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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Atrial fibrillation &#40;AF&#41; is the most common arrhythmia worldwide&#44; and its prevalence increases with age&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a> AF is associated with increased mortality and the risk of a cerebrovascular event&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">2</span></a> Patients with AF are usually elderly&#44; have significant comorbidity and consume numerous drugs&#44; all of which cause them to be quite frail&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">3</span></a> Frailty is defined as an age-related condition characterized by reduced physiological reserve&#44; increased risk of disability&#44; loss of resistance and greater vulnerability to adverse events&#44; as manifested by increased morbidity and mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">4</span></a> In a retrospective study conducted at the University of Milan &#40;Italy&#41;&#44; which included 403 patients with AF&#44; 57&#37; were classified as frail&#44; 29&#37; were classified as prefrail&#44; and only 14&#37; were classified as not frail&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Sarcopenia is a syndrome characterized by a gradual and generalized loss of skeletal muscle mass and strength&#44; with the risk of presenting adverse effects such as physical disability&#44; deficient quality of life and increased mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">5</span></a> Sarcopenia is considered primary when there is no other apparent cause except for aging and is considered secondary when there are one or several other causes&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">AF increases the incidence of cognitive impairment&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">7</span></a> In the ONTARGET and TRANSCEND studies&#44; patients with AF had a greater risk of cognitive impairment and dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">8</span></a> This risk is greater the higher the score on the CHADS<span class="elsevierStyleInf">2</span> and CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scales&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> In a meta-analysis&#44; AF was associated with cognitive impairment in patients with and without a diagnosis of stroke&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of this study was to determine the prevalence of sarcopenia&#44; frailty and cognitive impairment in elderly patients with nonvalvular AF &#40;NVAF&#41; and their influence on survival&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This analysis is a substudy of the patients included in the NONAVASC registry&#44; an observational&#44; prospective&#44; multicenter study conducted in the internal medicine departments of 64 hospitals in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">11</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Inclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">Between October 2014 and May 2015&#44; each investigator consecutively included at least 10 patients older than 75<span class="elsevierStyleHsp" style=""></span>years hospitalized for any cause&#44; who had NVAF&#44; previously or diagnosed during hospitalization&#46; We considered NVAF the AF which appears in the absence of moderate-severe rheumatic mitral stenosis or valvular prosthesis&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">12</span></a> NVAF was classified as paroxysmal&#44; persistent or permanent according to the definition of the European Society of Cardiology guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Procedures</span><p id="par0035" class="elsevierStylePara elsevierViewall">The data collection was conducted using an anonymized online database&#44; which included sociodemographic&#44; clinical&#44; laboratory&#44; image&#44; therapeutic and outcome parameters&#46; The thrombotic and hemorrhagic risk at admission was assessed using the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">14</span></a> and HAS-BLED scales&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">15</span></a> respectively&#46; The assessment of the patient&#39;s social&#44; functional and cognitive state was performed at admission through a personal interview with the patient or their main caregiver&#46; Comorbidity was assessed with the Charlson index&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">16</span></a> the ability to perform basic activities of daily life was assessed with the Barthel index&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a> and cognitive impairment was assessed with the Short Portable Mental State Questionnaire&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">18</span></a> We considered the patient to have cognitive impairment when the number of errors on this questionnaire was &#8805;4&#46; Sarcopenia was assessed with the SARC-F scale<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> and was considered to be present when the score was &#8805;4&#46; Frailty was assessed with the FRAIL scale&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">20</span></a> and patients were considered frail when their score was &#8805;3<span class="elsevierStyleHsp" style=""></span>points&#46; We also recorded creatinine&#44; hemoglobin and platelet levels&#44; defining renal failure as an estimated glomerular filtration rate &#60;60<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#46; We recorded the number of drugs prescribed at discharge and the use of oral anticoagulants and subsequently conducted a 1-year follow-up&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The study was approved by the Ethics Committee for Clinical Research of University Hospital de la Princesa&#44; and all patients &#40;or their relatives in the event of cognitive impairment&#41; gave their written informed consent&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">The qualitative variables are presented as absolute frequencies and percentages&#44; and the quantitative variables are presented as mean and standard deviation&#46; The qualitative variables were compared using the chi-squared test&#44; applying the Yates correction or Fisher test when necessary&#46; The quantitative variables were compared using Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">To study the variables associated with mortality&#44; we constructed a Cox regression model&#46; We excluded the variables with colinearity and included the variables age&#44; sex&#44; scores on the Charlson index and CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc and HAS-BLED scales&#44; cognitive impairment&#44; frailty&#44; sarcopenia and the prescription of oral anticoagulants at discharge&#46; The multivariate analysis included all variables with statistical significance &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;1&#41; in the univariate analysis&#46; For the survival analysis&#44; we constructed Kaplan&#8211;Meier curves for the patients with 3 or fewer study conditions &#40;i&#46;e&#46;&#44; sarcopenia&#44; frailty and cognitive impairment&#41;&#46; We compared the curves with the log-rank test&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In all cases&#44; the level of statistical significance is established for a value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The statistical analysis was performed using the SPSS v22&#46;0 program&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the flow diagram for patient inclusion&#46; Of the 697 initial patients&#44; we lost 101 &#40;14&#46;5&#37;&#41; during the follow-up&#46; The lost patients had lower comorbidity as measured by the Charlson index&#44; had been hospitalized less in the past year&#44; consumed fewer drugs and were prescribed fewer oral anticoagulants at discharge&#46; There were no differences in the other characteristics or in the prevalence of sarcopenia&#44; frailty and cognitive impairment&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">We ultimately included 596 patients with a mean age of 84&#46;9 &#40;5&#46;2&#41; years&#44; 315 &#40;52&#46;9&#37;&#41; of whom were women&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the characteristics of patients included in the study&#46; The mean score on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc and HAS-BLED scales was 5&#46;3 &#40;1&#46;4&#41; and 2&#46;7 &#40;1&#46;2&#41;&#44; respectively&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the prevalence of sarcopenia&#44; frailty and cognitive impairment&#46; These conditions were frequently associated&#59; 436 &#40;73&#46;1&#37;&#41; patients presented 1 of the conditions&#44; and 136 &#40;22&#46;8&#37;&#41; patients presented 3&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Sarcopenia</span><p id="par0075" class="elsevierStylePara elsevierViewall">Sarcopenia was present in 295 &#40;49&#46;5&#37;&#41; patients&#44; who were older&#44; more often women and less frequently had excess weight or obesity&#46; Cerebrovascular disease was more common in these patients&#44; and they had higher scores on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale but not on the HAS-BLED&#46; At discharge&#44; they were prescribed oral anticoagulants less frequently &#40;49&#46;3&#37; vs&#46; 58&#46;7&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Their ability to perform basic activities of daily life as measured with the Barthel index was lower&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Frailty</span><p id="par0080" class="elsevierStylePara elsevierViewall">Frailty was present in 305 &#40;51&#46;2&#37;&#41; patients&#44; who were more often female&#44; had more comorbidity measured with the Charlson index and had higher scores on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc and HAS-BLED scales&#46; The patients more often had a history of cerebrovascular disease&#44; kidney failure and hemorrhaging&#44; and their ability to perform daily life activities was lower &#40;Barthel index&#44; 56 vs&#46; 78&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The prescription of oral anticoagulants at discharge was lower for the frail patients &#40;44&#46;9&#37; vs&#46; 54&#46;0&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;027&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Cognitive impairment</span><p id="par0085" class="elsevierStylePara elsevierViewall">Cognitive impairment was present in 251 &#40;42&#46;1&#37;&#41; patients&#44; who were older&#44; scored lower on the Barthel index&#44; were more frequently female and had cerebrovascular disease and peripheral embolism&#46; They less frequently had obesity or excess weight&#44; heart failure and a history of hemorrhaging&#46; They scored higher on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale