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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">Las incidencias y las tasas de mortalidad por cardiopat&#237;a coronaria e ictus est&#225;n disminuyendo de forma constante&#44; especialmente en los pa&#237;ses occidentales<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a>&#46; No obstante&#44; explican el 38 y el 34&#37; de las muertes en varones y mujeres&#44; respectivamente&#44; y probablemente constituir&#225;n las principales causas de a&#241;os de vida perdidos evitables en 2040<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a>&#46; Algunas sociedades cient&#237;ficas han propuesto el uso de una estrategia integrada de evaluaci&#243;n del riesgo cardiovascular que ajuste las intervenciones terap&#233;uticas o preventivas al riesgo vascular absoluto estimado&#46; La mayor&#237;a de estas evaluaciones est&#225;n dise&#241;adas para predecir la aparici&#243;n de enfermedades cardiovasculares en la poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">3</span></a> y tan solo unas pocas se emplean de manera sistem&#225;tica para estratificar el riesgo&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A los pacientes en prevenci&#243;n secundaria se les suele clasificar en el grupo de mayor riesgo<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">4&#44;5</span></a> conforme a la estratificaci&#243;n planteada por las funciones de riesgo utilizadas en prevenci&#243;n primaria &#40;FRP&#41;&#44; aunque el riesgo real no es homog&#233;neo entre ellos<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">6</span></a>&#46; Las recurrencias dependen b&#225;sicamente de las secuelas cl&#237;nicas que dejan los eventos previos&#44; del perfil de los factores de riesgo cl&#225;sicos en el momento del evento &#237;ndice<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a> y de su grado de control posterior<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a>&#46; Se han elaborado y validado varias funciones y puntuaciones de riesgo para prevenci&#243;n secundaria &#40;en adelante&#44; F&#47;PRS&#41; con el fin de predecir recurrencias o la muerte&#44; si bien la mayor&#237;a son espec&#237;ficas de un territorio vascular concreto&#44; principalmente coronario<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">9</span></a> o cerebrovascular<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">10</span></a>&#46; Tan solo unas pocas&#44; como SMART<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">11&#44;12</span></a> o REACH<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a>&#44; se obtuvieron para predecir varios tipos de desenlace en cohortes mixtas de pacientes con enfermedad cardiovascular establecida&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Existe una necesidad cada vez mayor de modelos v&#225;lidos basados en conjuntos de variables accesibles y asequibles para identificar a los pacientes con un mayor riesgo de recurrencias<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a>&#46; En pocos estudios se ha comparado el rendimiento predictivo de las diferentes funciones y puntuaciones disponibles en pacientes con enfermedad cardiovascular ateroescler&#243;tica en varios territorios vasculares&#46; Uthoff et al&#46; se&#241;alaron que la puntuaci&#243;n SMART tuvo un mejor rendimiento que las funciones de Framingham y SCORE en pacientes con ateroesclerosis cl&#237;nicamente evidente &#40;coronaria&#44; cerebrovascular&#44; arteriopat&#237;a perif&#233;rica &#91;AP&#93; y enfermedad vasculorrenal&#41;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo principal de este estudio consisti&#243; en comparar la supervivencia y la capacidad discriminativa de la estratificaci&#243;n del riesgo seg&#250;n las funciones y puntuaciones de Framingham-Wilson<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">15</span></a>&#44; SCORE<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a>&#44; REGICOR<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">17</span></a>&#44; REACH<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a>&#44; Bohula-TIMI<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">18</span></a> y SMART<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">12</span></a> en la cohorte Atenci&#243;n Integral al Riesgo Cardiovascular &#40;AIRVAG&#41; de pacientes&#46; El objetivo secundario era determinar si la adici&#243;n de otras variables de f&#225;cil obtenci&#243;n podr&#237;a mejorar el rendimiento de un modelo que ya incluyera 6 de los principales factores de riesgo cardiovascular&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o de la cohorte y definici&#243;n de las variables</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se utilizaron datos de todos los pacientes incluidos en la cohorte AIRVAG<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">19</span></a>&#44; una cohorte prospectiva con 269 pacientes consecutivos de entre 35 y 70 a&#241;os con ateroesclerosis sintom&#225;tica en cualquier lecho vascular&#44; atendidos en la Unidad de Riesgo Vascular del Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#46; Los pacientes fueron seleccionados entre junio de 2000 y julio de 2002&#44; y seguidos hasta junio de 2006&#46; La selecci&#243;n se bas&#243; en las definiciones de evento &#237;ndice que se exponen a continuaci&#243;n&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Un evento isqu&#233;mico cerebrovascular se defini&#243; como un accidente isqu&#233;mico transitorio o un ictus isqu&#233;mico aterotromb&#243;tico o lacunar&#59; se excluyeron los ictus hemorr&#225;gicos y cardioemb&#243;licos&#46; La cardiopat&#237;a isqu&#233;mica se defini&#243; como un s&#237;ndrome coronario agudo&#44; incluyendo el infarto de miocardio y la revascularizaci&#243;n coronaria &#40;angioplastia o derivaci&#243;n aortocoronaria&#41;&#46; La AP se defini&#243; como un &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9 o claudicaci&#243;n intermitente cl&#237;nicamente evidente con una distancia de claudicaci&#243;n de entre 50 y 200<span class="elsevierStyleHsp" style=""></span>m &#40;estadio IIb&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se examin&#243; a todos los pacientes en el mes siguiente al evento &#237;ndice aplicando un protocolo uniforme&#46; Los nuevos eventos vasculares fueron confirmados por el mismo especialista m&#233;dico y con aplicaci&#243;n de los mismos criterios&#44; excepto los nuevos eventos de AP&#44; que se definieron como la presencia de isquemia en reposo&#44; revascularizaci&#243;n perif&#233;rica o amputaci&#243;n&#46; Se excluy&#243; a los pacientes mayores de 70 a&#241;os y a aquellos con una esperanza de vida inferior a 3 a&#241;os&#44; insuficiencia renal cr&#243;nica &#40;creatinina<span class="elsevierStyleHsp" style=""></span>&#62;&#160;3&#160;mg&#47;dl o en un programa de di&#225;lisis&#41; o incapacidad para entender el consentimiento informado&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Los factores de riesgo cardiovascular se definieron como sigue&#58; tabaquismo y fumadores activos o exfumadores &#40;sin fumar en los &#250;ltimos 6 meses&#41;&#46; La dislipidemia se defini&#243; como un colesterol total<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5&#44;17&#160;mmol&#47;l&#44; un colesterol total<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>5&#44;17&#160;mmol&#47;l y unos triglic&#233;ridos<span class="elsevierStyleHsp" style=""></span>&#62;&#160;2&#44;26&#160;mmol&#47;l o el uso de hipolipidemiantes&#46; La hipertensi&#243;n arterial se defini&#243; como una presi&#243;n arterial sist&#243;lica<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;140&#160;mmHg o una presi&#243;n arterial diast&#243;lica<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;90&#160;mmHg en reposo en al menos 2 determinaciones independientes &#40;d&#237;as diferentes&#41; o el uso de antihipertensivos&#46; La diabetes se defini&#243; como el hecho de tener 2 determinaciones de glucemia en ayunas<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;7&#160;mmol&#47;l o el uso de tratamiento hipoglucemiante&#46; La obesidad se defini&#243; como un &#237;ndice de masa corporal<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;30&#160;kg&#47;m<span class="elsevierStyleSup">2</span>&#46; La albuminuria se defini&#243; como un cociente alb&#250;mina&#47;creatina<span class="elsevierStyleHsp" style=""></span>&#62;&#160;3&#44;4&#160;mg&#47;mmol &#40;&#62;&#160;30&#160;mg&#47;g&#41;&#46; La obesidad visceral se defini&#243; como un cociente cintura cadera<span class="elsevierStyleHsp" style=""></span>&#62;&#160;0&#44;8 en las mujeres y<span class="elsevierStyleHsp" style=""></span>&#62;&#160;1 en los varones&#46; La enfermedad polivascular se defini&#243; como el n&#250;mero total de territorios vasculares afectados &#40;coronario&#44; cerebrovascular o perif&#233;rico&#41;&#44; con independencia del tiempo transcurrido e incluido el evento &#237;ndice&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se calcul&#243; el riesgo cardiovascular de cada paciente mediante las funciones de riesgo cardiovascular de Framingham<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">15</span></a>&#44; REGICOR<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">17</span></a> y SCORE &#40;eventos mortales y no mortales en pa&#237;ses de bajo riesgo&#41;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a> publicadas originalmente&#46; Las estimaciones de la funci&#243;n de riesgo SCORE se multiplicaron por 3 y 5 en los varones y las mujeres con diabetes&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">20</span></a>&#46; Tambi&#233;n se obtuvieron las funciones REACH<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a> y Bohula-TIMI &#40;B-TIMI&#41;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">18</span></a> y la puntuaci&#243;n SMART<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">12</span></a>&#44; dise&#241;adas para calcular el riesgo de eventos aterotromb&#243;ticos recurrentes&#46; El estudio se llev&#243; a cabo de conformidad con la Declaraci&#243;n de Helsinki y fue aprobado por el Comit&#233; de &#201;tica del Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Las variables continuas de distribuci&#243;n normal se describieron mediante medias y desviaciones est&#225;ndar y el resto mediante medianas e intervalos intercuart&#237;licos&#46; Las variables discretas se presentan en forma de recuentos y porcentajes&#46; Las diferencias en las variables continuas se analizaron con un ANOVA de una v&#237;a cuando se cumpl&#237;an los supuestos de normalidad y homocedasticidad&#44; y con la prueba de Kruskal-Wallis cuando no se cumpl&#237;an estos supuestos&#46; En caso necesario&#44; despu&#233;s del ANOVA o la prueba de Kruskal-Wallis se realizaron comparaciones emparejadas con las pruebas de Tukey-Kramer y Dunn&#44; respectivamente&#46; La homogeneidad entre proporciones se analiz&#243; mediante la prueba &#967;<span class="elsevierStyleSup">2</span> de Pearson o la prueba exacta de Fisher&#44; seg&#250;n procediera&#46; Las diferencias en la proporci&#243;n del tipo de evento nuevo entre los grupos se basaron en las estimaciones de modelos multinomiales univariados&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se calcul&#243; la funci&#243;n de riesgo acumulada de Nelson-Aalen correspondiente a la cohorte completa y para cada tipo de evento &#237;ndice&#46; Se representaron gr&#225;ficamente las funciones de supervivencia de Kaplan-Meier para cada nivel de riesgo seg&#250;n los valores de corte habituales para cada funci&#243;n o puntuaci&#243;n de riesgo cardiovascular y se compararon mediante la prueba de Wilcoxon-Breslow-Gehan&#46; Se calcul&#243; la raz&#243;n de riesgos instant&#225;neos para cada variable mediante regresi&#243;n de Cox&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En los modelos multivariados se incluyeron las variables asociadas a un evento nuevo en el an&#225;lisis univariado &#40;p&#160;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;15&#41; y las que se consideraron relevantes con independencia del valor de p&#46; Los modelos multivariados que inclu&#237;an funciones o puntuaciones de riesgo no se ajustaron respecto a variables ya incluidas en su c&#225;lculo&#46; El rendimiento global del modelo se evalu&#243; mediante la R<span class="elsevierStyleSup">2</span> de Nagelkerke ajustada al m&#225;ximo valor alcanzable&#46; Los valores de &#237;ndice C de Harrell se compararon con un m&#233;todo basado en el estad&#237;stico D de Somers&#44; seg&#250;n lo propuesto por Newson<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">21</span></a>&#46; El supuesto de riesgos proporcionales se evalu&#243; con las pruebas de Grambusch y Therneau y la calibraci&#243;n mediante las pruebas &#243;mnibus de Gr&#248;nnesby y Borgan&#46; Todos los modelos cumplieron la suposici&#243;n de proporcionalidad y mostraron una calibraci&#243;n aceptable&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se construy&#243; un modelo b&#225;sico &#40;&#171;conjunto cl&#225;sico&#187;&#41; con 6 factores de riesgo cardiovascular tradicionales &#40;sexo&#44; edad&#44; colesterol total&#44; hipertensi&#243;n arterial&#44; tabaquismo y diabetes&#41; y se analiz&#243; si la adici&#243;n de nuevas variables mejor&#243; su rendimiento en cuanto a capacidad discriminativa y reclasificaci&#243;n&#46; Se obtuvieron estimadores corregidos mediante <span class="elsevierStyleItalic">bootstrap</span> para el &#237;ndice de reclasificaci&#243;n neta &#40;IRN&#41;&#44; continuo &#40;cIRN&#41; y el categ&#243;rico &#40;cat-IRN&#41; utilizando la funci&#243;n de Kaplan-Meier<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">22&#44;23</span></a> para obtener la probabilidad de un evento al cabo de 5 a&#241;os&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">El an&#225;lisis de supervivencia se realiz&#243; con el programa inform&#225;tico STATA &#40;StataCorp&#46; 2017&#44; Stata Statistical Software&#58; Release 15&#46; College Station&#44; TX&#58; StataCorp LLC&#41;&#46; Los IRN se obtuvieron con el paquete nricens &#40;versi&#243;n 1&#46;6&#41; y se gener&#243; un modelo multinomial para calcular las diferencias entre los grupos en cuanto al tipo de evento nuevo mediante la funci&#243;n <span class="elsevierStyleItalic">multinom</span> del paquete nnet &#40;versi&#243;n 4&#46;3-14&#41;&#44; elaborados ambos para R &#40;versi&#243;n 3&#46;6&#46;0&#41;&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Caracter&#237;sticas iniciales</span><p id="par0075" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se muestran las variables basales&#44; algunas de las cuales ya se han descrito<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">19</span></a>&#46; Brevemente&#44; la edad media fue de 60 &#40;DE 8&#44;1&#41; a&#241;os&#46; La proporci&#243;n de mujeres fue mayor en el grupo cerebrovascular&#46; En