Editorial
De novo or acutely decompensated heart failure: the 2 sides of the coin
Insuficiencia cardiaca de novo o agudamente descompensada: las 2 caras de la moneda
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Jiménez-Puente, M.D. Martín-Escalante, F. Martos-Pérez, J. García-Alegría" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Jiménez-Puente" ] 1 => array:2 [ "nombre" => "M.D." "apellidos" => "Martín-Escalante" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Martos-Pérez" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "García-Alegría" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419300967?idApp=WRCEE" "url" => "/22548874/0000021900000009/v3_201912041809/S2254887419300967/v3_201912041809/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "De novo or acutely decompensated heart failure: the 2 sides of the coin" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "490" "paginaFinal" => "491" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "B. Díaz-Molina, P. Avanzas" "autores" => array:2 [ 0 => array:3 [ "nombre" => "B." "apellidos" => "Díaz-Molina" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "nombre" => "P." "apellidos" => "Avanzas" "email" => array:1 [ 0 => "avanzas@secardiologia.es" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Insuficiencia cardiaca <span class="elsevierStyleItalic">de novo</span> o agudamente descompensada: las 2 caras de la moneda" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Acute heart failure (AHF) is defined as the rapid onset or worsening of the signs and symptoms of heart failure. AHF can present as the first manifestation of heart failure (<span class="elsevierStyleItalic">de novo</span>) or, more typically, as the consequence of an acute decompensation of chronic heart failure and can be caused by a primary cardiac dysfunction or triggered by extrinsic factors, more commonly in patients with chronic heart failure.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> AHF is a life-threatening condition that requires emergency assessment and treatment and typically entails hospitalization. In Spain, AHF is the leading cause of hospitalization for individuals older than 65 years,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> although 24% of patients with AHF are discharged from hospital emergency departments without requiring hospitalization.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In this issue of <span class="elsevierStyleItalic">Revista Clínica Española</span>, García, Sarasola et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> present the results of the <span class="elsevierStyleItalic">de novo</span> Acute Heart Failure study (<span class="elsevierStyleItalic">Insuficiencia Cardiaca Aguda de novo,</span> NOVICA), a secondary and retrospective analysis of the Epidemiology of Acute Heart Failure in Emergency Departments (EAHFE) registry, a multicenter, multipurpose, analytical, noninterventional registry, with a prospective follow-up that consecutively included all patients treated for AHF in 34 Spanish hospital emergency departments. This study included 8647 patients from EAHFE-1 (2007) to EAHFE-4 (2014)<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> for which the variable “first episode of AHF or HF decompensation in patients with a previous AHF episode” was available. The patients were differentiated between de novo acute heart failure (NOAHF, n = 3288) and acute decompensated heart failure (ADHF, n = 5359). Patients were considered to have NOAHF if they had an initial decompensated AHF that required emergency care. The study’s primary objective was two-fold: 1) to report the clinical characteristics and conduct with the patients treated in the hospital emergency departments for NOAHF and compare them with those who were treated for ADHF and 2) to assess the prognosis of the patients with NOAHF compared with that of the patients with ADHF in terms of survival (hospital, at 30 days and at 12 months) and emergency department readmission for AHF 30 after the discharge. In terms of the results, NOAHF was associated with lower comorbidity, better baseline condition, lesser severity of the acute episode and lower hospitalization rate. The patients with NOAHF were more often admitted to the cardiology departments or intensive care units than those with ADHF, who were more often managed in short-stay units. Rates of raw mortality at 30 days and 12 months and readmission at 30 days were lower for the patients with NOAHF. In the adjusted analysis, however, only the rate of readmission at 30 days was lower for NOAHF (p < .001).</p><p id="par0015" class="elsevierStylePara elsevierViewall">The epidemiology and risk factors of AHF have merited the attention of various registries (ADHERE, OPTIMIZE-HF, EHFS I AND II, ESC-HF and ALARM-HF, among others). These registries have observed data similar to that found in NOVICA,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> given that the mean age at presentation was approximately 70 years, with approximately 50% women, arterial hypertension being the most common comorbidity and with a proportion of patients with ADHF of 65–75%.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">An important point is that the pathophysiology and profile of patients with NOAHF are different from those of patients with ADHF. NOAHF usually presents as acute pulmonary edema within a sudden increase in intracardiac filling pressure and/or in the presence of acute myocardial dysfunction. ADHF presents as the result of chronic neurohormonal deregulation, which leads to the onset of congestive signs and symptoms in patients with already known cardiomyopathy.