but not on the HAS-BLED scale&#46; At discharge&#44; these patients were prescribed oral anticoagulants less often &#40;38&#46;2&#37; vs&#46; 57&#46;4&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Survival</span><p id="par0090" class="elsevierStylePara elsevierViewall">At the end of 1 year&#44; 226 &#40;37&#46;9&#37;&#41; patients had died&#46; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> shows the Kaplan&#8211;Meier survival curves&#44; with shorter survival for the patients with sarcopenia &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A&#41;&#44; frailty &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>B&#41; and cognitive impairment &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>C&#41;&#46; Mortality was higher the more of these conditions the patient presented &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>D&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The factors associated with mortality at the end of 1 year are listed in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; In the univariate analysis&#44; mortality was associated with sarcopenia&#44; frailty and cognitive impairment&#46; In the multivariate analysis&#44; however&#44; only age&#44; comorbidity measured with the Charlson index&#44; a previous history of peripheral embolism and sarcopenia &#40;HR&#44; 1&#46;775&#59; 95&#37; CI 1&#46;270&#8211;2&#46;481&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; were independently associated with increased mortality&#46; The prescription of oral anticoagulants at discharge &#40;HR&#44; 0&#46;415&#58; 95&#37; CI 0&#46;307&#8211;0&#46;560&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; was associated with reduced mortality&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">Our study&#39;s main findings were that sarcopenia&#44; frailty and cognitive impairment are highly prevalent and frequently associated conditions in hospitalized elderly patients with NVAF and that sarcopenia is independently associated with mortality at the end of 1 year&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Sarcopenia is a loss of muscle mass or strength generally&#44; but not exclusively&#44; associated with aging&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">21</span></a> The condition affects 5&#8211;13&#37; of individuals older than 60<span class="elsevierStyleHsp" style=""></span>years and up to 50&#37; of octogenarians&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">22</span></a> Acute sarcopenia can appear during hospitalization<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">23</span></a>&#59; 1 of every 2 of our elderly patients hospitalized with NVAF had sarcopenia&#46; As far as we know&#44; there have been no studies on the association between sarcopenia and NVAF&#46; We observed cellular remodeling with cardiomyocyte dedifferentiation in NVAF<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">24</span></a> and dysregulated myogenic regeneration in sarcopenia&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">25</span></a> Our hypothesis is that there is a relationship between the two conditions and that further studies are needed to elucidate whether NVAF is a manifestation of cardiac sarcopenia or whether sarcopenia is a systemic consequence of NVAF&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Frailty is a condition of vulnerability and loss of resistance against external stress factors and increases the risk of presenting adverse effects such as falls&#44; disability&#44; immobility&#44; hospitalization and death&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">26</span></a> Frailty is characterized by weight or height loss&#44; weakness&#44; exhaustion&#44; slowness and low activity&#46; The prevalence of frailty in elderly patients with NVAF has been estimated at 39&#37; but varies depending on the instrument employed for measuring frailty&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">27</span></a> The frailty rate was 25&#37; in studies that employed the Clinical Frailty Scale&#59; when employing the Edmonton Frail Scale&#44; the rate was 53&#8211;60&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">28&#8211;30</span></a> Using the FRAIL scale&#44; we observed a prevalence of 49&#46;8&#37;&#46; We can therefore conclude that frailty is common in elderly patients with NVAF&#46; In our study&#44; frailty was also associated with an increased risk of both stroke &#40;as measured with the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale&#41; and hemorrhaging &#40;as measured with the HAS-BLED scale&#41;&#46; The association between frailty and these scales&#8217; scores has been previously reported&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">31</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The relationship between NVAF and cognitive impairment is also well-established&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">32</span></a> NVAF predisposes patients to stroke&#44; which can cause cognitive impairment&#46; However&#44; it has been shown that NVAF is associated with cognitive impairment even in the absence of stroke&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">10&#44;33</span></a> In addition to overt and silent strokes&#44; other mechanisms are involved in the onset of cognitive impairment&#44; such as cerebral hypoperfusion&#44; microhemorrhages&#44; genetic factors and a vascular inflammatory state with increased amyloid precursor protein production&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">34</span></a> Higher scores on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale are associated with an increased risk of dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> Our patients with cognitive impairment scored higher on this scale&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Our patients scored lower on the Barthel index&#44; indicating high disability&#46; Given that sarcopenia&#44; frailty and cognitive impairment cause disability&#44; we did not include disability in the mortality analysis&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">It has been proposed that oral anticoagulation with warfarin can decrease the risk of dementia by up to 20&#37; in patients with NVAF&#46; The risk will also decrease the longer the time in the therapeutic range&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">35</span></a> The use of direct oral anticoagulants has also been associated with a reduced onset of dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">36</span></a> As with other previous studies&#44; however&#44; direct oral anticoagulants were prescribed less for our patients with cognitive impairment&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">37</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Direct oral anticoagulants have been shown to decrease bleeding in patients with frailty and a risk of falls&#46;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">38&#44;39</span></a> Rivaroxaban has been shown to reduce stroke and systemic embolisms&#44;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">38</span></a> while edoxaban has been shown to decrease all-cause mortality in these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">39</span></a> As with other studies&#44; however&#44; our patients with frailty were prescribed oral anticoagulants less often&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">27</span></a> We should not forget&#44; however&#44; that for patients with advanced disease and NVAF&#44; who frequently have disability and cognitive impairment&#44; the functional status is more closely associated with survival than anticoagulation&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">40</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">In our study&#44; we often observed not only the association between frailty and cognitive impairment &#40;known as cognitive frailty&#41; but also the association between sarcopenia and frailty and between sarcopenia and cognitive impairment&#46; All of these conditions were also associated with disability and mortality at the end of 1 year&#46; However&#44; only sarcopenia was independently associated&#46; Sarcopenia in the elderly is known to be associated with all-cause mortality<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">41</span></a> and is a potentially reversible condition&#46; The guidelines recommend physical activity and nutritional intervention for adults with sarcopenia&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">42</span></a> Unfortunately&#44; studies that have evaluated the effect of exercise-based cardiac rehabilitation in patients with AF have been small and of low-quality&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">43</span></a> Therefore&#44; once NVAF has been diagnosed&#44; sarcopenia needs to be prevented and detected early in the progression of NVAF&#46; Proper diets and customized physical exercise regimens are advisable in this case&#46; To determine the efficacy of these measures&#44; ad hoc clinical trials need to be implemented&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our study had several limitations&#46; Firstly&#44; 14&#46;5&#37; of the study group were lost in the follow-up&#46; Although the threshold for considering a study valid is 20&#37;&#44; the losses can affect the applicability and generalization of the results&#46; Secondly&#44; we only included elderly patients with NVAF hospitalized in internal medicine departments&#46; The results might therefore not be applicable to patients with NVAF hospitalized in cardiology&#44; neurology or intensive care wards&#46; Frailty and sarcopenia are known to be more prevalent in hospitalized patients&#44; and our results are not applicable to elderly patients with NVAF treated in primary care centers&#46; Finally&#44; sarcopenia was diagnosed with a questionnaire&#46; The results might have been different if we had employed a hand grip strength test and a bioimpedance meter&#46; However&#44; the SARC-F questionnaire has been validated and&#44; due to its simplicity and speed&#44; is increasingly employed in clinical practice&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Our study also had a number of strengths&#46; This was a multicenter study&#44; which is known to provide more robust results than studies conducted in a single center&#46; In addition&#44; the only exclusion criterion was not granting informed consent&#44; which ensured broad representativeness of the sample&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In conclusion&#44; sarcopenia&#44; frailty and cognitive impairment are common in elderly patients with NVAF and are associated with high mortality&#46; Detecting these conditions should be part of these patients&#8217; comprehensive evaluation&#44; and strategies need to be adopted to prevent these conditions and provide early treatment&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Funding</span><p id="par0155" class="elsevierStylePara elsevierViewall">The NONAVASC study was funded by an unconditional grant from Bayer&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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              "titulo" => "Sarcopenia"