el grupo de AP hubo un mayor porcentaje de fumadores activos&#44; una mayor concentraci&#243;n de c-LDL&#44; una menor concentraci&#243;n de c-HDL&#44; una mayor prevalencia de diabetes y un peor control de la glucemia&#46; El 64&#37; de los pacientes hab&#237;a sufrido uno o m&#225;s eventos vasculares previos antes del evento &#237;ndice y el 19&#44;7&#37; presentaba 2 o 3 territorios vasculares afectados&#46; La prevalencia de albuminuria fue similar en los distintos grupos&#44; aunque notablemente mayor entre los pacientes diab&#233;ticos &#40;26&#44;9 frente al 9&#44;5&#37;&#41;&#46; Globalmente&#44; las funciones y puntuaciones de Framingham&#44; SCORE&#44; B-TIMI y SMART clasificaron a m&#225;s del 25&#37; de los pacientes en el grupo de riesgo alto&#44; siendo este porcentaje significativamente mayor &#40;&#62;&#160;50&#37;&#41; en el grupo de AP &#40;<a class="elsevierStyleCrossRef" href="#sec0070">ver material suplementario</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">An&#225;lisis de supervivencia</span><p id="par0080" class="elsevierStylePara elsevierViewall">Durante una mediana de seguimiento de 4&#44;82 a&#241;os &#40;p25-p75&#58; 4&#44;1-5&#44;4&#41; se observaron 61 eventos &#40;22&#44;7&#37;&#41;&#46; Se produjeron 6 p&#233;rdidas de seguimiento &#40;una por cambio de residencia y 5 por abandono tras un diagn&#243;stico de neoplasia&#41;&#46; La tasa de incidencia fue de 5&#44;2 eventos por 100 a&#241;os-persona en la cohorte completa&#44; significativamente mayor en el grupo de AP &#40;9&#44;9 por 100 a&#241;os-persona&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41;&#46; La tasa de riesgo acumulado al cabo de 5 a&#241;os fue del 24&#44;2&#37; en la cohorte &#237;ntegra y del 42&#37; en el grupo de AP&#46; Los pacientes mostraron propensi&#243;n a experimentar el nuevo evento en el mismo territorio vascular que el evento &#237;ndice&#46; Los pacientes del grupo de AP tambi&#233;n tuvieron un mayor riesgo de presentar un evento coronario que los del grupo cerebrovascular &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Los modelos de Cox univariados indicaron que la diabetes&#44; el tabaquismo activo y la concentraci&#243;n de colesterol total aumentaron el riesgo de presentar un nuevo evento &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a><a class="elsevierStyleCrossRef" href="#sec0070">Ver tabla 2 completa en material suplementario</a>&#41;&#46; En comparaci&#243;n con el grupo coronario&#44; &#250;nicamente el de AP present&#243; un mayor riesgo&#46; De manera an&#225;loga&#44; la albuminuria&#44; la enfermedad polivascular&#44; un &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;&#160;0&#44;9&#44; la fibrilaci&#243;n auricular y la insuficiencia card&#237;aca se asociaron a un riesgo entre 2 y 3 veces superior &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Los pacientes del grupo de riesgo alto seg&#250;n la definici&#243;n de cualquiera de las FRP y F&#47;PRS tuvieron un riesgo entre 2 y 3 veces mayor de presentar un nuevo evento&#44; respectivamente&#44; que los del grupo de riesgo bajo &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a> y <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a> se incluye el modelo 0 &#40;conjunto cl&#225;sico&#41;&#44; el modelo 1 &#40;modelo 0 m&#225;s las variables seleccionadas despu&#233;s del an&#225;lisis univariado&#41; y los modelos 2 a 7&#44; modelos multivariados correspondientes a las funciones o puntuaciones de Framingham&#44; REGICOR&#44; SCORE&#44; SMART&#44; REACH y B-TIMI&#44; m&#225;s las variables seleccionadas que no estuvieran ya incluidas en la f&#243;rmula de la funci&#243;n o puntuaci&#243;n&#46; En el modelo 1&#44; la diabetes&#44; la enfermedad polivascular&#44; la albuminuria y la insuficiencia card&#237;aca siguieron siendo factores predictivos independientes de recurrencia&#46; Tras el ajuste respecto a la enfermedad polivascular&#44; la albuminuria&#44; el &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;&#160;0&#44;9&#44; la fibrilaci&#243;n auricular&#44; la insuficiencia card&#237;aca y el tipo de evento &#237;ndice&#44; el coeficiente correspondiente a las categor&#237;as de riesgo alto de las funciones de Framingham&#44; REGICOR y SCORE disminuy&#243; un 68&#44; 78 y 86&#37;&#44; respectivamente&#46; No se observaron estas variaciones en los modelos REACH y B-TIMI tras el ajuste&#46; Seg&#250;n la R<span class="elsevierStyleSup">2</span> ajustada&#44; la proporci&#243;n de la varianza explicada por cualquiera de los modelos de regresi&#243;n oscil&#243; entre el 8 y el 17&#37;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Capacidad discriminativa y reclasificaci&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran los &#237;ndices C de Harrell correspondientes a cada modelo y las diferencias entre las versiones uni y multivariada de cada uno de ellos&#46; El modelo que inclu&#237;a 6 factores de riesgo cl&#225;sicos tuvo una capacidad discriminativa similar al de las versiones uni y multivariada de los modelos que inclu&#237;an funciones o puntuaciones de riesgo&#46; Las F&#47;PRS tuvieron una capacidad discriminativa algo mayor que las FRP cuando se consideraron por s&#237; solas&#46; De entre las F&#47;PRS y las FRP&#44; las m&#225;s discriminativas fueron B-TIMI y Framingham-Wilson&#44; respectivamente&#46; Se produjo una mejora moderada de la capacidad discriminativa al incluir la albuminuria y la enfermedad polivascular en el modelo multivariado o cuando ya formaban parte de la propia funci&#243;n&#47;escala de riesgo&#46; Los &#237;ndices C de Harrell de los modelos multivariados fueron similares&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> muestra la mejora de la capacidad discriminativa y la reclasificaci&#243;n al a&#241;adir nuevas variables al modelo &#171;conjunto cl&#225;sico&#187;&#46; Tras la adici&#243;n de la albuminuria y la enfermedad polivascular se observ&#243; una mejora moderada de la capacidad discriminativa y un aumento leve del c-IRN&#44; debido principalmente al grupo sin nuevos eventos&#46; Esta mejora no se observ&#243; en el cat-IRN &#40;valor de corte del 20&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discusi&#243;n</span><p id="par0105" class="elsevierStylePara elsevierViewall">Los pacientes con enfermedad cardiovascular establecida clasificados en los grupos de riesgo alto seg&#250;n las funciones y puntuaciones de Framingham&#44; REGICOR&#44; SCORE&#44; SMART&#44; REACH y B-TIMI calculadas a partir de las variables medidas en el momento del &#250;ltimo evento presentaron un mayor riesgo de presentar un nuevo evento&#46; Este mayor riesgo ya se ha descrito con las funciones de Framingham<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">24</span></a> y SCORE<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">25</span></a> en pacientes con enfermedad coronaria&#46; La prevalencia de factores de riesgo cl&#225;sicos en cada grupo y el peor perfil de riesgo en los pacientes con AP coinciden con los resultados de cohortes nacionales contempor&#225;neas<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">26&#8211;28</span></a>&#46; El grupo de AP tambi&#233;n cont&#243; con la mayor proporci&#243;n de pacientes clasificados en el grupo de riesgo alto&#46; La incidencia acumulada de recurrencia al cabo de 5 a&#241;os fue el doble de la observada en los grupos coronario o cerebrovascular&#44; tambi&#233;n concordante con lo ya publicado en relaci&#243;n con cohortes de pacientes que incluyeron un solo tipo de evento<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">7&#44;29</span></a> y mixtas<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">30</span></a>&#46; Recientemente se ha efectuado una revisi&#243;n sistem&#225;tica de este mayor&#44; aunque a menudo ignorado&#44; riesgo de recurrencia en los pacientes con AP<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Previamente publicamos que la microalbuminuria se asocia estrechamente a la presencia de lesiones vasculares ocultas en pacientes con eventos previos<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">32</span></a>&#44; afectando a una cuarta parte de aquellos con s&#237;ndrome coronario agudo<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">33</span></a>&#44; con independencia de la existencia de diabetes&#46; Nuestros resultados respaldan el papel independiente de la albuminuria<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">34</span></a> y la enfermedad polivascular<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">7&#44;35</span></a> en el riesgo de presentar un nuevo evento&#46; Aunque en algunas puntuaciones&#44; como GRACE y SMART&#44; ya se incluyen variables relacionadas con la extensi&#243;n de la enfermedad ateroescler&#243;tica&#44; muchas de ellas no son f&#225;ciles de obtener&#46; Los cambios en el coeficiente correspondiente a las FRP tras la introducci&#243;n de la albuminuria y la enfermedad polivascular&#44; no observados en las F&#47;PRS que ya incluyen alguna de ellas&#44; respaldan la relevancia de estas variables a efectos de predicci&#243;n del riesgo&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La capacidad discriminativa de los modelos que inclu&#237;an alguna de las funciones o puntuaciones de riesgo fue bastante escasa&#44; especialmente la de aquellos basados en FRP&#44; aunque fueron concordantes con estimaciones procedentes de estudios en los que se agrup&#243; una proporci&#243;n similar de eventos de referencia&#46; Uthoff et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a> tambi&#233;n observaron una mayor capacidad discriminativa de la puntuaci&#243;n SMART &#40;AUC&#58; 0&#44;67 &#91;0&#44;54-0&#44;77&#93;&#41; que de las funciones de Framingham &#40;AUC&#58; 0&#44;56 &#91;0&#44;43-0&#44;69&#93;&#41; y SCORE &#40;AUC&#58; 0&#44;6 &#91;0&#44;46-0&#44;73&#93;&#41;&#46; Kaasenbrood et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">6</span></a> obtuvieron un &#237;ndice C de Harrell de 0&#44;64 &#40;IC 95&#37;&#58; 0&#44;63-0&#44;65&#41; para la puntuaci&#243;n SMART recalibrada y Dorresteijn et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a> obtuvieron estimaciones similares &#40;C de Harrell&#58; 0&#44;683 &#91;0&#44;650-0&#44;717&#93;&#41; en una cohorte mixta&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Seg&#250;n nuestros resultados&#44; la puntuaci&#243;n SMART no tiene un rendimiento significativamente mejor que la TIMI cuando se utiliza sola o en modelos multivariados&#46; Adem&#225;s&#44; su rendimiento fue similar al de las funciones de Framingham&#44; REGICOR o SCORE cuando en el modelo multivariado se tuvo en cuenta de alg&#250;n modo la extensi&#243;n de la enfermedad ateroescler&#243;tica&#46; El rendimiento discriminativo del modelo para el &#171;conjunto cl&#225;sico&#187; fue bajo&#44; pero similar al observado en pacientes semejantes<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a>&#44; con una mejora moderada del &#237;ndice C de Harrell despu&#233;s de a&#241;adir nuevas variables al modelo&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Los resultados contradictorios de cat-IRN y cIRN indican que las variaciones de las probabilidades te&#243;ricas&#44; principalmente en los pacientes sin eventos&#44; no son lo bastante notables como para reclasificar correctamente a los pacientes por encima o por debajo del umbral&#46; Ace&#241;a et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">24</span></a> comunicaron un cat-IRN de 0&#44;097 &#40;0&#44;096&#59; 0&#44;098&#41; tras a&#241;adir la puntuaci&#243;n de Framingham a un modelo que ya inclu&#237;a la hipertensi&#243;n arterial y el &#237;ndice de masa corporal&#44; mientras que Van den Berg et al&#46; comunicaron que la enfermedad polivascular fue el &#250;nico factor individual que mejor&#243; la reclasificaci&#243;n &#40;cat-IRN&#58; 0&#44;032 &#91;0&#44;014&#59; 0&#44;051&#93;&#41; en ambas cohortes&#44; REACH y SMART&#44; al a&#241;adirla a los criterios de riesgo muy alto del ACC&#47;AHA<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Existe una conciencia cada vez mayor de la necesidad de estratificar el riesgo para identificar a los pacientes con m&#225;s probabilidades de beneficiarse de un control m&#225;s intensivo de los factores de riesgo&#44; por ejemplo un objetivo de c-LDL<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1&#160;mmol&#47;l<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">36</span></a> y&#44; en particular&#44; del posible tratamiento con inhibidores de la PCSK-9<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">37</span></a>&#46; Consideramos que la enfermedad polivascular y la albuminuria ser&#237;an variables relevantes para este prop&#243;sito&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n de nuestro estudio radica en la falta de potencia estad&#237;stica&#44; especialmente importante en relaci&#243;n con el cIRN y el cat-IRN<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">38</span></a>&#46; En segundo lugar&#44; la cohorte AIRVAG es una cohorte mixta de pacientes con 3 tipos de eventos&#44; te&#243;ricamente con diferentes determinantes para la recurrencia&#46; No obstante&#44; y en consonancia con el concepto de riesgo vascular ateroescler&#243;tico global&#44; consideramos que era fundamental contrastar nuestra hip&#243;tesis en la cohorte &#237;ntegra&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En nuestros modelos&#44; la disminuci&#243;n de la funci&#243;n renal se bas&#243; en el cociente alb&#250;mina&#47;creatinina&#44; de forma que los pacientes con otros marcadores de da&#241;o renal o con un FG<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60&#160;ml&#47;min&#47;<span class="elsevierStyleHsp" style=""></span>1&#44;73&#160;m<span class="elsevierStyleSup">2</span>&#44; pero con un cociente alb&#250;mina&#47;creatinina<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>30&#160;mg&#47;g no estar&#237;an representados&#46; Entre las fortalezas del estudio destacamos la baja proporci&#243;n de pacientes perdidos durante el seguimiento &#40;2&#44;2&#37;&#41; y la uniformidad en la evaluaci&#243;n de las variables&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusiones</span><p id="par0145" class="elsevierStylePara elsevierViewall">Los pacientes del grupo de riesgo alto seg&#250;n cualquiera de las funciones o puntuaciones evaluadas tuvieron un mayor riesgo de recurrencia de eventos cardiovasculares&#46; Modelos tales como el REACH&#44; el B-TIMI y el SMART solo tienen una capacidad discriminativa algo mejor que las funciones de riesgo de Framingham&#44; REGICOR y SCORE&#46; Nuestros resultados subrayan la importancia de tener en cuenta el efecto combinado de los factores de riesgo cl&#225;sicos y otros marcadores de enfermedad&#44; como la albuminuria o la enfermedad polivascular&#44; en la identificaci&#243;n de los pacientes con un &#171;riesgo extremo&#187;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Financiaci&#243;n</span><p