 &#40;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55 &#40;0&#44;3&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Otras comorbilidades&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>C&#225;ncer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;534 &#40;10&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">883 &#40;12&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Enfermedad pulmonar obstructiva cr&#243;nica&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><span class="elsevierStyleHsp" style=""></span>Amputaciones de miembros inferiores&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;0&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">115 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">151 &#40;0&#44;7&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hemorragia organoespec&#237;fica grave&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">383 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">246 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">629 &#40;2&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;004&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"><span class="elsevierStyleBold">Tratamientos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Medicamentos para la insuficiencia card&#237;aca&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14&#46;480 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#46;371 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21&#46;851 &#40;100&#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">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inhibidores del sistema renina-angiotensina&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">9&#46;253 &#40;63&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;193 &#40;70&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14&#46;446 &#40;66&#44;1&#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
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inhibidores de la enzima convertidora de la angiotensina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4&#46;421 &#40;30&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;419 &#40;32&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46;840 &#40;31&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antagonistas de los receptores de angiotensina&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">4&#46;832 &#40;33&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;774 &#40;37&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;606 &#40;34&#44;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">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Betabloqueantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;678 &#40;66&#44;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">5&#46;482 &#40;74&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;160 &#40;69&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Diur&#233;ticos del asa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;018 &#40;69&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;662 &#40;76&#44;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">15&#46;680 &#40;71&#44;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">&#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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antagonistas de la aldosterona&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;493 &#40;31&#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">2&#46;323 &#40;31&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;816 &#40;31&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;463&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Sacubitrilo&#47;valsart&#225;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;202 &#40;8&#44;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">430 &#40;5&#44;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">1&#46;632 &#40;7&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Digoxina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;105 &#40;7&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">571 &#40;7&#44;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">1&#46;676 &#40;7&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;762&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="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Otra medicaci&#243;n cardiovascular&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#193;cido acetilsalic&#237;lico en dosis bajas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;947 &#40;20&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;230 &#40;30&#44;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">5&#46;177 &#40;23&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antagonistas del receptor P2Y12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;284 &#40;8&#44;9&#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">853 &#40;11&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;137 &#40;9&#44;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">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Estatinas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;325 &#40;50&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;573 &#40;62&#44;0&#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">11&#46;898 &#40;54&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Antihipertensivos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;709 &#40;18&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;892 &#40;25&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;601 &#40;21&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>AC dihidropirid&#237;nicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;641 &#40;11&#44;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">1&#46;434 &#40;19&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;075 &#40;14&#44;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="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tiazidas&nbsp;\t\t\t\t\t\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">835 &#40;5&#44;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">379 &#40;5&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;214 &#40;5&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;057&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>AC no dihidropirid&#237;nicos&nbsp;\t\t\t\t\t\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">417 &#40;2&#44;9&#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">232 &#40;3&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">649 &#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">0&#44;271&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sin DM2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#46;480&#59; 66&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">Con DM2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;371&#59; 33&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">IC total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#46;851&#59; 100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Mortalidad global&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;708 &#40;11&#44;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
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                  \t\t\t\t">969 &#40;13&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;677 &#40;12&#44;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
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                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\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">12&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">178&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>70&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">187&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>69&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">181&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>70&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Infarto de miocardio&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">442 &#40;3&#44;1&#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">618 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;060 &#40;4&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\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">3&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#44;9&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\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\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">132&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>61&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">126&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>72&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;167&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Ictus&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">466 &#40;3&#44;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">299 &#40;4&#44;1&#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">765 &#40;3&#44;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;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">133&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>83&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">115&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>714&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">126&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>79&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" 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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Insuficiencia card&#237;aca&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;070 &#40;28&#44;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
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;442 &#40;33&#44;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
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                  \t\t\t\t">6&#46;512 &#40;29&#44;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
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                  \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-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo hasta el primer episodio&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>73&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115&#44;2<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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>72&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acontecimientos por 100 pacientes-a&#241;o&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 00142565
Original language: Spanish
DOI:10.1016/j.rce.2021.04.008
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