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              "titulo" => "Frailty"
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              "titulo" => "Cognitive impairment"
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              "titulo" => "Survival"
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    "fechaRecibido" => "2019-01-17"
    "fechaAceptado" => "2019-04-01"
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          "clase" => "keyword"
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            0 => "Atrial fibrillation"
            1 => "Sarcopenia"
            2 => "Frailty"
            3 => "Cognitive impairment"
            4 => "Mortality"
            5 => "Elderly"
            6 => "Cohort study"
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          "palabras" => array:7 [
            0 => "Fibrilaci&#243;n auricular"
            1 => "Sarcopenia"
            2 => "Fragilidad"
            3 => "Deterioro cognitivo"
            4 => "Mortalidad"
            5 => "Ancianos"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence of sarcopenia&#44; frailty and cognitive impairment in elderly patients with nonvalvular atrial fibrillation &#40;NVAF&#41; and the factors&#8217; influence on survival&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prospective&#44; multicentre cohort study of patients older than 75 years with NVAF hospitalised in internal medicine departments in Spain&#46; For each patient&#44; we recorded the creatinine&#44; hemoglobin and platelet levels&#44; the scores on the CHA2DS2-VASc and HAS-BLED scales and Charlson index&#44; as well as the use of oral anticoagulants&#46; We measured sarcopenia with the SARC-F scale&#44; frailty with the FRAIL scale and cognitive impairment with the Short Portable Mental State Questionnaire&#46; We also conducted a 1-year follow-up&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included 596 patients with NVAF&#44; with a mean age of 84&#46;9 &#40;SD&#58; 5&#46;2&#41; years&#46; Of these&#44; 295 &#40;49&#46;5&#37;&#41; presented sarcopenia&#44; 305 &#40;51&#46;2&#37;&#41; presented frailty&#44; and 251 &#40;42&#46;1&#37;&#41; presented cognitive impairment&#46; At the end of 1<span class="elsevierStyleHsp" style=""></span>year&#44; 226 &#40;37&#46;9&#37;&#41; patients had died&#46; Mortality was greater for the patients with sarcopenia&#44; frailty and cognitive impairment&#46; In the multivariate analysis&#44; sarcopenia &#40;HR&#58; 1&#46;775&#59; 95&#37; CI&#58; 1&#46;270&#8211;2&#46;481&#41;&#44; age&#44; comorbidity and a history of peripheral embolism were associated with increased mortality&#44; and the use of oral anticoagulants at discharge &#40;HR&#58; 0&#46;415&#59; 95&#37; CI&#58; 0&#46;307&#8211;0&#46;560&#41; was associated with lower mortality&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Sarcopenia&#44; frailty and cognitive impairment are very common in elderly patients with NVAF and are frequently associated&#46; Sarcopenia was associated with increased mortality&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia de la sarcopenia&#44; la fragilidad y el deterioro cognitivo en pacientes ancianos con fibrilaci&#243;n auricular no valvular &#40;FANV&#41; y su influencia en la supervivencia&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes&#44; prospectivo y multic&#233;ntrico realizado con pacientes &#62;<span class="elsevierStyleHsp" style=""></span>75<span class="elsevierStyleHsp" style=""></span>a&#241;os con FANV hospitalizados en servicios de Medicina Interna en Espa&#241;a&#46; Para cada paciente se recogieron los niveles de creatinina&#44; hemoglobina y plaquetas&#44; as&#237; como las escalas CHA2DS2-Vasc&#44; HAS-BLED&#44; el &#237;ndice de Charlson y el uso de anticoagulantes orales&#46; Se midi&#243; la sarcopenia con escala SARC-F&#44; la fragilidad con la escala FRAIL y el deterioro cognitivo con el <span class="elsevierStyleItalic">Short Portable Mental State Questionnaire</span>&#46; Se realiz&#243; seguimiento durante un a&#241;o&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 596 pacientes con FANV&#44; con edad media de 84&#44;9 &#40;DE&#58; 5&#44;2&#41; a&#241;os&#46; De ellos&#44; 295 &#40;49&#44;5&#37;&#41; presentaban sarcopenia&#44; 305 &#40;51&#44;2&#37;&#41; fragilidad y 251 &#40;42&#44;1&#37;&#41; deterioro cognitivo&#46; Al cabo de un a&#241;o fallecieron 226 &#40;37&#44;9&#37;&#41; pacientes&#46; La mortalidad fue superior en los pacientes con sarcopenia&#44; fragilidad y deterioro cognitivo&#46; En el an&#225;lisis multivariante la sarcopenia &#40;HR&#58; 1&#44;775&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;270-2&#44;481&#41;&#44; la edad&#44; la comorbilidad y el antecedente de embolismo perif&#233;rico se asociaron con mayor mortalidad&#44; y el uso de anticoagulantes orales al alta &#40;HR&#58; 0&#44;415&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;307-0&#44;560&#41;&#44; con menor mortalidad&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En los pacientes ancianos con FANV la sarcopenia&#44; la fragilidad y el deterioro cognitivo son muy prevalentes y se asocian con frecuencia&#46; La sarcopenia se asocia a mayor mortalidad&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as&#58; Requena Calleja MA&#44; Arenas Miqu&#233;lez A&#44; D&#237;ez-Manglano J&#44; Gull&#243;n A&#44; Pose A&#44; Formiga F&#44; et al&#46; Sarcopenia&#44; fragilidad&#44; deterioro cognitivo y mortalidad en pacientes ancianos con fibrilaci&#243;n auricular no valvular&#46; Rev Clin Esp&#46; 2019&#59;219&#58;424&#8211;432&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">The rest of the components of the group of researchers of the NONAVASC study of the Vascular Risk Group of the Spanish Society of Internal Medicine are related in <a class="elsevierStyleCrossRef" href="#sec0070">Appendix</a>&#46;</p>"
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            "apendice" => "<p id="par0165" class="elsevierStylePara elsevierViewall">M&#46; Camafort&#44; E&#46; Jarauta Sim&#243;n&#44; J&#46; Castiella&#44; E&#46; Rovira&#44; I&#46; Garc&#237;a-Polo&#44; J&#46;C&#46; Ar&#233;valo-Lorido&#44; J&#46; Portillo-S&#225;nchez&#44; I&#46; Mart&#237;nez-Moreno&#44; C&#46; de la Guerra-Acebal&#44; C&#46; Arg&#252;ello-Mart&#237;n&#44; S&#46;I&#46; Aranda-S&#225;nchez&#44; I&#46; Novo-Veleiro&#44; M&#46; Pena-Seijo&#44; F&#46; Salgado-Ordo&#241;ez&#44; J&#46;A&#46; Vargas-Hitos&#44; J&#46; Gonz&#225;lez-Moraleja&#44; N&#46;R&#46; Tobares-Carrasco&#44; P&#46; Freixas-Descarrega&#44; I&#46; Campodarve-Botet&#44; C&#46; Fern&#225;ndez-Capit&#225;n&#44; L&#46;M&#46; Palomar-Rodr&#237;guez&#44; A&#46;B&#46; G&#243;mez-Belda&#44; D&#46; Chivite-Guill&#233;n&#44; M&#46;A&#46; Rico-Corral&#44; J&#46;L&#46; Hern&#225;ndez-Hern&#225;ndez&#44; E&#46; Coloma-Baz&#225;n&#44; X&#46; Sobrino-Mart&#237;nez&#44; J&#46; Grandes-Ib&#225;&#241;ez&#44; M&#46; Mart&#237;n-Mill&#225;n&#44; R&#46; Cuenca-Acevedo&#44; J&#46;B&#46; P&#233;rez-Lorenz&#44; A&#46; de la Pe&#241;a Fern&#225;ndez&#44; G&#46; L&#243;pez-Castellanos&#44; E&#46; Montero-Hern&#225;ndez&#44; E&#46; Calder&#243;n-Sandubete&#44; C&#46; Lahoz-Rallo&#44; A&#46; de los Santos-Moreno&#44; J&#46;A&#46; Mart&#237;nez-Muradas&#44; J&#46; Alfonso-Megido&#44; J&#46;I&#46; Cuende-Melero&#44; R&#46; Cotos-Cancas&#44; J&#46;J&#46; Tamarit-Garc&#237;a&#44; F&#46; Bonilla-Rovira&#44; A&#46; Epalza-Bueno&#44; M&#46; Morales-Conejo&#44; L&#46; Manzano-Espinosa&#44; S&#46; Freire Castro&#44; A&#46; Rodr&#237;guez Gonz&#225;lez&#44; M&#46; Mendui&#241;a-Guill&#233;n&#44; A&#46; L&#243;pez-Su&#225;rez&#44; J&#46;F S&#225;nchez Mu&#241;oz-Torrero&#44; M&#46;D&#46; Mart&#237;n-Escalante&#44; J&#46;A&#46; Ortiz-Minuesa&#44; J&#46;C&#46; Mart&#237;nez-Acitores&#44; M&#46;B&#46; Alonso-Ortiz&#44; D&#46; Filella-Agull&#243;&#44; H&#46; Agreda-L&#243;pez&#44; M&#46; Romero-Jim&#233;nez&#44; M&#46;E&#46; Fern&#225;ndez-P&#233;rez&#44; J&#46;L&#46; D&#237;az-D&#237;az&#44; C&#46; P&#233;rez-Bocanegra&#44; R&#46; Mart&#237;nez-Fern&#225;ndez&#44; J&#46;A&#46; Nieto-Rodr&#237;guez&#44; J&#46; Masferrer-Serra&#44; L&#46; M&#233;rida-Rodrigo&#44; J&#46;M&#46; Varela-Aguilar&#44; A&#46; Mujal-Mart&#237;nez&#44; L&#46; Castilla-Guerra&#44; P&#46; Castellanos-Llauger&#44; G&#46; Tiberio-L&#243;pez&#44; E&#46; Guevara-Sierra and J&#46; Fern&#225;ndez-Pardo&#46;</p>"
            "etiqueta" => "Appendix"
            "titulo" => "Members of the Vascular Risk Group of the Spanish Society of Internal Medicine"
            "identificador" => "sec0070"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1364
            "Ancho" => 1419
            "Tamanyo" => 103645
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow diagram of patient inclusion&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1566
            "Ancho" => 1667
            "Tamanyo" => 147906
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Prevalence of sarcopenia&#44; frailty and cognitive impairment&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2360
            "Ancho" => 2919
            "Tamanyo" => 219831