id="par0150" class="elsevierStylePara elsevierViewall">La selecci&#243;n y seguimiento de la cohorte AIRVAG fueron financiados por una beca del Instituto de Salud Carlos III &#40;beca FIS 00&#47;0412-03&#47;1570&#41; y por Sanofi Aventis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0155" class="elsevierStylePara elsevierViewall">Los autores declaran 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">Antecedentes y objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En la enfermedad cardiovascular ateroescler&#243;tica no existe consenso respecto a los instrumentos de estratificaci&#243;n del riesgo en su prevenci&#243;n secundaria&#46; Nuestro objetivo consist&#237;a en comparar la capacidad discriminativa de las funciones de riesgo de Framingham&#44; REGICOR&#44; SCORE y REACH y las puntuaciones de riesgo Bohula-TIMI y SMART&#44; as&#237; como en evaluar el posible valor a&#241;adido de otras variables cl&#237;nicas en cuanto a la predicci&#243;n de recurrencias en pacientes con enfermedad cardiovascular&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analiz&#243; una cohorte de 269 pacientes con enfermedad cardiovascular establecida &#40;52&#44;8&#37; coronaria&#44; 32&#37; cerebrovascular&#44; 15&#44;2&#37; arteriopat&#237;a perif&#233;rica&#41;&#46; Se compararon las funciones de supervivencia de los grupos de riesgo &#40;bajo&#47;intermedio&#47;alto&#41; seg&#250;n los valores de corte de uso habitual de cada funci&#243;n o puntuaci&#243;n y se calcularon las razones de riesgos instant&#225;neos &#40;RRI&#41; correspondientes a cada una mediante regresi&#243;n de Cox&#46; Se calcul&#243; el &#916; <span class="elsevierStyleSmallCaps">C</span> de Harrell&#44; el cat-IRN y el cIRN despu&#233;s de a&#241;adir nuevos factores predictivos a un modelo base que inclu&#237;a edad&#44; sexo&#44; colesterol total&#44; tabaquismo activo&#44; hipertensi&#243;n arterial y diabetes&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Al cabo de 6 a&#241;os de seguimiento &#40;mediana de 4&#44;82 a&#241;os&#41; se hab&#237;an producido 61 eventos &#40;23&#37;&#41;&#46; Los grupos de riesgo alto tuvieron un mayor riesgo de recurrencia&#58; SMART &#40;RRI&#58; 3&#44;17 &#91;1&#44;55-6&#44;5&#93;&#41;&#44; Framingham &#40;RRI&#58; 3&#44;08 &#91;1&#44;65-5&#44;75&#93;&#41;&#44; REGICOR &#40;RRI&#58; 2&#44;71 &#91;1&#44;39-5&#44;27&#93;&#41;&#44; SCORE &#40;RRI&#58; 2&#44;14 &#91;1&#44;01-4&#44;5&#93;&#44; REACH &#40;RRI&#58; 5&#44;74 &#91;2&#44;83-11&#44;7&#93;&#41; y B-TIMI &#40;RRI&#58; 3&#44;68 &#91;0&#44;88-15&#44;3&#93;&#41;&#46; La enfermedad polivascular &#40;3 territorios&#44; RRI&#58; 5&#44;6 &#91;2&#44;2-14&#44;25&#93;&#41;&#44; la albuminuria &#40;RRI&#58; 3&#44;55 &#91;2&#44;06-6&#44;11&#93;&#41; y la insuficiencia card&#237;aca &#40;RRI&#58; 3&#44;11 &#91;1&#44;34-7&#44;25&#93;&#41; tambi&#233;n incrementaron el riesgo&#46; La capacidad discriminativa &#40;&#237;ndice C de Harrell&#41; fue baja&#44; pero mejor&#243; tras a&#241;adir la albuminuria y la enfermedad polivascular&#46; Ambas variables tambi&#233;n mejoraron el rendimiento del modelo base &#40;cIRN&#58; 0&#44;326 &#91;0&#44;036&#59; 0&#44;607&#93;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las funciones de Framingham&#44; REGICOR&#44; SCORE y REACH y las puntuaciones B-TIMI y SMART mostraron un rendimiento bajo&#44; aunque similar&#44; en prevenci&#243;n secundaria&#46; La albuminuria y la enfermedad polivascular mejoraron el rendimiento predictivo de los principales factores de riesgo cardiovascular cl&#225;sicos&#46;</p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and aims</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">There is no consensus regarding risk stratification tools for secondary prevention in atherosclerotic cardiovascular disease&#46; Our aim was to compare the discriminative performance of the Framingham&#44; REGICOR&#44; SCORE&#44; and REACH risk functions and the Bohula-TIMI and SMART risk scores&#44; as well as to assess the potential added value of other clinical variables for the prediction of recurrent events in patients with established vascular disease&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A cohort of 269 patients with established vascular disease &#40;52&#46;8&#37; coronary&#44; 32&#37; cerebrovascular&#44; 15&#46;2&#37; peripheral artery disease&#41; was included&#46; The survival functions of risk groups &#40;low&#47;medium&#47;high&#41; according to commonly used cutoff points for each function&#47;score were compared&#44; and hazard ratios &#40;HR&#41; for each were estimated using Cox regression&#46; We calculated &#916; Harrell&#39;s C statistic&#44; cat-NRI&#44; and cNRI after adding new predictors to a base model including age&#44; sex&#44; total cholesterol&#44; current smoking status&#44; hypertension&#44; and diabetes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">After 6 years of follow-up &#40;median 4&#46;82 years&#41;&#44; 61 events occurred &#40;23&#37;&#41;&#46; High-risk groups had a higher risk of recurrent event&#58; SMART &#40;HR&#58; 3&#46;17 &#91;1&#46;55-6&#46;5&#93;&#41;&#44; Framingham &#40;HR&#58; 3&#46;08 &#91;1&#46;65-5&#46;75&#93;&#41;&#44; REGICOR &#40;HR&#58; 2&#46;71 &#91;1&#46;39-5&#46;27&#93;&#41;&#44; SCORE &#40;HR&#58; 2&#46;14 &#91;1&#46;01-4&#46;5&#93;&#44; REACH &#40;HR&#58; 5&#46;74 &#91;2&#46;83-11&#46;7&#93;&#41;&#44; B-TIMI &#40;HR&#58; 3&#46;68 &#91;0&#46;88-15&#46;3&#93;&#41;&#46; Polyvascular disease &#40;3 territories HR&#58; 5&#46;6 &#91;2&#46;2-14&#46;25&#93;&#41;&#44; albuminuria &#40;HR&#58; 3&#46;55 &#91;2&#46;06-6&#46;11&#93;&#41;&#44; and heart failure &#40;HR&#58; 3&#46;11 &#91;1&#46;34-7&#46;25&#93;&#41; also increased risk&#46; Discrimination &#40;Harrell&#39;s C&#41; was low but improved after adding albuminuria and polyvascular disease&#46; Both variables also improved the performance of the base model &#40;cNRI&#58; 0&#46;326 &#91;0&#46;036&#59; 0&#46;607&#93;&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The Framingham&#44; REGICOR&#44; SCORE&#44; and REACH functions and the B-TIMI and SMART scores showed low yet similar performance in secondary prevention&#46; Albuminuria and polyvascular disease improved the predictive performance of major classical cardiovascular risk factors&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Background and aims"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Methods"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
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      0 => array:3 [
        "etiqueta" => "&#9674;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0070">El resto de los componentes del grupo AIRVAG est&#225;n mencionados en el anexo&#46;</p>"
        "identificador" => "fn0005"
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      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0175" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Anexo A"
            "titulo" => "Material adicional"
            "identificador" => "sec0070"
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        ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas de supervivencia de Kaplan-Meier correspondientes a la estratificaci&#243;n del riesgo seg&#250;n los valores de corte habituales&#46; &#40;A&#41; Framingham&#44; &#40;B&#41; REGICOR&#44; &#40;C&#41; SCORE&#44; &#40;D&#41; SMART&#44; &#40;E&#41; B-TIMI y &#40;F&#41; REACH&#46;</p>"
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        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">HbA<span class="elsevierStyleInf">1c</span>&#58; hemoglobina glucosilada&#59; HDL&#58; lipoprote&#237;nas de alta densidad&#59; IMC&#58; &#237;ndice de masa corporal&#59; ITB&#58; &#237;ndice tobillo&#47;brazo&#59; LDL&#58; lipoprote&#237;nas de baja densidad&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Los valores se presentan en forma de frecuencia &#40;porcentaje&#41;&#44; media &#40;desviaci&#243;n est&#225;ndar&#41; o mediana y l&#237;mites del intervalo intercuart&#237;lico &#91;del percentil 25 al 75&#93;&#44; seg&#250;n proceda&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleItalic">Colesterol LDL &#40;mmol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Colesterol HDL &#40;mmol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Triglic&#233;ridos &#40;mmol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;0102<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Presi&#243;n arterial sist&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;069&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="elsevierStyleItalic">Presi&#243;n arterial diast&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">79 &#40;11&#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="elsevierStyleItalic">Hipertensi&#243;n arterial</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">168 &#40;62&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">85 &#40;60&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;380&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diabetes</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">HbA</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">1c</span></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#62;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">7&#37;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">28 &#40;38&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Creatinina s&#233;rica &#40;&#956;mol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">95&#44;5 &#91;84&#44;4&#44; 105&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cociente</span><span class="elsevierStyleItalic">alb&#250;mina&#47;creatinina</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;73 &#91;0&#44;42&#44; 2&#44;01&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39 &#40;14&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;19&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#706;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;138<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Un territorio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dos territorios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tres territorios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Recurrencia &#40;tipo de evento&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronario&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cerebrovascular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><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"><span class="elsevierStyleItalic">P&#233;rdida para el seguimiento y abandonos</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;367<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Incidencia acumulada&#37; &#40;IC 95&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&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</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">24&#44;2 &#40;18&#44;5-31&#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">22&#44;9 &#40;14&#44;2-37&#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">42&#44;1 &#40;24&#44;8-71&#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="" valign="\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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">Univariado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="8" align="center" valign="\n
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                  \t\t\t\t" scope="col">Multivariado</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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">Modelo 0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 2Framingham-Wilson&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 3REGICOR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 4SCORE<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 5SMART&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">Modelo 6REACH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 7B-TIMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><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">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#37;&#41;&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">Edad &#40;intervalos de 5 a&#241;os&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;15 &#40;0&#44;97-1&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;18 &#40;0&#44;98-1&#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">1&#44;06 &#40;0&#44;88-1&#44;28&#41;&nbsp;\t\t\t\t\t\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><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><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><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><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><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">Sexo &#40;Ref&#46; mujeres&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;94 &#40;0&#44;51-1&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9 &#40;0&#44;48-1&#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;72 &#40;0&#44;37-1&#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="" 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><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><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><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><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><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">Fumadores activos&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;97 &#40;1&#44;11-3&#44;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;81 &#40;0&#44;91-3&#44;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;57 &#40;0&#44;76-3&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" 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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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">CT &#40;&#916; de 0&#44;26&#160;mmol&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;05 &#40;0&#44;99-1&#44;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">1&#44;03 &#40;0&#44;96-1&#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&#44;03 &#40;0&#44;96-1&#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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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">c-LDL &#40;&#916; de 0&#44;26&#160;mmol&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;04 &#40;0&#44;97-1&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" 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><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><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><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><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><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><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><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">c-HDL &#40;&#916; de 0&#44;13&#160;mmol&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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 &#40;0&#44;89-1&#44;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="" 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><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><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><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><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><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><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><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">Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;63 &#40;0&#44;92-2&#44;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;16 &#40;0&#44;6-2&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;76 &#40;0&#44;38-1&#44;53&#41;&nbsp;\t\t\t\t\t\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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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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">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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;55 &#40;1&#44;54-4&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;45 &#40;1&#44;39-4&#44;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&#44;13 &#40;1&#44;15-3&#44;94&#41;&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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">Obesidad &#40;IMC &#8805;&#160;30&#160;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;96 &#40;0&#44;56-1&#44;64&#41;&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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><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><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">Enfermedad polivascular&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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><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><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><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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Dos territorios</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;35 &#40;0&#44;69-2&#44;64&#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="" 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  " 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  " align="left" valign="\n
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                  \t\t\t\t">0&#44;97 &#40;0&#44;49-1&#44;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Tres territorios</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">5&#44;6 &#40;2&#44;2-14&#44;25&#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">3&#44;25 &#40;1&#44;07-9&#44;89&#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">3&#44;89 &#40;1&#44;36-11&#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">3&#44;71 &#40;1&#44;32-10&#44;42&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;03 &#40;1&#44;42-11&#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  " align="left" valign="\n
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                  \t\t\t\t">3&#44;29 &#40;1&#44;18-9&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Albuminuria<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">a</span></a>&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">3&#44;55 &#40;2&#44;06-6&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;54 &#40;1&#44;32-4&#44;87&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;55 &#40;1&#44;39-4&#44;68&#41;&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">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;75 &#40;1&#44;54-4&#44;91&#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">&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">ITB &#8804;&#160;0&#44;9 &#40;en cualquier lado&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;38 &#40;0&#44;71-2&#44;68&#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">1&#44;35 &#40;0&#44;7-2&#44;63&#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">1&#44;45 &#40;0&#44;76-2&#44;79&#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">1&#44;42 &#40;0&#44;75-2&#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">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;37 &#40;0&#44;75-2&#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">1&#44;55 &#40;0&#44;84-2&#44;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Antecedentes de fibrilaci&#243;n auricular&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  " align="left" valign="\n
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                  \t\t\t\t">1&#44;73 &#40;0&#44;74-4&#44;04&#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">1&#44;58 &#40;0&#44;69-3&#44;65&#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">1&#44;58 &#40;0&#44;68-3&#44;67&#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">1&#44;64 &#40;0&#44;71-3&#44;78&#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="" valign="\n
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;19 &#40;1-4&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Insuficiencia card&#237;aca&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">3&#44;11 &#40;1&#44;34-7&#44;25&#41;&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><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">2&#44;62 &#40;1&#44;05-6&#44;55&#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">3&#44;02 &#40;1&#44;21-7&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;91 &#40;1&#44;16-7&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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 &#40;1&#44;26-7&#44;63&#41;&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&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="" 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
                  \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">Evento &#237;ndice&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
                  \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
                  \t\t\t\t</td><td class="td" title="\n
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                  \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
                  \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
                  \t\t\t\t</td><td class="td" title="\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
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">IC 95&#37;&#58; intervalo de confianza al 95&#37;&#59; REACH&#58; REduction of Atherothrombosis for Continued Health Registry&#59; REGICOR&#58; Registre GiRonI del Cor&#59; SCORE&#58; Systematic COronary Risk Evaluation&#59; SMART&#58; Second Manifestations of ARTerial disease&#59; TIMI&#58; Thrombolysis In Myocardial Infarction-Grupo del estudio TIMI&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cohorte &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>264&#41;</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Univariado<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#916; C de Harrell &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t">Cl&#225;sico&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</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;028 &#40;&#8722;0&#44;023&#59; 0&#44;079&#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;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Framingham-Wilson&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;085 &#40;0&#44;012&#59; 0&#44;158&#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;023&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">REGICOR&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">SCORE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;092 &#40;0&#44;023&#59; 0&#44;161&#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">0&#44;149&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">REACH<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">d</span></a>&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</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;666 &#40;0&#44;6-0&#44;732&#41;&nbsp;\t\t\t\t\t\t\n
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            0 => array:3 [
              "identificador" => "tblfn0040"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">El modelo univariado incluye la variable con estratificaci&#243;n del riesgo &#40;3 niveles&#41; seg&#250;n la funci&#243;n de riesgo o los valores de corte habituales de la puntuaci&#243;n&#44; excepto el modelo cl&#225;sico&#44; que incluye edad&#44; sexo&#44; colesterol total&#44; hipertensi&#243;n arterial&#44; tabaquismo y diabetes&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0045"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Las versiones multivariadas de los modelos cl&#225;sicos&#44; Framingham-Wilson&#44; REGICOR y SCORE&#44; tambi&#233;n se ajustaron respecto a albuminuria&#44; enfermedad polivascular&#44; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular&#44; insuficiencia card&#237;aca y tipo de evento &#237;ndice&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0050"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0050">El modelo multivariado SMART se ajust&#243; respecto al tipo de evento &#237;ndice&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0055"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0055">El modelo multivariado REACH se ajust&#243; respecto a albuminuria&#44; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9 y tipo de evento &#237;ndice&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0060"
              "etiqueta" => "e"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0060">El modelo multivariado B-TIMI se ajust&#243; respecto a enfermedad polivascular&#44; ITB<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular y tipo de evento &#237;ndice&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Variaci&#243;n del &#237;ndice C de Harrell con la adici&#243;n de nuevos factores predictivos al modelo univariado en relaci&#243;n con cada funci&#243;n o puntuaci&#243;n de riesgo</p>"
        ]
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            "identificador" => "at4"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">cIRN&#58; &#237;ndice de reclasificaci&#243;n neta continuo&#59; cat-IRN&#58; &#237;ndice de reclasificaci&#243;n neta categ&#243;rico&#59; IC 95&#37;&#58; intervalo de confianza al 95&#37;&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Cl&#225;sico &#40;conjunto A&#41;&#58; edad&#44; sexo&#44; tabaquismo activo&#44; colesterol total &#40;con ajuste a 0&#44;26&#160;mmol&#47;l&#41;&#44; hipertensi&#243;n arterial y diabetes&#46; Conjunto B&#58; albuminuria y enfermedad polivascular&#46; Conjunto C&#58; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular&#44; insuficiencia card&#237;aca congestiva y tipo de evento &#237;ndice&#46; Conjunto D&#58; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular&#44; insuficiencia card&#237;aca congestiva&#44; tipo de evento &#237;ndice&#44; albuminuria y enfermedad polivascular&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">C de Harrell &#40;IC 95&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#916; C de Harrell &#40;IC 95&#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">cIRN con evento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">cIRN sin eventos&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">cat-IRN &#40;20&#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">cat-IRN con evento&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">cat-IRN sin eventos&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">Cl&#225;sico &#40;A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;701 &#40;0&#44;633-0&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&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">Cl&#225;sico<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>B&nbsp;\t\t\t\t\t\t\n
                  \t\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;72 &#40;0&#44;649-0&#44;791&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;017 &#40;&#8722;0&#44;026&#59;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;326 &#40;0&#44;036&#59;0&#44;607&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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">&#8722;0&#44;02 &#40;&#8722;0&#44;29&#59;0&#44;239&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;346 &#40;0&#44;215&#59;0&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;027 &#40;&#8722;0&#44;1&#59;0&#44;156&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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">&#8722;0&#44;038 &#40;&#8722;0&#44;155&#59;0&#44;074&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;064 &#40;0&#44;007&#59;0&#44;123&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Cl&#225;sico<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>C&nbsp;\t\t\t\t\t\t\n
                  \t\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;731 &#40;0&#44;663-0&#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;029 &#40;&#8722;0&#44;007&#59;0&#44;064&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;111&nbsp;\t\t\t\t\t\t\n
                  \t\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;397 &#40;0&#44;091&#59;0&#44;709&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;044 &#40;&#8722;0&#44;238&#59;0&#44;317&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;353 &#40;0&#44;234&#59;0&#44;478&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;029 &#40;&#8722;0&#44;078&#59;0&#44;129&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;019&#59; &#40;&#8722;0&#44;068&#59;0&#44;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">0&#44;01 &#40;&#8722;0&#44;038&#59;0&#44;061&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Cl&#225;sico<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>D&nbsp;\t\t\t\t\t\t\n
                  \t\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;735 &#40;0&#44;666-0&#44;803&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;033 &#40;&#8722;0&#44;015&#59;0&#44;081&#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">0&#44;18&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</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">0&#44;069 &#40;0&#44;015&#59;0&#44;131&#41;&nbsp;\t\t\t\t\t\t\n
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ORIGINAL
La albuminuria y la enfermedad polivascular mejoran la capacidad predictiva de los modelos multivariados después de un evento cardiovascular agudo. Cohorte AIRVAG
Albuminuria and polyvascular disease improve multivariate predictive models after an acute cardiovascular event. The AIRVAG cohort
R. Sáez-Jiméneza,b, J. Esteban-Hernándezb,
Autor para correspondencia
jesus.esteban@urjc.es

Autor para correspondencia.