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Patients with ADHF are also older, with a higher proportion of women and a higher prevalence of arterial hypertension, diabetes mellitus, pulmonary disease and atrial fibrillation.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">As in previous studies, the raw mortality in NOVICA for the patients with ADHF was higher than that for those with NOAHF, due in part to the fact that patients with ADHF are in a more advanced stage of disease. However, the weight of a history of heart failure varies from one study to another. For example, the FINN-AKVA registry analyzed 620 patients with AHF and found that a history of heart failure was an independent predictor of mortality at 5 years.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In the EHFS II registry, which included 2981 patients with AHF, the factors independently associated with increased mortality were age, previous myocardial infarction, serum creatinine and hyponatremia.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The main finding of NOVICA<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> is that all-cause mortality during the year following the emergency department visit was similar for the patients with ADHF and for those with NOAHF, when the analysis was performed adjusted to the baseline characteristics and those of the acute episode. Unfortunately, we do not have the causes of death (cardiac vs. non-cardiac), whose analysis would have been very interesting. One of the reasons that could have contributed to these results and a strength of NOVICA is that it provides a holistic view of the problem, because it includes all patients who were admitted to an emergency department for AHF, while most registries that compare both forms of the AHF presentation have an approach limited to patients hospitalized in certain medical departments.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,12</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The authors openly recognized 2 obvious limitations of the registry: exclusion of patients with acute coronary syndrome and the lack of the sample size calculation, given that this was a secondary analysis.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion, NOVICA once more demonstrates that AHF is an entity with a somber prognosis. We therefore need to continue researching strategies, both pharmacological and organizational, that can contribute to preventing episodes of decompensation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-07-05" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Díaz-Molina B, Avanzas P. Insuficiencia cardiaca <span class="elsevierStyleItalic">de novo</span> o agudamente descompensada: las 2 caras de la moneda. Rev Clin Esp. 2019;219:490–491.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Ponikowski" 1 => "A.A. Voors" 2 => "S.D. Anker" 3 => "H. Bueno" 4 => "J.G.F. Cleland" 5 => "A.J.S. Coats" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehw128" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2016" "volumen" => "37" "paginaInicial" => "2129" "paginaFinal" => "2200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27206819" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiología de la insuficiencia cardiaca en España en los últimos 20 años" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Sayago-Silva" 1 => "F. García-López" 2 => "J. Segovia-Cubero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2013.03.012" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2013" "volumen" => "66" "paginaInicial" => "649" "paginaFinal" => "736" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24776334" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Características clínicas, terapéuticas y evolutivas de los pacientes con insuficiencia cardiaca aguda atendidos en servicios de urgencias españoles: Registro EAHFE (Epidemiology of Acute Heart Failure in Spanish Emergency Departments)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Llorens" 1 => "R. Escoda" 2 => "O. Miró" 3 => "P. Herrero-Puente" 4 => "F.J. Martín-Sánchez" 5 => "J. Jacob" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Emergencias." "fecha" => "2015" "volumen" => "27" "paginaInicial" => "11" "paginaFinal" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29077328" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "NOVICA: characteristics and outcomes of patients who have a first episode of heart failure (de novo)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. García Sarasola" 1 => "A. Alquézar Arbé" 2 => "V. Gil" 3 => "F.J. Martín-Sánchez" 4 => "J. Jacob" 5 => "P. Llorens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2019.04.006" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2019" "volumen" => "219" "paginaInicial" => "469" "paginaFinal" => "476" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31253436" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Time trends in characteristics, clinical course, and outcomes of 13,791 patients with acute heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Llorens" 1 => "P. Javaloyes" 2 => "F.J. Martín-Sánchez" 3 => "J. Jacob" 4 => "P. Herrero-Puente" 5 => "V. Gil" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00392-018-1261-z" "Revista" => array:6 [ "tituloSerie" => "Clin Res Cardiol" "fecha" => "2018" "volumen" => "107" "paginaInicial" => "897" "paginaFinal" => "913" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29728831" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Insuficiencia cardiaca aguda: epidemiología, factores de riesgo y prevención" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Farmakis" 1 => "J. Parissis" 2 => "J. Lekakis" 3 => "G. Filipatos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2014.11.004" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol." "fecha" => "2015" "volumen" => "68" "paginaInicial" => "245" "paginaFinal" => "248" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25659507" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute heart failure: definition, classification and epidemiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Kurmani" 1 => "I. Squire" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11897-017-0351-y" "Revista" => array:6 [ "tituloSerie" => "Curr Heart Fail Rep." "fecha" => "2017" "volumen" => "14" "paginaInicial" => "385" "paginaFinal" => "392" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28785969" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes of de novo and acute decompensated heart failure patients according to ejection fraction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.H. Choi" 1 => "G.Y. Lee" 2 => "J.O. Choi" 3 => "E.S. Jeon" 4 => "H.Y. Lee" 5 => "H.J. Cho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/heartjnl-2017-311813" "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2018" "volumen" => "104" "paginaInicial" => "525" "paginaFinal" => "532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28982721" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term survival after hospitalization for acute heart failure-differences in prognosis of acutely decompensated chronic and new-onset acute heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Lassus" 1 => "K. Siirilä-Waris" 2 => "M.S. Nieminen" 3 => "J. Tolonen" 4 => "T. Tarvasmäki" 5 => "K. Peuhkurinen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2012.09.128" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2013" "volumen" => "168" "paginaInicial" => "458" "paginaFinal" => "462" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23073273" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V.P. Harjola" 1 => "F. Follath" 2 => "M.S. Nieminen" 3 => "D. Brutsaert" 4 => "K. Dickstein" 5 => "H. Drexler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurjhf/hfq002" "Revista" => array:6 [ "tituloSerie" => "Eur J Heart Fail" "fecha" => "2010" "volumen" => "12" "paginaInicial" => "239" "paginaFinal" => "248" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20156940" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical phenotypes and outcome of patients hospitalizated for acute heart failure: the ESC Heart Failure Long-Term Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Chioncel" 1 => "A. Mebazaa" 2 => "V.P. Harjola" 3 => "A.J. Coats" 4 => "M.F. Piepoli" 5 => "M.G. Crespo-Leiro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ejhf.890" "Revista" => array:6 [ "tituloSerie" => "Eur J Heart Fail." "fecha" => "2017" "volumen" => "19" "paginaInicial" => "1242" "paginaFinal" => "1254" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28463462" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "De novo acute heart failure: clinical features and one-year mortality in the Spanish nationwide Registry of Acute Heart Failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Franco" 1 => "F. Formiga" 2 => "X. Corbella" 3 => "A. Conde-Martel" 4 => "P. Llácer" 5 => "P. Álvarez Rocha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2019" "volumen" => "152" "paginaInicial" => "127" "paginaFinal" => "134" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021900000009/v3_201912041809/S2254887419301766/v3_201912041809/en/main.assets" "Apartado" => array:4 [ "identificador" => "72714" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021900000009/v3_201912041809/S2254887419301766/v3_201912041809/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419301766?idApp=WRCEE" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 0 | 6 |
| 2024 October | 64 | 5 | 69 |
| 2024 September | 68 | 0 | 68 |
| 2024 August | 56 | 0 | 56 |
| 2024 July | 60 | 0 | 60 |
| 2024 June | 34 | 2 | 36 |
| 2024 May | 149 | 5 | 154 |
| 2024 April | 40 | 4 | 44 |
| 2024 March | 45 | 2 | 47 |
| 2024 February | 40 | 1 | 41 |
| 2024 January | 54 | 0 | 54 |
| 2023 December | 46 | 1 | 47 |
| 2023 November | 41 | 5 | 46 |
| 2023 October | 54 | 0 | 54 |
| 2023 September | 60 | 4 | 64 |
| 2023 August | 42 | 2 | 44 |
| 2023 July | 68 | 1 | 69 |
| 2023 June | 33 | 0 | 33 |
| 2023 May | 25 | 3 | 28 |
| 2023 April | 23 | 1 | 24 |
| 2023 March | 28 | 6 | 34 |
| 2023 February | 22 | 1 | 23 |
| 2023 January | 20 | 0 | 20 |
| 2022 December | 21 | 0 | 21 |
| 2022 November | 13 | 0 | 13 |
| 2022 October | 14 | 2 | 16 |
| 2022 September | 12 | 0 | 12 |
| 2022 August | 12 | 2 | 14 |
| 2022 July | 19 | 2 | 21 |
| 2022 June | 12 | 0 | 12 |
| 2022 May | 18 | 0 | 18 |
| 2022 April | 16 | 2 | 18 |
| 2022 March | 20 | 2 | 22 |
| 2022 February | 15 | 2 | 17 |
| 2022 January | 18 | 0 | 18 |
| 2021 December | 8 | 0 | 8 |
| 2021 November | 5 | 0 | 5 |
| 2020 January | 1 | 2 | 3 |
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