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curves for the patients with one or several study conditions &#40;sarcopenia&#44; frailty and cognitive impairment&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The data are presented as <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41; or as&#8230;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Variable&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">Total &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>596&#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  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sarcopenia</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frailty</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cognitive impairment</th></tr><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" style="border-bottom: 2px solid black">&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" style="border-bottom: 2px solid black">&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">Yes &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>295&#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">No &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>301&#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"><span class="elsevierStyleItalic">p</span>&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">Yes &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>305&#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">No &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>291&#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"><span class="elsevierStyleItalic">p</span>&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">Yes &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>251&#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">No &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>345&#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"><span class="elsevierStyleItalic">p</span>&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">Age<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;9 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;8 &#40;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;1 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;5 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;9 &#40;504&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;877&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;3 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;9 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">315 &#40;52&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">191 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">185 &#40;60&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130 &#40;44&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">164 &#40;65&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">151 &#40;43&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Underweight &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;159&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;246&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;379&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">Excess weight or obesity &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</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  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">367 &#40;65&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">166 &#40;60&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">201 &#40;70&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;013&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">188 &#40;65&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179 &#40;66&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;847&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127 &#40;55&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">240 &#40;72&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">238 &#40;39&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">118 &#40;40&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">120 &#40;39&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;974&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">136 &#40;44&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;35&#46;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;39&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138 &#40;40&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;969&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">Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">524 &#40;87&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">257 &#40;87&#46;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">267 &#40;88&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;553&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">275 &#40;90&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">249 &#40;85&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;085&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">218 &#40;86&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">306 &#40;88&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hyperlipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">268 &#40;45&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">124 &#40;42&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">144 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#46;143&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">145 &#40;47&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">123 &#40;42&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114 &#40;45&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">154 &#40;44&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;865&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">Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">407 &#40;68&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">198 &#40;67&#46;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">209 &#40;69&#46;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;543&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">217 &#40;71&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">190 &#40;65&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">158 &#40;62&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">249 &#40;72&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;017&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">History of peripheral embolism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">34 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">21 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;4&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;211&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;020&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">Previous history of AF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#46;338&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">History of hemorrhaging&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;040&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Renal impairment&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peripheral artery disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;737&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32 &#40;11&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34 &#40;13&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;876&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">Cerebrovascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">60 &#40;20&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">99 &#40;33&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;18&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">83 &#40;33&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">69 &#40;20&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dementia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">131 &#40;22&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">105 &#40;36&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">77 &#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">54 &#40;18&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#46;049&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">121 &#40;48&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Delirium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">95 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">71 &#40;24&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24 &#40;8&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">59 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;016&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">Pressure ulcers&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;2&#46;1&#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">Falls in the past year<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">&#46;015&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">171 &#40;59&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">210 &#40;84&#46;3&#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">Charlson index<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">4&#46;1 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;2 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;0 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;359&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;6 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;6 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">CHA2DS2-Vasc Scale<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">5&#46;3 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;4 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;042&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">HAS-BLED scale<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">Charlson index&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">CHA2DS2-Vasc&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">History of peripheral embolism&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;091 &#40;1&#46;288&#8211;3&#46;395&#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">Sarcopenia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;508 &#40;1&#46;884&#8211;3&#46;340&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;775 &#40;1&#46;270&#8211;2&#46;481&#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">Frailty&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;866 &#40;1&#46;414&#8211;2&#46;463&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;218 &#40;0&#46;888&#8211;1&#46;672&#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">Cognitive impairment&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;108 &#40;1&#46;611&#8211;2&#46;757&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;266 &#40;0&#46;939&#8211;1&#46;707&#41;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Sarcopenia&#58; European consensus on definition and diagnosis&#46; Report of the European working group on sarcopenia in older people"
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                            0 => "A&#46;J&#46; Cruz-Jentoft"
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                            2 => "J&#46; Bauer"
                            3 => "Y&#46; Boirie"
                            4 => "T&#46; Cederholm"
                            5 => "F&#46; Landi"
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                        "paginaInicial" => "412"
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                            2 => "B&#46;M&#46; Psaty"
                            3 => "W&#46;T&#46; Longstreht Jr&#46;"
                            4 => "C&#46;M&#46; Sitlani"
                            5 => "S&#46; Dublin"
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Original article
Sarcopenia, frailty, cognitive impairment and mortality in elderly patients with non-valvular atrial fibrillation
Sarcopenia, fragilidad, deterioro cognitivo y mortalidad en pacientes ancianos con fibrilación auricular no valvular
M.A. Requena Callejaa, A. Arenas Miquéleza, J. Díez-Manglanoa,
Corresponding author
jdiez@aragon.es

Corresponding author.