, B. Herrerosc, A. Huelmosd, C. Guijarroc,e, en nombre del grupo de investigadores AIRVAG ◊
a Centro de Atención Primaria Presentación Sabio, Móstoles, Madrid, España
b Área de Salud Pública y Medicina Preventiva, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
c Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
d Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
e Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
Anexo. Miembros del equipo AIRVAG
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        "titulo" => "Albuminuria and polyvascular disease improve multivariate predictive models after an acute cardiovascular event&#46; The AIRVAG cohort"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas de supervivencia de Kaplan-Meier correspondientes a la estratificaci&#243;n del riesgo seg&#250;n los valores de corte habituales&#46; &#40;A&#41; Framingham&#44; &#40;B&#41; REGICOR&#44; &#40;C&#41; SCORE&#44; &#40;D&#41; SMART&#44; &#40;E&#41; B-TIMI y &#40;F&#41; REACH&#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">Las incidencias y las tasas de mortalidad por cardiopat&#237;a coronaria e ictus est&#225;n disminuyendo de forma constante&#44; especialmente en los pa&#237;ses occidentales<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a>&#46; No obstante&#44; explican el 38 y el 34&#37; de las muertes en varones y mujeres&#44; respectivamente&#44; y probablemente constituir&#225;n las principales causas de a&#241;os de vida perdidos evitables en 2040<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a>&#46; Algunas sociedades cient&#237;ficas han propuesto el uso de una estrategia integrada de evaluaci&#243;n del riesgo cardiovascular que ajuste las intervenciones terap&#233;uticas o preventivas al riesgo vascular absoluto estimado&#46; La mayor&#237;a de estas evaluaciones est&#225;n dise&#241;adas para predecir la aparici&#243;n de enfermedades cardiovasculares en la poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">3</span></a> y tan solo unas pocas se emplean de manera sistem&#225;tica para estratificar el riesgo&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A los pacientes en prevenci&#243;n secundaria se les suele clasificar en el grupo de mayor riesgo<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">4&#44;5</span></a> conforme a la estratificaci&#243;n planteada por las funciones de riesgo utilizadas en prevenci&#243;n primaria &#40;FRP&#41;&#44; aunque el riesgo real no es homog&#233;neo entre ellos<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">6</span></a>&#46; Las recurrencias dependen b&#225;sicamente de las secuelas cl&#237;nicas que dejan los eventos previos&#44; del perfil de los factores de riesgo cl&#225;sicos en el momento del evento &#237;ndice<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a> y de su grado de control posterior<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a>&#46; Se han elaborado y validado varias funciones y puntuaciones de riesgo para prevenci&#243;n secundaria &#40;en adelante&#44; F&#47;PRS&#41; con el fin de predecir recurrencias o la muerte&#44; si bien la mayor&#237;a son espec&#237;ficas de un territorio vascular concreto&#44; principalmente coronario<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">9</span></a> o cerebrovascular<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">10</span></a>&#46; Tan solo unas pocas&#44; como SMART<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">11&#44;12</span></a> o REACH<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a>&#44; se obtuvieron para predecir varios tipos de desenlace en cohortes mixtas de pacientes con enfermedad cardiovascular establecida&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Existe una necesidad cada vez mayor de modelos v&#225;lidos basados en conjuntos de variables accesibles y asequibles para identificar a los pacientes con un mayor riesgo de recurrencias<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a>&#46; En pocos estudios se ha comparado el rendimiento predictivo de las diferentes funciones y puntuaciones disponibles en pacientes con enfermedad cardiovascular ateroescler&#243;tica en varios territorios vasculares&#46; Uthoff et al&#46; se&#241;alaron que la puntuaci&#243;n SMART tuvo un mejor rendimiento que las funciones de Framingham y SCORE en pacientes con ateroesclerosis cl&#237;nicamente evidente &#40;coronaria&#44; cerebrovascular&#44; arteriopat&#237;a perif&#233;rica &#91;AP&#93; y enfermedad vasculorrenal&#41;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo principal de este estudio consisti&#243; en comparar la supervivencia y la capacidad discriminativa de la estratificaci&#243;n del riesgo seg&#250;n las funciones y puntuaciones de Framingham-Wilson<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">15</span></a>&#44; SCORE<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a>&#44; REGICOR<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">17</span></a>&#44; REACH<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a>&#44; Bohula-TIMI<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">18</span></a> y SMART<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">12</span></a> en la cohorte Atenci&#243;n Integral al Riesgo Cardiovascular &#40;AIRVAG&#41; de pacientes&#46; El objetivo secundario era determinar si la adici&#243;n de otras variables de f&#225;cil obtenci&#243;n podr&#237;a mejorar el rendimiento de un modelo que ya incluyera 6 de los principales factores de riesgo cardiovascular&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o de la cohorte y definici&#243;n de las variables</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se utilizaron datos de todos los pacientes incluidos en la cohorte AIRVAG<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">19</span></a>&#44; una cohorte prospectiva con 269 pacientes consecutivos de entre 35 y 70 a&#241;os con ateroesclerosis sintom&#225;tica en cualquier lecho vascular&#44; atendidos en la Unidad de Riesgo Vascular del Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#46; Los pacientes fueron seleccionados entre junio de 2000 y julio de 2002&#44; y seguidos hasta junio de 2006&#46; La selecci&#243;n se bas&#243; en las definiciones de evento &#237;ndice que se exponen a continuaci&#243;n&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Un evento isqu&#233;mico cerebrovascular se defini&#243; como un accidente isqu&#233;mico transitorio o un ictus isqu&#233;mico aterotromb&#243;tico o lacunar&#59; se excluyeron los ictus hemorr&#225;gicos y cardioemb&#243;licos&#46; La cardiopat&#237;a isqu&#233;mica se defini&#243; como un s&#237;ndrome coronario agudo&#44; incluyendo el infarto de miocardio y la revascularizaci&#243;n coronaria &#40;angioplastia o derivaci&#243;n aortocoronaria&#41;&#46; La AP se defini&#243; como un &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9 o claudicaci&#243;n intermitente cl&#237;nicamente evidente con una distancia de claudicaci&#243;n de entre 50 y 200<span class="elsevierStyleHsp" style=""></span>m &#40;estadio IIb&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se examin&#243; a todos los pacientes en el mes siguiente al evento &#237;ndice aplicando un protocolo uniforme&#46; Los nuevos eventos vasculares fueron confirmados por el mismo especialista m&#233;dico y con aplicaci&#243;n de los mismos criterios&#44; excepto los nuevos eventos de AP&#44; que se definieron como la presencia de isquemia en reposo&#44; revascularizaci&#243;n perif&#233;rica o amputaci&#243;n&#46; Se excluy&#243; a los pacientes mayores de 70 a&#241;os y a aquellos con una esperanza de vida inferior a 3 a&#241;os&#44; insuficiencia renal cr&#243;nica &#40;creatinina<span class="elsevierStyleHsp" style=""></span>&#62;&#160;3&#160;mg&#47;dl o en un programa de di&#225;lisis&#41; o incapacidad para entender el consentimiento informado&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Los factores de riesgo cardiovascular se definieron como sigue&#58; tabaquismo y fumadores activos o exfumadores &#40;sin fumar en los &#250;ltimos 6 meses&#41;&#46; La dislipidemia se defini&#243; como un colesterol total<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5&#44;17&#160;mmol&#47;l&#44; un colesterol total<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>5&#44;17&#160;mmol&#47;l y unos triglic&#233;ridos<span class="elsevierStyleHsp" style=""></span>&#62;&#160;2&#44;26&#160;mmol&#47;l o el uso de hipolipidemiantes&#46; La hipertensi&#243;n arterial se defini&#243; como una presi&#243;n arterial sist&#243;lica<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;140&#160;mmHg o una presi&#243;n arterial diast&#243;lica<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;90&#160;mmHg en reposo en al menos 2 determinaciones independientes &#40;d&#237;as diferentes&#41; o el uso de antihipertensivos&#46; La diabetes se defini&#243; como el hecho de tener 2 determinaciones de glucemia en ayunas<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;7&#160;mmol&#47;l o el uso de tratamiento hipoglucemiante&#46; La obesidad se defini&#243; como un &#237;ndice de masa corporal<span class="elsevierStyleHsp" style=""></span>&#8805;&#160;30&#160;kg&#47;m<span class="elsevierStyleSup">2</span>&#46; La albuminuria se defini&#243; como un cociente alb&#250;mina&#47;creatina<span class="elsevierStyleHsp" style=""></span>&#62;&#160;3&#44;4&#160;mg&#47;mmol &#40;&#62;&#160;30&#160;mg&#47;g&#41;&#46; La obesidad visceral se defini&#243; como un cociente cintura cadera<span class="elsevierStyleHsp" style=""></span>&#62;&#160;0&#44;8 en las mujeres y<span class="elsevierStyleHsp" style=""></span>&#62;&#160;1 en los varones&#46; La enfermedad polivascular se defini&#243; como el n&#250;mero total de territorios vasculares afectados &#40;coronario&#44; cerebrovascular o perif&#233;rico&#41;&#44; con independencia del tiempo transcurrido e incluido el evento &#237;ndice&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se calcul&#243; el riesgo cardiovascular de cada paciente mediante las funciones de riesgo cardiovascular de Framingham<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">15</span></a>&#44; REGICOR<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">17</span></a> y SCORE &#40;eventos mortales y no mortales en pa&#237;ses de bajo riesgo&#41;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a> publicadas originalmente&#46; Las estimaciones de la funci&#243;n de riesgo SCORE se multiplicaron por 3 y 5 en los varones y las mujeres con diabetes&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">20</span></a>&#46; Tambi&#233;n se obtuvieron las funciones REACH<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a> y Bohula-TIMI &#40;B-TIMI&#41;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">18</span></a> y la puntuaci&#243;n SMART<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">12</span></a>&#44; dise&#241;adas para calcular el riesgo de eventos aterotromb&#243;ticos recurrentes&#46; El estudio se llev&#243; a cabo de conformidad con la Declaraci&#243;n de Helsinki y fue aprobado por el Comit&#233; de &#201;tica del Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Las variables continuas de distribuci&#243;n normal se describieron mediante medias y desviaciones est&#225;ndar y el resto mediante medianas e intervalos intercuart&#237;licos&#46; Las variables discretas se presentan en forma de recuentos y porcentajes&#46; Las diferencias en las variables continuas se analizaron con un ANOVA de una v&#237;a cuando se cumpl&#237;an los supuestos de normalidad y homocedasticidad&#44; y con la prueba de Kruskal-Wallis cuando no se cumpl&#237;an estos supuestos&#46; En caso necesario&#44; despu&#233;s del ANOVA o la prueba de Kruskal-Wallis se realizaron comparaciones emparejadas con las pruebas de Tukey-Kramer y Dunn&#44; respectivamente&#46; La homogeneidad entre proporciones se analiz&#243; mediante la prueba &#967;<span class="elsevierStyleSup">2</span> de Pearson o la prueba exacta de Fisher&#44; seg&#250;n procediera&#46; Las diferencias en la proporci&#243;n del tipo de evento nuevo entre los grupos se basaron en las estimaciones de modelos multinomiales univariados&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se calcul&#243; la funci&#243;n de riesgo acumulada de Nelson-Aalen correspondiente a la cohorte completa y para cada tipo de evento &#237;ndice&#46; Se representaron gr&#225;ficamente las funciones de supervivencia de Kaplan-Meier para cada nivel de riesgo seg&#250;n los valores de corte habituales para cada funci&#243;n o puntuaci&#243;n de riesgo cardiovascular y se compararon mediante la prueba de Wilcoxon-Breslow-Gehan&#46; Se calcul&#243; la raz&#243;n de riesgos instant&#225;neos para cada variable mediante regresi&#243;n de Cox&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En los modelos multivariados se incluyeron las variables asociadas a un evento nuevo en el an&#225;lisis univariado &#40;p&#160;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;15&#41; y las que se consideraron relevantes con independencia del valor de p&#46; Los modelos multivariados que inclu&#237;an funciones o puntuaciones de riesgo no se ajustaron respecto a variables ya incluidas en su c&#225;lculo&#46; El rendimiento global del modelo se evalu&#243; mediante la R<span class="elsevierStyleSup">2</span> de Nagelkerke ajustada al m&#225;ximo valor alcanzable&#46; Los valores de &#237;ndice C de Harrell se compararon con un m&#233;todo basado en el estad&#237;stico D de Somers&#44; seg&#250;n lo propuesto por Newson<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">21</span></a>&#46; El supuesto de riesgos proporcionales se evalu&#243; con las pruebas de Grambusch y Therneau y la calibraci&#243;n mediante las pruebas &#243;mnibus de Gr&#248;nnesby y Borgan&#46; Todos los modelos cumplieron la suposici&#243;n de proporcionalidad y mostraron una calibraci&#243;n aceptable&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se construy&#243; un modelo b&#225;sico &#40;&#171;conjunto cl&#225;sico&#187;&#41; con 6 factores de riesgo cardiovascular tradicionales &#40;sexo&#44; edad&#44; colesterol total&#44; hipertensi&#243;n arterial&#44; tabaquismo y diabetes&#41; y se analiz&#243; si la adici&#243;n de nuevas variables mejor&#243; su rendimiento en cuanto a capacidad discriminativa y reclasificaci&#243;n&#46; Se obtuvieron estimadores corregidos mediante <span class="elsevierStyleItalic">bootstrap</span> para el &#237;ndice de reclasificaci&#243;n neta &#40;IRN&#41;&#44; continuo &#40;cIRN&#41; y el categ&#243;rico &#40;cat-IRN&#41; utilizando la funci&#243;n de Kaplan-Meier<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">22&#44;23</span></a> para obtener la probabilidad de un evento al cabo de 5 a&#241;os&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">El an&#225;lisis de supervivencia se realiz&#243; con el programa inform&#225;tico STATA &#40;StataCorp&#46; 2017&#44; Stata Statistical Software&#58; Release 15&#46; College Station&#44; TX&#58; StataCorp LLC&#41;&#46; Los IRN se obtuvieron con el paquete nricens &#40;versi&#243;n 1&#46;6&#41; y se gener&#243; un modelo multinomial para calcular las diferencias entre los grupos en cuanto al tipo de evento nuevo mediante la funci&#243;n <span class="elsevierStyleItalic">multinom</span> del paquete nnet &#40;versi&#243;n 4&#46;3-14&#41;&#44; elaborados ambos para R &#40;versi&#243;n 3&#46;6&#46;0&#41;&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Caracter&#237;sticas iniciales</span><p id="par0075" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se muestran las variables basales&#44; algunas de las cuales ya se han descrito<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">19</span></a>&#46; Brevemente&#44; la edad media fue de 60 &#40;DE 8&#44;1&#41; a&#241;os&#46; La proporci&#243;n de mujeres fue mayor en el grupo cerebrovascular&#46; En el grupo de AP hubo un mayor porcentaje de fumadores activos&#44; una mayor concentraci&#243;n de c-LDL&#44; una menor concentraci&#243;n de c-HDL&#44; una mayor prevalencia de diabetes y un peor control de la glucemia&#46; El 64&#37; de los pacientes hab&#237;a sufrido uno o m&#225;s eventos vasculares previos antes del evento &#237;ndice y el 19&#44;7&#37; presentaba 2 o 3 territorios vasculares afectados&#46; La prevalencia de albuminuria fue similar en los distintos grupos&#44; aunque notablemente mayor entre los pacientes diab&#233;ticos &#40;26&#44;9 frente al 9&#44;5&#37;&#41;&#46; Globalmente&#44; las funciones y puntuaciones de Framingham&#44; SCORE&#44; B-TIMI y SMART clasificaron a m&#225;s del 25&#37; de los pacientes en el grupo de riesgo alto&#44; siendo este porcentaje significativamente mayor &#40;&#62;&#160;50&#37;&#41; en el grupo de AP &#40;<a class="elsevierStyleCrossRef" href="#sec0070">ver material suplementario</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">An&#225;lisis de supervivencia</span><p id="par0080" class="elsevierStylePara elsevierViewall">Durante una mediana de seguimiento de 4&#44;82 a&#241;os &#40;p25-p75&#58; 4&#44;1-5&#44;4&#41; se observaron 61 eventos &#40;22&#44;7&#37;&#41;&#46; Se produjeron 6 p&#233;rdidas de seguimiento &#40;una por cambio de residencia y 5 por abandono tras un diagn&#243;stico de neoplasia&#41;&#46; La tasa de incidencia fue de 5&#44;2 eventos por 100 a&#241;os-persona en la cohorte completa&#44; significativamente mayor en el grupo de AP &#40;9&#44;9 por 100 a&#241;os-persona&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41;&#46; La tasa de riesgo acumulado al cabo de 5 a&#241;os fue del 24&#44;2&#37; en la cohorte &#237;ntegra y del 42&#37; en el grupo de AP&#46; Los pacientes mostraron propensi&#243;n a experimentar el nuevo evento en el mismo territorio vascular que el evento &#237;ndice&#46; Los pacientes del grupo de AP tambi&#233;n tuvieron un mayor riesgo de presentar un evento coronario que los del grupo cerebrovascular &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Los modelos de Cox univariados indicaron que la diabetes&#44; el tabaquismo activo y la concentraci&#243;n de colesterol total aumentaron el riesgo de presentar un nuevo evento &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a><a class="elsevierStyleCrossRef" href="#sec0070">Ver tabla 2 completa en material suplementario</a>&#41;&#46; En comparaci&#243;n con el grupo coronario&#44; &#250;nicamente el de AP present&#243; un mayor riesgo&#46; De manera an&#225;loga&#44; la albuminuria&#44; la enfermedad polivascular&#44; un &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;&#160;0&#44;9&#44; la fibrilaci&#243;n auricular y la insuficiencia card&#237;aca se asociaron a un riesgo entre 2 y 3 veces superior &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Los pacientes del grupo de riesgo alto seg&#250;n la definici&#243;n de cualquiera de las FRP y F&#47;PRS tuvieron un riesgo entre 2 y 3 veces mayor de presentar un nuevo evento&#44; respectivamente&#44; que los del grupo de riesgo bajo &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a> y <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 2</a> se incluye el modelo 0 &#40;conjunto cl&#225;sico&#41;&#44; el modelo 1 &#40;modelo 0 m&#225;s las variables seleccionadas despu&#233;s del an&#225;lisis univariado&#41; y los modelos 2 a 7&#44; modelos multivariados correspondientes a las funciones o puntuaciones de Framingham&#44; REGICOR&#44; SCORE&#44; SMART&#44; REACH y B-TIMI&#44; m&#225;s las variables seleccionadas que no estuvieran ya incluidas en la f&#243;rmula de la funci&#243;n o puntuaci&#243;n&#46; En el modelo 1&#44; la diabetes&#44; la enfermedad polivascular&#44; la albuminuria y la insuficiencia card&#237;aca siguieron siendo factores predictivos independientes de recurrencia&#46; Tras el ajuste respecto a la enfermedad polivascular&#44; la albuminuria&#44; el &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;&#160;0&#44;9&#44; la fibrilaci&#243;n auricular&#44; la insuficiencia card&#237;aca y el tipo de evento &#237;ndice&#44; el coeficiente correspondiente a las categor&#237;as de riesgo alto de las funciones de Framingham&#44; REGICOR y SCORE disminuy&#243; un 68&#44; 78 y 86&#37;&#44; respectivamente&#46; No se observaron estas variaciones en los modelos REACH y B-TIMI tras el ajuste&#46; Seg&#250;n la R<span class="elsevierStyleSup">2</span> ajustada&#44; la proporci&#243;n de la varianza explicada por cualquiera de los modelos de regresi&#243;n oscil&#243; entre el 8 y el 17&#37;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Capacidad discriminativa y reclasificaci&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran los &#237;ndices C de Harrell correspondientes a cada modelo y las diferencias entre las versiones uni y multivariada de cada uno de ellos&#46; El modelo que inclu&#237;a 6 factores de riesgo cl&#225;sicos tuvo una capacidad discriminativa similar al de las versiones uni y multivariada de los modelos que inclu&#237;an funciones o puntuaciones de riesgo&#46; Las F&#47;PRS tuvieron una capacidad discriminativa algo mayor que las FRP cuando se consideraron por s&#237; solas&#46; De entre las F&#47;PRS y las FRP&#44; las m&#225;s discriminativas fueron B-TIMI y Framingham-Wilson&#44; respectivamente&#46; Se produjo una mejora moderada de la capacidad discriminativa al incluir la albuminuria y la enfermedad polivascular en el modelo multivariado o cuando ya formaban parte de la propia funci&#243;n&#47;escala de riesgo&#46; Los &#237;ndices C de Harrell de los modelos multivariados fueron similares&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> muestra la mejora de la capacidad discriminativa y la reclasificaci&#243;n al a&#241;adir nuevas variables al modelo &#171;conjunto cl&#225;sico&#187;&#46; Tras la adici&#243;n de la albuminuria y la enfermedad polivascular se observ&#243; una mejora moderada de la capacidad discriminativa y un aumento leve del c-IRN&#44; debido principalmente al grupo sin nuevos eventos&#46; Esta mejora no se observ&#243; en el cat-IRN &#40;valor de corte del 20&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discusi&#243;n</span><p id="par0105" class="elsevierStylePara elsevierViewall">Los pacientes con enfermedad cardiovascular establecida clasificados en los grupos de riesgo alto seg&#250;n las funciones y puntuaciones de Framingham&#44; REGICOR&#44; SCORE&#44; SMART&#44; REACH y B-TIMI calculadas a partir de las variables medidas en el momento del &#250;ltimo evento presentaron un mayor riesgo de presentar un nuevo evento&#46; Este mayor riesgo ya se ha descrito con las funciones de Framingham<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">24</span></a> y SCORE<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">25</span></a> en pacientes con enfermedad coronaria&#46; La prevalencia de factores de riesgo cl&#225;sicos en cada grupo y el peor perfil de riesgo en los pacientes con AP coinciden con los resultados de cohortes nacionales contempor&#225;neas<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">26&#8211;28</span></a>&#46; El grupo de AP tambi&#233;n cont&#243; con la mayor proporci&#243;n de pacientes clasificados en el grupo de riesgo alto&#46; La incidencia acumulada de recurrencia al cabo de 5 a&#241;os fue el doble de la observada en los grupos coronario o cerebrovascular&#44; tambi&#233;n concordante con lo ya publicado en relaci&#243;n con cohortes de pacientes que incluyeron un solo tipo de evento<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">7&#44;29</span></a> y mixtas<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">30</span></a>&#46; Recientemente se ha efectuado una revisi&#243;n sistem&#225;tica de este mayor&#44; aunque a menudo ignorado&#44; riesgo de recurrencia en los pacientes con AP<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Previamente publicamos que la microalbuminuria se asocia estrechamente a la presencia de lesiones vasculares ocultas en pacientes con eventos previos<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">32</span></a>&#44; afectando a una cuarta parte de aquellos con s&#237;ndrome coronario agudo<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">33</span></a>&#44; con independencia de la existencia de diabetes&#46; Nuestros resultados respaldan el papel independiente de la albuminuria<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">34</span></a> y la enfermedad polivascular<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">7&#44;35</span></a> en el riesgo de presentar un nuevo evento&#46; Aunque en algunas puntuaciones&#44; como GRACE y SMART&#44; ya se incluyen variables relacionadas con la extensi&#243;n de la enfermedad ateroescler&#243;tica&#44; muchas de ellas no son f&#225;ciles de obtener&#46; Los cambios en el coeficiente correspondiente a las FRP tras la introducci&#243;n de la albuminuria y la enfermedad polivascular&#44; no observados en las F&#47;PRS que ya incluyen alguna de ellas&#44; respaldan la relevancia de estas variables a efectos de predicci&#243;n del riesgo&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La capacidad discriminativa de los modelos que inclu&#237;an alguna de las funciones o puntuaciones de riesgo fue bastante escasa&#44; especialmente la de aquellos basados en FRP&#44; aunque fueron concordantes con estimaciones procedentes de estudios en los que se agrup&#243; una proporci&#243;n similar de eventos de referencia&#46; Uthoff et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a> tambi&#233;n observaron una mayor capacidad discriminativa de la puntuaci&#243;n SMART &#40;AUC&#58; 0&#44;67 &#91;0&#44;54-0&#44;77&#93;&#41; que de las funciones de Framingham &#40;AUC&#58; 0&#44;56 &#91;0&#44;43-0&#44;69&#93;&#41; y SCORE &#40;AUC&#58; 0&#44;6 &#91;0&#44;46-0&#44;73&#93;&#41;&#46; Kaasenbrood et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">6</span></a> obtuvieron un &#237;ndice C de Harrell de 0&#44;64 &#40;IC 95&#37;&#58; 0&#44;63-0&#44;65&#41; para la puntuaci&#243;n SMART recalibrada y Dorresteijn et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a> obtuvieron estimaciones similares &#40;C de Harrell&#58; 0&#44;683 &#91;0&#44;650-0&#44;717&#93;&#41; en una cohorte mixta&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Seg&#250;n nuestros resultados&#44; la puntuaci&#243;n SMART no tiene un rendimiento significativamente mejor que la TIMI cuando se utiliza sola o en modelos multivariados&#46; Adem&#225;s&#44; su rendimiento fue similar al de las funciones de Framingham&#44; REGICOR o SCORE cuando en el modelo multivariado se tuvo en cuenta de alg&#250;n modo la extensi&#243;n de la enfermedad ateroescler&#243;tica&#46; El rendimiento discriminativo del modelo para el &#171;conjunto cl&#225;sico&#187; fue bajo&#44; pero similar al observado en pacientes semejantes<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a>&#44; con una mejora moderada del &#237;ndice C de Harrell despu&#233;s de a&#241;adir nuevas variables al modelo&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Los resultados contradictorios de cat-IRN y cIRN indican que las variaciones de las probabilidades te&#243;ricas&#44; principalmente en los pacientes sin eventos&#44; no son lo bastante notables como para reclasificar correctamente a los pacientes por encima o por debajo del umbral&#46; Ace&#241;a et al&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">24</span></a> comunicaron un cat-IRN de 0&#44;097 &#40;0&#44;096&#59; 0&#44;098&#41; tras a&#241;adir la puntuaci&#243;n de Framingham a un modelo que ya inclu&#237;a la hipertensi&#243;n arterial y el &#237;ndice de masa corporal&#44; mientras que Van den Berg et al&#46; comunicaron que la enfermedad polivascular fue el &#250;nico factor individual que mejor&#243; la reclasificaci&#243;n &#40;cat-IRN&#58; 0&#44;032 &#91;0&#44;014&#59; 0&#44;051&#93;&#41; en ambas cohortes&#44; REACH y SMART&#44; al a&#241;adirla a los criterios de riesgo muy alto del ACC&#47;AHA<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Existe una conciencia cada vez mayor de la necesidad de estratificar el riesgo para identificar a los pacientes con m&#225;s probabilidades de beneficiarse de un control m&#225;s intensivo de los factores de riesgo&#44; por ejemplo un objetivo de c-LDL<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1&#160;mmol&#47;l<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">36</span></a> y&#44; en particular&#44; del posible tratamiento con inhibidores de la PCSK-9<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">37</span></a>&#46; Consideramos que la enfermedad polivascular y la albuminuria ser&#237;an variables relevantes para este prop&#243;sito&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n de nuestro estudio radica en la falta de potencia estad&#237;stica&#44; especialmente importante en relaci&#243;n con el cIRN y el cat-IRN<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">38</span></a>&#46; En segundo lugar&#44; la cohorte AIRVAG es una cohorte mixta de pacientes con 3 tipos de eventos&#44; te&#243;ricamente con diferentes determinantes para la recurrencia&#46; No obstante&#44; y en consonancia con el concepto de riesgo vascular ateroescler&#243;tico global&#44; consideramos que era fundamental contrastar nuestra hip&#243;tesis en la cohorte &#237;ntegra&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En nuestros modelos&#44; la disminuci&#243;n de la funci&#243;n renal se bas&#243; en el cociente alb&#250;mina&#47;creatinina&#44; de forma que los pacientes con otros marcadores de da&#241;o renal o con un FG<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60&#160;ml&#47;min&#47;<span class="elsevierStyleHsp" style=""></span>1&#44;73&#160;m<span class="elsevierStyleSup">2</span>&#44; pero con un cociente alb&#250;mina&#47;creatinina<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>30&#160;mg&#47;g no estar&#237;an representados&#46; Entre las fortalezas del estudio destacamos la baja proporci&#243;n de pacientes perdidos durante el seguimiento &#40;2&#44;2&#37;&#41; y la uniformidad en la evaluaci&#243;n de las variables&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusiones</span><p id="par0145" class="elsevierStylePara elsevierViewall">Los pacientes del grupo de riesgo alto seg&#250;n cualquiera de las funciones o puntuaciones evaluadas tuvieron un mayor riesgo de recurrencia de eventos cardiovasculares&#46; Modelos tales como el REACH&#44; el B-TIMI y el SMART solo tienen una capacidad discriminativa algo mejor que las funciones de riesgo de Framingham&#44; REGICOR y SCORE&#46; Nuestros resultados subrayan