, A. Gullónb, A. Posec, F. Formigad, J.M. Mostazae, J.M. Cepedaf, C. Suárezb, on behalf of the researchers of the NONAVASC study Vascular Risk Group of the Spanish Society of Internal Medicine 1
a Departamento de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain
b Departamento de Medicina Interna, Hospital Universitario de La Princesa, Madrid, Spain
c Departamento de Medicina Interna, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
d Departamento de Medicina Interna, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
e Departamento de Medicina Interna, Hospital Carlos III, Madrid, Spain
f Departamento de Medicina Interna, Hospital Vega Baja, Orihuela, Alicante, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Atrial fibrillation &#40;AF&#41; is the most common arrhythmia worldwide&#44; and its prevalence increases with age&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a> AF is associated with increased mortality and the risk of a cerebrovascular event&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">2</span></a> Patients with AF are usually elderly&#44; have significant comorbidity and consume numerous drugs&#44; all of which cause them to be quite frail&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">3</span></a> Frailty is defined as an age-related condition characterized by reduced physiological reserve&#44; increased risk of disability&#44; loss of resistance and greater vulnerability to adverse events&#44; as manifested by increased morbidity and mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">4</span></a> In a retrospective study conducted at the University of Milan &#40;Italy&#41;&#44; which included 403 patients with AF&#44; 57&#37; were classified as frail&#44; 29&#37; were classified as prefrail&#44; and only 14&#37; were classified as not frail&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Sarcopenia is a syndrome characterized by a gradual and generalized loss of skeletal muscle mass and strength&#44; with the risk of presenting adverse effects such as physical disability&#44; deficient quality of life and increased mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">5</span></a> Sarcopenia is considered primary when there is no other apparent cause except for aging and is considered secondary when there are one or several other causes&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">AF increases the incidence of cognitive impairment&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">7</span></a> In the ONTARGET and TRANSCEND studies&#44; patients with AF had a greater risk of cognitive impairment and dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">8</span></a> This risk is greater the higher the score on the CHADS<span class="elsevierStyleInf">2</span> and CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scales&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> In a meta-analysis&#44; AF was associated with cognitive impairment in patients with and without a diagnosis of stroke&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of this study was to determine the prevalence of sarcopenia&#44; frailty and cognitive impairment in elderly patients with nonvalvular AF &#40;NVAF&#41; and their influence on survival&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This analysis is a substudy of the patients included in the NONAVASC registry&#44; an observational&#44; prospective&#44; multicenter study conducted in the internal medicine departments of 64 hospitals in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">11</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Inclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">Between October 2014 and May 2015&#44; each investigator consecutively included at least 10 patients older than 75<span class="elsevierStyleHsp" style=""></span>years hospitalized for any cause&#44; who had NVAF&#44; previously or diagnosed during hospitalization&#46; We considered NVAF the AF which appears in the absence of moderate-severe rheumatic mitral stenosis or valvular prosthesis&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">12</span></a> NVAF was classified as paroxysmal&#44; persistent or permanent according to the definition of the European Society of Cardiology guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Procedures</span><p id="par0035" class="elsevierStylePara elsevierViewall">The data collection was conducted using an anonymized online database&#44; which included sociodemographic&#44; clinical&#44; laboratory&#44; image&#44; therapeutic and outcome parameters&#46; The thrombotic and hemorrhagic risk at admission was assessed using the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">14</span></a> and HAS-BLED scales&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">15</span></a> respectively&#46; The assessment of the patient&#39;s social&#44; functional and cognitive state was performed at admission through a personal interview with the patient or their main caregiver&#46; Comorbidity was assessed with the Charlson index&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">16</span></a> the ability to perform basic activities of daily life was assessed with the Barthel index&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a> and cognitive impairment was assessed with the Short Portable Mental State Questionnaire&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">18</span></a> We considered the patient to have cognitive impairment when the number of errors on this questionnaire was &#8805;4&#46; Sarcopenia was assessed with the SARC-F scale<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> and was considered to be present when the score was &#8805;4&#46; Frailty was assessed with the FRAIL scale&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">20</span></a> and patients were considered frail when their score was &#8805;3<span class="elsevierStyleHsp" style=""></span>points&#46; We also recorded creatinine&#44; hemoglobin and platelet levels&#44; defining renal failure as an estimated glomerular filtration rate &#60;60<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#46; We recorded the number of drugs prescribed at discharge and the use of oral anticoagulants and subsequently conducted a 1-year follow-up&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The study was approved by the Ethics Committee for Clinical Research of University Hospital de la Princesa&#44; and all patients &#40;or their relatives in the event of cognitive impairment&#41; gave their written informed consent&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">The qualitative variables are presented as absolute frequencies and percentages&#44; and the quantitative variables are presented as mean and standard deviation&#46; The qualitative variables were compared using the chi-squared test&#44; applying the Yates correction or Fisher test when necessary&#46; The quantitative variables were compared using Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">To study the variables associated with mortality&#44; we constructed a Cox regression model&#46; We excluded the variables with colinearity and included the variables age&#44; sex&#44; scores on the Charlson index and CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc and HAS-BLED scales&#44; cognitive impairment&#44; frailty&#44; sarcopenia and the prescription of oral anticoagulants at discharge&#46; The multivariate analysis included all variables with statistical significance &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;1&#41; in the univariate analysis&#46; For the survival analysis&#44; we constructed Kaplan&#8211;Meier curves for the patients with 3 or fewer study conditions &#40;i&#46;e&#46;&#44; sarcopenia&#44; frailty and cognitive impairment&#41;&#46; We compared the curves with the log-rank test&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In all cases&#44; the level of statistical significance is established for a value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The statistical analysis was performed using the SPSS v22&#46;0 program&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the flow diagram for patient inclusion&#46; Of the 697 initial patients&#44; we lost 101 &#40;14&#46;5&#37;&#41; during the follow-up&#46; The lost patients had lower comorbidity as measured by the Charlson index&#44; had been hospitalized less in the past year&#44; consumed fewer drugs and were prescribed fewer oral anticoagulants at discharge&#46; There were no differences in the other characteristics or in the prevalence of sarcopenia&#44; frailty and cognitive impairment&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">We ultimately included 596 patients with a mean age of 84&#46;9 &#40;5&#46;2&#41; years&#44; 315 &#40;52&#46;9&#37;&#41; of whom were women&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the characteristics of patients included in the study&#46; The mean score on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc and HAS-BLED scales was 5&#46;3 &#40;1&#46;4&#41; and 2&#46;7 &#40;1&#46;2&#41;&#44; respectively&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the prevalence of sarcopenia&#44; frailty and cognitive impairment&#46; These conditions were frequently associated&#59; 436 &#40;73&#46;1&#37;&#41; patients presented 1 of the conditions&#44; and 136 &#40;22&#46;8&#37;&#41; patients presented 3&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Sarcopenia</span><p id="par0075" class="elsevierStylePara elsevierViewall">Sarcopenia was present in 295 &#40;49&#46;5&#37;&#41; patients&#44; who were older&#44; more often women and less frequently had excess weight or obesity&#46; Cerebrovascular disease was more common in these patients&#44; and they had higher scores on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale but not on the HAS-BLED&#46; At discharge&#44; they were prescribed oral anticoagulants less frequently &#40;49&#46;3&#37; vs&#46; 58&#46;7&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Their ability to perform basic activities of daily life as measured with the Barthel index was lower&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Frailty</span><p id="par0080" class="elsevierStylePara elsevierViewall">Frailty was present in 305 &#40;51&#46;2&#37;&#41; patients&#44; who were more often female&#44; had more comorbidity measured with the Charlson index and had higher scores on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc and HAS-BLED scales&#46; The patients more often had a history of cerebrovascular disease&#44; kidney failure and hemorrhaging&#44; and their ability to perform daily life activities was lower &#40;Barthel index&#44; 56 vs&#46; 78&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The prescription of oral anticoagulants at discharge was lower for the frail patients &#40;44&#46;9&#37; vs&#46; 54&#46;0&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;027&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Cognitive impairment</span><p id="par0085" class="elsevierStylePara elsevierViewall">Cognitive impairment was present in 251 &#40;42&#46;1&#37;&#41; patients&#44; who were older&#44; scored lower on the Barthel index&#44; were more frequently female and had cerebrovascular disease and peripheral embolism&#46; They less frequently had obesity or excess weight&#44; heart failure and a history of hemorrhaging&#46; They scored higher on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale but not on the HAS-BLED scale&#46; At discharge&#44; these patients were prescribed oral anticoagulants less often &#40;38&#46;2&#37; vs&#46; 57&#46;4&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Survival</span><p id="par0090" class="elsevierStylePara elsevierViewall">At the end of 1 year&#44; 226 &#40;37&#46;9&#37;&#41; patients had died&#46; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> shows the Kaplan&#8211;Meier survival curves&#44; with shorter survival for the patients with sarcopenia &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A&#41;&#44; frailty &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>B&#41; and cognitive impairment &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>C&#41;&#46; Mortality was higher the more of these conditions the patient presented &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>D&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The factors associated with mortality at the end of 1 year are listed in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; In the univariate analysis&#44; mortality was associated with sarcopenia&#44; frailty and cognitive impairment&#46; In the multivariate analysis&#44; however&#44; only age&#44; comorbidity measured with the Charlson index&#44; a previous history of peripheral embolism and sarcopenia &#40;HR&#44; 1&#46;775&#59; 95&#37; CI 1&#46;270&#8211;2&#46;481&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; were independently associated with increased mortality&#46; The prescription of oral anticoagulants at discharge &#40;HR&#44; 0&#46;415&#58; 95&#37; CI 0&#46;307&#8211;0&#46;560&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; was associated with reduced mortality&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">Our study&#39;s main findings were that sarcopenia&#44; frailty and cognitive impairment are highly prevalent and frequently associated conditions in hospitalized elderly patients with NVAF and that sarcopenia is independently associated with mortality at the end of 1 year&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Sarcopenia is a loss of muscle mass or strength generally&#44; but not exclusively&#44; associated with aging&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">21</span></a> The condition affects 5&#8211;13&#37; of individuals older than 60<span class="elsevierStyleHsp" style=""></span>years and up to 50&#37; of octogenarians&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">22</span></a> Acute sarcopenia can appear during hospitalization<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">23</span></a>&#59; 1 of every 2 of our elderly patients hospitalized with NVAF had sarcopenia&#46; As far as we know&#44; there have been no studies on the association between sarcopenia and NVAF&#46; We observed cellular remodeling with cardiomyocyte dedifferentiation in NVAF<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">24</span></a> and dysregulated myogenic regeneration in sarcopenia&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">25</span></a> Our hypothesis is that there is a relationship between the two conditions and that further studies are needed to elucidate whether NVAF is a manifestation of cardiac sarcopenia or whether sarcopenia is a systemic consequence of NVAF&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Frailty is a condition of vulnerability and loss of resistance against external stress factors and increases the risk of presenting adverse effects such as falls&#44; disability&#44; immobility&#44; hospitalization and death&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">26</span></a> Frailty is characterized by weight or height loss&#44; weakness&#44; exhaustion&#44; slowness and low activity&#46; The prevalence of frailty in elderly patients with NVAF has been estimated at 39&#37; but varies depending on the instrument employed for measuring frailty&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">27</span></a> The frailty rate was 25&#37; in studies that employed the Clinical Frailty Scale&#59; when employing the Edmonton Frail Scale&#44; the rate was 53&#8211;60&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">28&#8211;30</span></a> Using the FRAIL scale&#44; we observed a prevalence of 49&#46;8&#37;&#46; We can therefore conclude that frailty is common in elderly patients with NVAF&#46; In our study&#44; frailty was also associated with an increased risk of both stroke &#40;as measured with the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale&#41; and hemorrhaging &#40;as measured with the HAS-BLED scale&#41;&#46; The association between frailty and these scales&#8217; scores has been previously reported&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">31</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The relationship between NVAF and cognitive impairment is also well-established&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">32</span></a> NVAF predisposes patients to stroke&#44; which can cause cognitive impairment&#46; However&#44; it has been shown that NVAF is associated with cognitive impairment even in the absence of stroke&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">10&#44;33</span></a> In addition to overt and silent strokes&#44; other mechanisms are involved in the onset of cognitive impairment&#44; such as cerebral hypoperfusion&#44; microhemorrhages&#44; genetic factors and a vascular inflammatory state with increased amyloid precursor protein production&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">34</span></a> Higher scores on the CHA<span class="elsevierStyleInf">2</span>DS<span class="elsevierStyleInf">2</span>-VASc scale are associated with an increased risk of dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> Our patients with cognitive impairment scored higher on this scale&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Our patients scored lower on the Barthel index&#44; indicating high disability&#46; Given that sarcopenia&#44; frailty and cognitive impairment cause disability&#44; we did not include disability in the mortality analysis&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">It has been proposed that oral anticoagulation with warfarin can decrease the risk of dementia by up to 20&#37; in patients with NVAF&#46; The risk will also decrease the longer the time in the therapeutic range&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">35</span></a> The use of direct oral anticoagulants has also been associated with a reduced onset of dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">36</span></a> As with other previous studies&#44; however&#44; direct oral anticoagulants were prescribed less for our patients with cognitive impairment&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">37</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Direct oral anticoagulants have been shown to decrease bleeding in patients with frailty and a risk of falls&#46;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">38&#44;39</span></a> Rivaroxaban has been shown to reduce stroke and systemic embolisms&#44;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">38</span></a> while edoxaban has been shown to decrease all-cause mortality in these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">39</span></a> As with other studies&#44; however&#44; our patients with frailty were prescribed oral anticoagulants less often&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">27</span></a> We should not forget&#44; however&#44; that for patients with advanced disease and NVAF&#44; who frequently have disability and cognitive impairment&#44; the functional status is more closely associated with survival than anticoagulation&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">40</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">In our study&#44; we often observed not only the association between frailty and cognitive impairment &#40;known as cognitive frailty&#41; but also the association between sarcopenia and frailty and between sarcopenia and cognitive impairment&#46; All of these conditions were also associated with disability and mortality at the end of 1 year&#46; However&#44; only sarcopenia was independently associated&#46; Sarcopenia in the elderly is known to be associated with all-cause mortality<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">41</span></a> and is a potentially reversible condition&#46; The guidelines recommend physical activity and nutritional intervention for adults with sarcopenia&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">42</span></a> Unfortunately&#44; studies that have evaluated the effect of exercise-based cardiac rehabilitation in patients with AF have been small and of low-quality&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">43</span></a> Therefore&#44; once NVAF has been diagnosed&#44; sarcopenia needs to be prevented and detected early in the progression of NVAF&#46; Proper diets and customized physical exercise regimens are advisable in this case&#46; To determine the efficacy of these measures&#44; ad hoc clinical trials need to be implemented&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our study had several limitations&#46; Firstly&#44; 14&#46;5&#37; of the study group were lost in the follow-up&#46; Although the threshold for considering a study valid is 20&#37;&#44; the losses can affect the applicability and generalization of the results&#46; Secondly&#44; we only included elderly patients with NVAF hospitalized in internal medicine departments&#46; The results might therefore not be applicable to patients with NVAF hospitalized in cardiology&#44; neurology or intensive care wards&#46; Frailty and sarcopenia are known to be more prevalent in hospitalized patients&#44; and our results are not applicable to elderly patients with NVAF treated in primary care centers&#46; Finally&#44; sarcopenia was diagnosed with a questionnaire&#46; The results might have been different if we had employed a hand grip strength test and a bioimpedance meter&#46; However&#44; the SARC-F questionnaire has been validated and&#44; due to its simplicity and speed&#44; is increasingly employed in clinical practice&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Our study also had a number of strengths&#46; This was a multicenter study&#44; which is known to provide more robust results than studies conducted in a single center&#46; In addition&#44; the only exclusion criterion was not granting informed consent&#44; which ensured broad representativeness of the sample&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In conclusion&#44; sarcopenia&#44; frailty and cognitive impairment are common in elderly patients with NVAF and are associated with high mortality&#46; Detecting these conditions should be part of these patients&#8217; comprehensive evaluation&#44; and strategies need to be adopted to prevent these conditions and provide early treatment&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Funding</span><p id="par0155" class="elsevierStylePara elsevierViewall">The NONAVASC study was funded by an unconditional grant from Bayer&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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          "titulo" => "Results"