la importancia de tener en cuenta el efecto combinado de los factores de riesgo cl&#225;sicos y otros marcadores de enfermedad&#44; como la albuminuria o la enfermedad polivascular&#44; en la identificaci&#243;n de los pacientes con un &#171;riesgo extremo&#187;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Financiaci&#243;n</span><p id="par0150" class="elsevierStylePara elsevierViewall">La selecci&#243;n y seguimiento de la cohorte AIRVAG fueron financiados por una beca del Instituto de Salud Carlos III &#40;beca FIS 00&#47;0412-03&#47;1570&#41; y por Sanofi Aventis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0155" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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            1 => "Modelos de riesgos proporcionales"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En la enfermedad cardiovascular ateroescler&#243;tica no existe consenso respecto a los instrumentos de estratificaci&#243;n del riesgo en su prevenci&#243;n secundaria&#46; Nuestro objetivo consist&#237;a en comparar la capacidad discriminativa de las funciones de riesgo de Framingham&#44; REGICOR&#44; SCORE y REACH y las puntuaciones de riesgo Bohula-TIMI y SMART&#44; as&#237; como en evaluar el posible valor a&#241;adido de otras variables cl&#237;nicas en cuanto a la predicci&#243;n de recurrencias en pacientes con enfermedad cardiovascular&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analiz&#243; una cohorte de 269 pacientes con enfermedad cardiovascular establecida &#40;52&#44;8&#37; coronaria&#44; 32&#37; cerebrovascular&#44; 15&#44;2&#37; arteriopat&#237;a perif&#233;rica&#41;&#46; Se compararon las funciones de supervivencia de los grupos de riesgo &#40;bajo&#47;intermedio&#47;alto&#41; seg&#250;n los valores de corte de uso habitual de cada funci&#243;n o puntuaci&#243;n y se calcularon las razones de riesgos instant&#225;neos &#40;RRI&#41; correspondientes a cada una mediante regresi&#243;n de Cox&#46; Se calcul&#243; el &#916; <span class="elsevierStyleSmallCaps">C</span> de Harrell&#44; el cat-IRN y el cIRN despu&#233;s de a&#241;adir nuevos factores predictivos a un modelo base que inclu&#237;a edad&#44; sexo&#44; colesterol total&#44; tabaquismo activo&#44; hipertensi&#243;n arterial y diabetes&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Al cabo de 6 a&#241;os de seguimiento &#40;mediana de 4&#44;82 a&#241;os&#41; se hab&#237;an producido 61 eventos &#40;23&#37;&#41;&#46; Los grupos de riesgo alto tuvieron un mayor riesgo de recurrencia&#58; SMART &#40;RRI&#58; 3&#44;17 &#91;1&#44;55-6&#44;5&#93;&#41;&#44; Framingham &#40;RRI&#58; 3&#44;08 &#91;1&#44;65-5&#44;75&#93;&#41;&#44; REGICOR &#40;RRI&#58; 2&#44;71 &#91;1&#44;39-5&#44;27&#93;&#41;&#44; SCORE &#40;RRI&#58; 2&#44;14 &#91;1&#44;01-4&#44;5&#93;&#44; REACH &#40;RRI&#58; 5&#44;74 &#91;2&#44;83-11&#44;7&#93;&#41; y B-TIMI &#40;RRI&#58; 3&#44;68 &#91;0&#44;88-15&#44;3&#93;&#41;&#46; La enfermedad polivascular &#40;3 territorios&#44; RRI&#58; 5&#44;6 &#91;2&#44;2-14&#44;25&#93;&#41;&#44; la albuminuria &#40;RRI&#58; 3&#44;55 &#91;2&#44;06-6&#44;11&#93;&#41; y la insuficiencia card&#237;aca &#40;RRI&#58; 3&#44;11 &#91;1&#44;34-7&#44;25&#93;&#41; tambi&#233;n incrementaron el riesgo&#46; La capacidad discriminativa &#40;&#237;ndice C de Harrell&#41; fue baja&#44; pero mejor&#243; tras a&#241;adir la albuminuria y la enfermedad polivascular&#46; Ambas variables tambi&#233;n mejoraron el rendimiento del modelo base &#40;cIRN&#58; 0&#44;326 &#91;0&#44;036&#59; 0&#44;607&#93;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las funciones de Framingham&#44; REGICOR&#44; SCORE y REACH y las puntuaciones B-TIMI y SMART mostraron un rendimiento bajo&#44; aunque similar&#44; en prevenci&#243;n secundaria&#46; La albuminuria y la enfermedad polivascular mejoraron el rendimiento predictivo de los principales factores de riesgo cardiovascular cl&#225;sicos&#46;</p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and aims</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">There is no consensus regarding risk stratification tools for secondary prevention in atherosclerotic cardiovascular disease&#46; Our aim was to compare the discriminative performance of the Framingham&#44; REGICOR&#44; SCORE&#44; and REACH risk functions and the Bohula-TIMI and SMART risk scores&#44; as well as to assess the potential added value of other clinical variables for the prediction of recurrent events in patients with established vascular disease&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A cohort of 269 patients with established vascular disease &#40;52&#46;8&#37; coronary&#44; 32&#37; cerebrovascular&#44; 15&#46;2&#37; peripheral artery disease&#41; was included&#46; The survival functions of risk groups &#40;low&#47;medium&#47;high&#41; according to commonly used cutoff points for each function&#47;score were compared&#44; and hazard ratios &#40;HR&#41; for each were estimated using Cox regression&#46; We calculated &#916; Harrell&#39;s C statistic&#44; cat-NRI&#44; and cNRI after adding new predictors to a base model including age&#44; sex&#44; total cholesterol&#44; current smoking status&#44; hypertension&#44; and diabetes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">After 6 years of follow-up &#40;median 4&#46;82 years&#41;&#44; 61 events occurred &#40;23&#37;&#41;&#46; High-risk groups had a higher risk of recurrent event&#58; SMART &#40;HR&#58; 3&#46;17 &#91;1&#46;55-6&#46;5&#93;&#41;&#44; Framingham &#40;HR&#58; 3&#46;08 &#91;1&#46;65-5&#46;75&#93;&#41;&#44; REGICOR &#40;HR&#58; 2&#46;71 &#91;1&#46;39-5&#46;27&#93;&#41;&#44; SCORE &#40;HR&#58; 2&#46;14 &#91;1&#46;01-4&#46;5&#93;&#44; REACH &#40;HR&#58; 5&#46;74 &#91;2&#46;83-11&#46;7&#93;&#41;&#44; B-TIMI &#40;HR&#58; 3&#46;68 &#91;0&#46;88-15&#46;3&#93;&#41;&#46; Polyvascular disease &#40;3 territories HR&#58; 5&#46;6 &#91;2&#46;2-14&#46;25&#93;&#41;&#44; albuminuria &#40;HR&#58; 3&#46;55 &#91;2&#46;06-6&#46;11&#93;&#41;&#44; and heart failure &#40;HR&#58; 3&#46;11 &#91;1&#46;34-7&#46;25&#93;&#41; also increased risk&#46; Discrimination &#40;Harrell&#39;s C&#41; was low but improved after adding albuminuria and polyvascular disease&#46; Both variables also improved the performance of the base model &#40;cNRI&#58; 0&#46;326 &#91;0&#46;036&#59; 0&#46;607&#93;&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The Framingham&#44; REGICOR&#44; SCORE&#44; and REACH functions and the B-TIMI and SMART scores showed low yet similar performance in secondary prevention&#46; Albuminuria and polyvascular disease improved the predictive performance of major classical cardiovascular risk factors&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Background and aims"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Methods"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
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      0 => array:3 [
        "etiqueta" => "&#9674;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0070">El resto de los componentes del grupo AIRVAG est&#225;n mencionados en el anexo&#46;</p>"
        "identificador" => "fn0005"
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      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0175" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Anexo A"
            "titulo" => "Material adicional"
            "identificador" => "sec0070"
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        ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curvas de supervivencia de Kaplan-Meier correspondientes a la estratificaci&#243;n del riesgo seg&#250;n los valores de corte habituales&#46; &#40;A&#41; Framingham&#44; &#40;B&#41; REGICOR&#44; &#40;C&#41; SCORE&#44; &#40;D&#41; SMART&#44; &#40;E&#41; B-TIMI y &#40;F&#41; REACH&#46;</p>"
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        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">HbA<span class="elsevierStyleInf">1c</span>&#58; hemoglobina glucosilada&#59; HDL&#58; lipoprote&#237;nas de alta densidad&#59; IMC&#58; &#237;ndice de masa corporal&#59; ITB&#58; &#237;ndice tobillo&#47;brazo&#59; LDL&#58; lipoprote&#237;nas de baja densidad&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Los valores se presentan en forma de frecuencia &#40;porcentaje&#41;&#44; media &#40;desviaci&#243;n est&#225;ndar&#41; o mediana y l&#237;mites del intervalo intercuart&#237;lico &#91;del percentil 25 al 75&#93;&#44; seg&#250;n proceda&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleItalic">Colesterol LDL &#40;mmol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Colesterol HDL &#40;mmol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Triglic&#233;ridos &#40;mmol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;0102<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Presi&#243;n arterial sist&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;069&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="elsevierStyleItalic">Presi&#243;n arterial diast&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">79 &#40;11&#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="elsevierStyleItalic">Hipertensi&#243;n arterial</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">168 &#40;62&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">85 &#40;60&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;380&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diabetes</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">HbA</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">1c</span></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#62;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">7&#37;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">28 &#40;38&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Creatinina s&#233;rica &#40;&#956;mol&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">95&#44;5 &#91;84&#44;4&#44; 105&#44;2&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cociente</span><span class="elsevierStyleItalic">alb&#250;mina&#47;creatinina</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;73 &#91;0&#44;42&#44; 2&#44;01&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39 &#40;14&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;19&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#706;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;138<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Un territorio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dos territorios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tres territorios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Recurrencia &#40;tipo de evento&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronario&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cerebrovascular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><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"><span class="elsevierStyleItalic">P&#233;rdida para el seguimiento y abandonos</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;367<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Incidencia acumulada&#37; &#40;IC 95&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&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</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">24&#44;2 &#40;18&#44;5-31&#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">22&#44;9 &#40;14&#44;2-37&#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">42&#44;1 &#40;24&#44;8-71&#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="" valign="\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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">Univariado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="8" align="center" valign="\n
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                  \t\t\t\t" scope="col">Multivariado</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&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">Modelo 0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 2Framingham-Wilson&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 3REGICOR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 4SCORE<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 5SMART&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">Modelo 6REACH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Modelo 7B-TIMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><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">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#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">RRI &#40;IC95&#37;&#41;&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">Edad &#40;intervalos de 5 a&#241;os&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;15 &#40;0&#44;97-1&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;18 &#40;0&#44;98-1&#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">1&#44;06 &#40;0&#44;88-1&#44;28&#41;&nbsp;\t\t\t\t\t\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><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><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><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><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><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">Sexo &#40;Ref&#46; mujeres&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;94 &#40;0&#44;51-1&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9 &#40;0&#44;48-1&#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;72 &#40;0&#44;37-1&#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="" 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><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><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><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><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><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">Fumadores activos&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;97 &#40;1&#44;11-3&#44;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;81 &#40;0&#44;91-3&#44;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;57 &#40;0&#44;76-3&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" 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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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">CT &#40;&#916; de 0&#44;26&#160;mmol&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;05 &#40;0&#44;99-1&#44;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">1&#44;03 &#40;0&#44;96-1&#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&#44;03 &#40;0&#44;96-1&#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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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">c-LDL &#40;&#916; de 0&#44;26&#160;mmol&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;04 &#40;0&#44;97-1&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" 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><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><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><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><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><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><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><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">c-HDL &#40;&#916; de 0&#44;13&#160;mmol&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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 &#40;0&#44;89-1&#44;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="" 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><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><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><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><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><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><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><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">Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;63 &#40;0&#44;92-2&#44;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;16 &#40;0&#44;6-2&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;76 &#40;0&#44;38-1&#44;53&#41;&nbsp;\t\t\t\t\t\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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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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">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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;55 &#40;1&#44;54-4&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;45 &#40;1&#44;39-4&#44;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&#44;13 &#40;1&#44;15-3&#44;94&#41;&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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">Obesidad &#40;IMC &#8805;&#160;30&#160;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;96 &#40;0&#44;56-1&#44;64&#41;&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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><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><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">Enfermedad polivascular&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\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><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><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><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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Dos territorios</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;35 &#40;0&#44;69-2&#44;64&#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="" 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  " 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  " align="left" valign="\n
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                  \t\t\t\t">0&#44;97 &#40;0&#44;49-1&#44;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Tres territorios</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">5&#44;6 &#40;2&#44;2-14&#44;25&#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">3&#44;25 &#40;1&#44;07-9&#44;89&#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">3&#44;89 &#40;1&#44;36-11&#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">3&#44;71 &#40;1&#44;32-10&#44;42&#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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;03 &#40;1&#44;42-11&#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  " align="left" valign="\n
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                  \t\t\t\t">3&#44;29 &#40;1&#44;18-9&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Albuminuria<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">a</span></a>&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">3&#44;55 &#40;2&#44;06-6&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;54 &#40;1&#44;32-4&#44;87&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;55 &#40;1&#44;39-4&#44;68&#41;&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">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;75 &#40;1&#44;54-4&#44;91&#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">&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">ITB &#8804;&#160;0&#44;9 &#40;en cualquier lado&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;38 &#40;0&#44;71-2&#44;68&#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">1&#44;35 &#40;0&#44;7-2&#44;63&#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">1&#44;45 &#40;0&#44;76-2&#44;79&#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">1&#44;42 &#40;0&#44;75-2&#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">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;37 &#40;0&#44;75-2&#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">1&#44;55 &#40;0&#44;84-2&#44;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Antecedentes de fibrilaci&#243;n auricular&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  " align="left" valign="\n
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                  \t\t\t\t">1&#44;73 &#40;0&#44;74-4&#44;04&#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">1&#44;58 &#40;0&#44;69-3&#44;65&#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">1&#44;58 &#40;0&#44;68-3&#44;67&#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">1&#44;64 &#40;0&#44;71-3&#44;78&#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="" valign="\n
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;19 &#40;1-4&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Insuficiencia card&#237;aca&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">3&#44;11 &#40;1&#44;34-7&#44;25&#41;&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><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">2&#44;62 &#40;1&#44;05-6&#44;55&#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">3&#44;02 &#40;1&#44;21-7&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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&#44;91 &#40;1&#44;16-7&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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 &#40;1&#44;26-7&#44;63&#41;&nbsp;\t\t\t\t\t\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
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&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="" 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
                  \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">Evento &#237;ndice&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
                  \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
                  \t\t\t\t</td><td class="td" title="\n
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                  \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
                  \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
                  \t\t\t\t</td><td class="td" title="\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
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">IC 95&#37;&#58; intervalo de confianza al 95&#37;&#59; REACH&#58; REduction of Atherothrombosis for Continued Health Registry&#59; REGICOR&#58; Registre GiRonI del Cor&#59; SCORE&#58; Systematic COronary Risk Evaluation&#59; SMART&#58; Second Manifestations of ARTerial disease&#59; TIMI&#58; Thrombolysis In Myocardial Infarction-Grupo del estudio TIMI&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cohorte &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>264&#41;</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Univariado<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#916; C de Harrell &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t">Cl&#225;sico&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</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;028 &#40;&#8722;0&#44;023&#59; 0&#44;079&#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;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Framingham-Wilson&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;085 &#40;0&#44;012&#59; 0&#44;158&#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;023&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">REGICOR&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">SCORE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;092 &#40;0&#44;023&#59; 0&#44;161&#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">0&#44;149&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">REACH<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">d</span></a>&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</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;666 &#40;0&#44;6-0&#44;732&#41;&nbsp;\t\t\t\t\t\t\n
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            0 => array:3 [
              "identificador" => "tblfn0040"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">El modelo univariado incluye la variable con estratificaci&#243;n del riesgo &#40;3 niveles&#41; seg&#250;n la funci&#243;n de riesgo o los valores de corte habituales de la puntuaci&#243;n&#44; excepto el modelo cl&#225;sico&#44; que incluye edad&#44; sexo&#44; colesterol total&#44; hipertensi&#243;n arterial&#44; tabaquismo y diabetes&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0045"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Las versiones multivariadas de los modelos cl&#225;sicos&#44; Framingham-Wilson&#44; REGICOR y SCORE&#44; tambi&#233;n se ajustaron respecto a albuminuria&#44; enfermedad polivascular&#44; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular&#44; insuficiencia card&#237;aca y tipo de evento &#237;ndice&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0050"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0050">El modelo multivariado SMART se ajust&#243; respecto al tipo de evento &#237;ndice&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0055"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0055">El modelo multivariado REACH se ajust&#243; respecto a albuminuria&#44; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9 y tipo de evento &#237;ndice&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0060"
              "etiqueta" => "e"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0060">El modelo multivariado B-TIMI se ajust&#243; respecto a enfermedad polivascular&#44; ITB<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular y tipo de evento &#237;ndice&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Variaci&#243;n del &#237;ndice C de Harrell con la adici&#243;n de nuevos factores predictivos al modelo univariado en relaci&#243;n con cada funci&#243;n o puntuaci&#243;n de riesgo</p>"
        ]
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            "identificador" => "at4"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">cIRN&#58; &#237;ndice de reclasificaci&#243;n neta continuo&#59; cat-IRN&#58; &#237;ndice de reclasificaci&#243;n neta categ&#243;rico&#59; IC 95&#37;&#58; intervalo de confianza al 95&#37;&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Cl&#225;sico &#40;conjunto A&#41;&#58; edad&#44; sexo&#44; tabaquismo activo&#44; colesterol total &#40;con ajuste a 0&#44;26&#160;mmol&#47;l&#41;&#44; hipertensi&#243;n arterial y diabetes&#46; Conjunto B&#58; albuminuria y enfermedad polivascular&#46; Conjunto C&#58; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular&#44; insuficiencia card&#237;aca congestiva y tipo de evento &#237;ndice&#46; Conjunto D&#58; &#237;ndice tobillo&#47;brazo<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#44; fibrilaci&#243;n auricular&#44; insuficiencia card&#237;aca congestiva&#44; tipo de evento &#237;ndice&#44; albuminuria y enfermedad polivascular&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">C de Harrell &#40;IC 95&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#916; C de Harrell &#40;IC 95&#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">cIRN con evento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">cIRN sin eventos&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">cat-IRN &#40;20&#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">cat-IRN con evento&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">cat-IRN sin eventos&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">Cl&#225;sico &#40;A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;701 &#40;0&#44;633-0&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&nbsp;\t\t\t\t\t\t\n
                  \t\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">-&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">Cl&#225;sico<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>B&nbsp;\t\t\t\t\t\t\n
                  \t\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;72 &#40;0&#44;649-0&#44;791&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;017 &#40;&#8722;0&#44;026&#59;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;326 &#40;0&#44;036&#59;0&#44;607&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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">&#8722;0&#44;02 &#40;&#8722;0&#44;29&#59;0&#44;239&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;346 &#40;0&#44;215&#59;0&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;027 &#40;&#8722;0&#44;1&#59;0&#44;156&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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">&#8722;0&#44;038 &#40;&#8722;0&#44;155&#59;0&#44;074&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;064 &#40;0&#44;007&#59;0&#44;123&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Cl&#225;sico<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>C&nbsp;\t\t\t\t\t\t\n
                  \t\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;731 &#40;0&#44;663-0&#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;029 &#40;&#8722;0&#44;007&#59;0&#44;064&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;111&nbsp;\t\t\t\t\t\t\n
                  \t\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;397 &#40;0&#44;091&#59;0&#44;709&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;044 &#40;&#8722;0&#44;238&#59;0&#44;317&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;353 &#40;0&#44;234&#59;0&#44;478&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;029 &#40;&#8722;0&#44;078&#59;0&#44;129&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;019&#59; &#40;&#8722;0&#44;068&#59;0&#44;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">0&#44;01 &#40;&#8722;0&#44;038&#59;0&#44;061&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Cl&#225;sico<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>D&nbsp;\t\t\t\t\t\t\n
                  \t\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;735 &#40;0&#44;666-0&#44;803&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\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;033 &#40;&#8722;0&#44;015&#59;0&#44;081&#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">0&#44;18&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</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">0&#44;069 &#40;0&#44;015&#59;0&#44;131&#41;&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 00142565
Idioma original: Español
DOI:10.1016/j.rce.2021.01.008
Datos actualizados diariamente
año/Mes Html Pdf Total
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2022 Mayo 3 2 5
2022 Abril 3 2 5
2022 Marzo 5 12 17
2022 Febrero 5 2 7
2021 Diciembre 1 2 3
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