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              "titulo" => "Sarcopenia"
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              "titulo" => "Frailty"
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              "titulo" => "Cognitive impairment"
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              "titulo" => "Survival"
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    "fechaRecibido" => "2019-01-17"
    "fechaAceptado" => "2019-04-01"
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          "clase" => "keyword"
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            0 => "Atrial fibrillation"
            1 => "Sarcopenia"
            2 => "Frailty"
            3 => "Cognitive impairment"
            4 => "Mortality"
            5 => "Elderly"
            6 => "Cohort study"
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          "clase" => "keyword"
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          "palabras" => array:7 [
            0 => "Fibrilaci&#243;n auricular"
            1 => "Sarcopenia"
            2 => "Fragilidad"
            3 => "Deterioro cognitivo"
            4 => "Mortalidad"
            5 => "Ancianos"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence of sarcopenia&#44; frailty and cognitive impairment in elderly patients with nonvalvular atrial fibrillation &#40;NVAF&#41; and the factors&#8217; influence on survival&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prospective&#44; multicentre cohort study of patients older than 75 years with NVAF hospitalised in internal medicine departments in Spain&#46; For each patient&#44; we recorded the creatinine&#44; hemoglobin and platelet levels&#44; the scores on the CHA2DS2-VASc and HAS-BLED scales and Charlson index&#44; as well as the use of oral anticoagulants&#46; We measured sarcopenia with the SARC-F scale&#44; frailty with the FRAIL scale and cognitive impairment with the Short Portable Mental State Questionnaire&#46; We also conducted a 1-year follow-up&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included 596 patients with NVAF&#44; with a mean age of 84&#46;9 &#40;SD&#58; 5&#46;2&#41; years&#46; Of these&#44; 295 &#40;49&#46;5&#37;&#41; presented sarcopenia&#44; 305 &#40;51&#46;2&#37;&#41; presented frailty&#44; and 251 &#40;42&#46;1&#37;&#41; presented cognitive impairment&#46; At the end of 1<span class="elsevierStyleHsp" style=""></span>year&#44; 226 &#40;37&#46;9&#37;&#41; patients had died&#46; Mortality was greater for the patients with sarcopenia&#44; frailty and cognitive impairment&#46; In the multivariate analysis&#44; sarcopenia &#40;HR&#58; 1&#46;775&#59; 95&#37; CI&#58; 1&#46;270&#8211;2&#46;481&#41;&#44; age&#44; comorbidity and a history of peripheral embolism were associated with increased mortality&#44; and the use of oral anticoagulants at discharge &#40;HR&#58; 0&#46;415&#59; 95&#37; CI&#58; 0&#46;307&#8211;0&#46;560&#41; was associated with lower mortality&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Sarcopenia&#44; frailty and cognitive impairment are very common in elderly patients with NVAF and are frequently associated&#46; Sarcopenia was associated with increased mortality&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia de la sarcopenia&#44; la fragilidad y el deterioro cognitivo en pacientes ancianos con fibrilaci&#243;n auricular no valvular &#40;FANV&#41; y su influencia en la supervivencia&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes&#44; prospectivo y multic&#233;ntrico realizado con pacientes &#62;<span class="elsevierStyleHsp" style=""></span>75<span class="elsevierStyleHsp" style=""></span>a&#241;os con FANV hospitalizados en servicios de Medicina Interna en Espa&#241;a&#46; Para cada paciente se recogieron los niveles de creatinina&#44; hemoglobina y plaquetas&#44; as&#237; como las escalas CHA2DS2-Vasc&#44; HAS-BLED&#44; el &#237;ndice de Charlson y el uso de anticoagulantes orales&#46; Se midi&#243; la sarcopenia con escala SARC-F&#44; la fragilidad con la escala FRAIL y el deterioro cognitivo con el <span class="elsevierStyleItalic">Short Portable Mental State Questionnaire</span>&#46; Se realiz&#243; seguimiento durante un a&#241;o&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 596 pacientes con FANV&#44; con edad media de 84&#44;9 &#40;DE&#58; 5&#44;2&#41; a&#241;os&#46; De ellos&#44; 295 &#40;49&#44;5&#37;&#41; presentaban sarcopenia&#44; 305 &#40;51&#44;2&#37;&#41; fragilidad y 251 &#40;42&#44;1&#37;&#41; deterioro cognitivo&#46; Al cabo de un a&#241;o fallecieron 226 &#40;37&#44;9&#37;&#41; pacientes&#46; La mortalidad fue superior en los pacientes con sarcopenia&#44; fragilidad y deterioro cognitivo&#46; En el an&#225;lisis multivariante la sarcopenia &#40;HR&#58; 1&#44;775&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;270-2&#44;481&#41;&#44; la edad&#44; la comorbilidad y el antecedente de embolismo perif&#233;rico se asociaron con mayor mortalidad&#44; y el uso de anticoagulantes orales al alta &#40;HR&#58; 0&#44;415&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;307-0&#44;560&#41;&#44; con menor mortalidad&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En los pacientes ancianos con FANV la sarcopenia&#44; la fragilidad y el deterioro cognitivo son muy prevalentes y se asocian con frecuencia&#46; La sarcopenia se asocia a mayor mortalidad&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as&#58; Requena Calleja MA&#44; Arenas Miqu&#233;lez A&#44; D&#237;ez-Manglano J&#44; Gull&#243;n A&#44; Pose A&#44; Formiga F&#44; et al&#46; Sarcopenia&#44; fragilidad&#44; deterioro cognitivo y mortalidad en pacientes ancianos con fibrilaci&#243;n auricular no valvular&#46; Rev Clin Esp&#46; 2019&#59;219&#58;424&#8211;432&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">The rest of the components of the group of researchers of the NONAVASC study of the Vascular Risk Group of the Spanish Society of Internal Medicine are related in <a class="elsevierStyleCrossRef" href="#sec0070">Appendix</a>&#46;</p>"
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            "apendice" => "<p id="par0165" class="elsevierStylePara elsevierViewall">M&#46; Camafort&#44; E&#46; Jarauta Sim&#243;n&#44; J&#46; Castiella&#44; E&#46; Rovira&#44; I&#46; Garc&#237;a-Polo&#44; J&#46;C&#46; Ar&#233;valo-Lorido&#44; J&#46; Portillo-S&#225;nchez&#44; I&#46; Mart&#237;nez-Moreno&#44; C&#46; de la Guerra-Acebal&#44; C&#46; Arg&#252;ello-Mart&#237;n&#44; S&#46;I&#46; Aranda-S&#225;nchez&#44; I&#46; Novo-Veleiro&#44; M&#46; Pena-Seijo&#44; F&#46; Salgado-Ordo&#241;ez&#44; J&#46;A&#46; Vargas-Hitos&#44; J&#46; Gonz&#225;lez-Moraleja&#44; N&#46;R&#46; Tobares-Carrasco&#44; P&#46; Freixas-Descarrega&#44; I&#46; Campodarve-Botet&#44; C&#46; Fern&#225;ndez-Capit&#225;n&#44; L&#46;M&#46; Palomar-Rodr&#237;guez&#44; A&#46;B&#46; G&#243;mez-Belda&#44; D&#46; Chivite-Guill&#233;n&#44; M&#46;A&#46; Rico-Corral&#44; J&#46;L&#46; Hern&#225;ndez-Hern&#225;ndez&#44; E&#46; Coloma-Baz&#225;n&#44; X&#46; Sobrino-Mart&#237;nez&#44; J&#46; Grandes-Ib&#225;&#241;ez&#44; M&#46; Mart&#237;n-Mill&#225;n&#44; R&#46; Cuenca-Acevedo&#44; J&#46;B&#46; P&#233;rez-Lorenz&#44; A&#46; de la Pe&#241;a Fern&#225;ndez&#44; G&#46; L&#243;pez-Castellanos&#44; E&#46; Montero-Hern&#225;ndez&#44; E&#46; Calder&#243;n-Sandubete&#44; C&#46; Lahoz-Rallo&#44; A&#46; de los Santos-Moreno&#44; J&#46;A&#46; Mart&#237;nez-Muradas&#44; J&#46; Alfonso-Megido&#44; J&#46;I&#46; Cuende-Melero&#44; R&#46; Cotos-Cancas&#44; J&#46;J&#46; Tamarit-Garc&#237;a&#44; F&#46; Bonilla-Rovira&#44; A&#46; Epalza-Bueno&#44; M&#46; Morales-Conejo&#44; L&#46; Manzano-Espinosa&#44; S&#46; Freire Castro&#44; A&#46; Rodr&#237;guez Gonz&#225;lez&#44; M&#46; Mendui&#241;a-Guill&#233;n&#44; A&#46; L&#243;pez-Su&#225;rez&#44; J&#46;F S&#225;nchez Mu&#241;oz-Torrero&#44; M&#46;D&#46; Mart&#237;n-Escalante&#44; J&#46;A&#46; Ortiz-Minuesa&#44; J&#46;C&#46; Mart&#237;nez-Acitores&#44; M&#46;B&#46; Alonso-Ortiz&#44; D&#46; Filella-Agull&#243;&#44; H&#46; Agreda-L&#243;pez&#44; M&#46; Romero-Jim&#233;nez&#44; M&#46;E&#46; Fern&#225;ndez-P&#233;rez&#44; J&#46;L&#46; D&#237;az-D&#237;az&#44; C&#46; P&#233;rez-Bocanegra&#44; R&#46; Mart&#237;nez-Fern&#225;ndez&#44; J&#46;A&#46; Nieto-Rodr&#237;guez&#44; J&#46; Masferrer-Serra&#44; L&#46; M&#233;rida-Rodrigo&#44; J&#46;M&#46; Varela-Aguilar&#44; A&#46; Mujal-Mart&#237;nez&#44; L&#46; Castilla-Guerra&#44; P&#46; Castellanos-Llauger&#44; G&#46; Tiberio-L&#243;pez&#44; E&#46; Guevara-Sierra and J&#46; Fern&#225;ndez-Pardo&#46;</p>"
            "etiqueta" => "Appendix"
            "titulo" => "Members of the Vascular Risk Group of the Spanish Society of Internal Medicine"
            "identificador" => "sec0070"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1364
            "Ancho" => 1419
            "Tamanyo" => 103645
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow diagram of patient inclusion&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1566
            "Ancho" => 1667
            "Tamanyo" => 147906
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Prevalence of sarcopenia&#44; frailty and cognitive impairment&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2360
            "Ancho" => 2919
            "Tamanyo" => 219831
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curves for the patients with one or several study conditions &#40;sarcopenia&#44; frailty and cognitive impairment&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The data are presented as <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41; or as&#8230;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Variable&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">Total &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>596&#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  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sarcopenia</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frailty</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cognitive impairment</th></tr><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" style="border-bottom: 2px solid black">&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" style="border-bottom: 2px solid black">&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">Yes &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>295&#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">No &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>301&#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"><span class="elsevierStyleItalic">p</span>&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">Yes &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>305&#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">No &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>291&#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"><span class="elsevierStyleItalic">p</span>&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">Yes &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>251&#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">No &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>345&#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"><span class="elsevierStyleItalic">p</span>&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">Age<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;9 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;8 &#40;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;1 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#46;5 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;9 &#40;504&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;877&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;3 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;9 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">315 &#40;52&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">191 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">185 &#40;60&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130 &#40;44&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">164 &#40;65&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">151 &#40;43&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Underweight &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;159&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;246&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;379&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">Excess weight or obesity &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</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  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">367 &#40;65&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">166 &#40;60&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">201 &#40;70&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;013&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">188 &#40;65&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179 &#40;66&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;847&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127 &#40;55&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">240 &#40;72&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">238 &#40;39&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">118 &#40;40&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">120 &#40;39&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;974&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">136 &#40;44&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;35&#46;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;39&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138 &#40;40&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;969&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">Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">524 &#40;87&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">257 &#40;87&#46;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">267 &#40;88&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;553&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">275 &#40;90&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">249 &#40;85&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;085&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">218 &#40;86&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">306 &#40;88&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hyperlipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">268 &#40;45&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">124 &#40;42&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">144 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#46;143&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">145 &#40;47&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">123 &#40;42&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114 &#40;45&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">154 &#40;44&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;865&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">Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">407 &#40;68&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">198 &#40;67&#46;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">209 &#40;69&#46;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;543&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">217 &#40;71&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">190 &#40;65&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">158 &#40;62&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">249 &#40;72&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;017&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">History of peripheral embolism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">34 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">21 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;4&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;211&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;020&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">Previous history of AF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#46;338&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">History of hemorrhaging&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;040&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Renal impairment&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peripheral artery disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;737&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32 &#40;11&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34 &#40;13&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;876&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">Cerebrovascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">60 &#40;20&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">99 &#40;33&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;18&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">83 &#40;33&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">69 &#40;20&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dementia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">131 &#40;22&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">105 &#40;36&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">77 &#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">54 &#40;18&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#46;049&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">121 &#40;48&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Delirium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">95 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">71 &#40;24&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24 &#40;8&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">59 &#40;19&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;016&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">Pressure ulcers&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;2&#46;1&#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">Falls in the past year<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">&#46;015&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">171 &#40;59&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">210 &#40;84&#46;3&#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">Charlson index<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">4&#46;1 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;2 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;0 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;359&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;6 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;6 &#40;2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">CHA2DS2-Vasc Scale<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">5&#46;3 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;4 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;042&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">HAS-BLED scale<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">Charlson index&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">CHA2DS2-Vasc&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">History of peripheral embolism&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;091 &#40;1&#46;288&#8211;3&#46;395&#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">Sarcopenia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;508 &#40;1&#46;884&#8211;3&#46;340&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;775 &#40;1&#46;270&#8211;2&#46;481&#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">Frailty&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;866 &#40;1&#46;414&#8211;2&#46;463&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;218 &#40;0&#46;888&#8211;1&#46;672&#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">Cognitive impairment&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;108 &#40;1&#46;611&#8211;2&#46;757&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;266 &#40;0&#46;939&#8211;1&#46;707&#41;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Sarcopenia&#58; European consensus on definition and diagnosis&#46; Report of the European working group on sarcopenia in older people"
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                            0 => "A&#46;J&#46; Cruz-Jentoft"
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                            2 => "J&#46; Bauer"
                            3 => "Y&#46; Boirie"
                            4 => "T&#46; Cederholm"
                            5 => "F&#46; Landi"
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                        "paginaInicial" => "412"
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                            2 => "B&#46;M&#46; Psaty"
                            3 => "W&#46;T&#46; Longstreht Jr&#46;"
                            4 => "C&#46;M&#46; Sitlani"
                            5 => "S&#46; Dublin"
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Article information
ISSN: 22548874
Original language: English
DOI:10.1016/j.rceng.2019.04.002
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