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Mir&#243; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> have published a study on the use of HH in patients who come to the HED for AHF&#46; They included 1473 patients who consulted for AHF in the HED of six hospitals that participated in the multicenter prospective EAHFE Registry between 2014 and 2018&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> They evaluated adjusted adverse events at 30 days and mortality at one year based on whether the patients were transferred directly to HH versus those admitted to internal medicine wards &#40;IM&#41; or short-stay units &#40;SSU&#41;&#46; HH was the smallest group&#44; with 4&#46;7&#37; of all admitted patients&#46; The duration of stay in HH was the same as for those in IM and longer than those in SSU&#46; Mortality at one year of follow-up did not differ among the three groups &#40;HH with respect to IM&#58; HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;91&#59; 95&#37; CI&#58; 0&#46;73&#8211;1&#46;14 and with respect to SSU&#58; HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;77&#59; 95&#37; CI&#58; 0&#46;46&#8211;1&#46;27&#41;&#46; There were also no differences in mortality or readmission at 30 days&#46; A decrease in HED readmissions was observed in the HH group with respect to the other two &#40;HH-IM&#44; HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;50&#59; 95&#37; CI&#58; 0&#46;25&#8211;0&#46;97 and HH-SSU&#44; HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;37&#59; 95&#37; CI&#58; 0&#46;19&#8211;0&#46;74&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The authors conclude that there are few centers that offer HH &#40;only six of the 45 participating centers in the registry&#41; and that it is an underutilized resource&#46; According to the mortality and adverse events outcomes&#44; HH is a safe resource for patients attended to for AHF in HED compared to other types of hospitalization&#44; decreasing short-term readmissions to these departments&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The population studied includes patients with AHF without acute coronary syndrome who were not candidates for invasive interventions&#59; thus&#44; they were patients who were frail&#44; with comorbidities&#44; elderly&#44; or with terminal heart failure&#46; The progressive aging of the population in our setting&#44; in which 19&#46;1&#37; of the population is older than 65 years and 6&#46;1&#37; is older than 80 years&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> means that this type of patient is responsible for a large number of AHF consultations in HED&#44; an aspect that makes this study highly interesting&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">This work seems to reinforce the safety of the HH option as well as its potential for decreasing HED readmissions&#44; a finding that has previously been described&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> This type of hospitalization requires an active attitude on the part of the patient and their social environment&#44; promotes healthcare education&#44; and very likely contributes to improving the transition process between hospital care and the posterior rehabilitation process upon discharge&#46; Treatment compliance and lifestyle habits are fundamental at home&#46; In this regard&#44; HH allows for supervised training on hygienic and dietary measures&#44; such as control of diuresis and weight&#44; which are key factors for preventing future decompensations&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A meta-analysis carried out by Malik et al&#46; described a significant decrease in mortality and readmissions &#40;22&#37; vs&#46; 16&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; in patients with AHF when they developed at-home support strategies after hospital discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">A population involved in basic healthcare practices and knowledgeable about the early signs of AHF decompensation will very likely have a greater perception of control and well-being when less invasive types of hospitalization&#44; such as HH&#44; are indicated&#46; Minimizing the institutionalization of these elderly patients during hospitalizations can prevent complications&#59; for example&#44; lower rates of nosocomial infections associated with HH have been observed&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">However&#44; one of the fundamental limitations of this study lies in the heterogeneity of the three groups&#46; Patients in the HH strategy were older&#44; had a worse functional class&#44; and a lower left ventricular ejection fraction &#40;LVEF&#41;&#46; The patients in this group received higher doses of oxygen therapy and loop diuretics in perfusion in the HED and more beta blockers upon discharge&#46; On the contrary&#44; there was a higher percentage of patients hospitalized in IM who had new-onset heart failure and they presented with more severe decompensations &#40;mortality predicted by the MEESSI scale&#41;&#46; It should be noted that patients in IM&#44; whose baseline characteristics could suggest a more acute&#44; severe profile&#44; received less intensive treatment than patients in HH&#44; a fact that could have had an influence on the worse progress of these patients&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Also of note is the low implementation of optimal treatment upon discharge in the three groups with respect to beta blockers &#40;45&#37;&#41;&#44; angiotensin-converting enzyme inhibitors &#40;52&#37;&#41;&#44; and aldosterone antagonists &#40;14&#37;&#41;&#46; This is concordant with the high percentage of AHF and preserved LVEF represented in the study &#40;mean LVEF in the HH group 48&#37;&#44; IM 53&#37;&#44; SSU 56&#37;&#41;&#44; in which there is less evidence that pharmacological treatment modifies prognosis&#46; Treatment of hypertension and congestive symptoms as well as heart rate control when there is atrial fibrillation must be prioritized&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In conclusion&#44; this study supports the HH strategy in patients with AHF&#44; especially in those with preserved LVEF and advanced age who are not candidates for interventional therapies&#46; New lines of research should be proposed regarding its cost-effectiveness&#44; but its main benefits &#40;such as the reduction in nosocomial infections&#44; better adaptation to hospitalization&#44; incorporation of educational measures&#44; and the active participations of patients and those around them&#41; favor a better reincorporation into normal life after discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Though they do not show an impact on mortality&#44; these findings could explain the lower number of readmissions to HED&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In parallel&#44; we must not forget the need to strengthen other multidisciplinary integrated care units&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> the shift of healthcare processes toward outpatient procedures&#44; the creation of day hospitals&#44; and remote follow-up with telemonitoring tools<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a> that allow for maintaining the benefits and preventing readmissions over longer periods of time&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; L&#243;pez-Sobrino T&#44; Andrea R&#46; Nuevos retos en insuficiencia card&#237;aca aguda&#46; M&#225;s all&#225; de la atenci&#243;n hospitalaria&#46; Rev Clin Esp&#46; 2021&#59;221&#58;26&#8211;27&#46;</p>"
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    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical epidemiology of heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Mosterd"
                            1 => "A&#46;W&#46; Hoes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/hrt.2003.025270"
                      "Revista" => array:6 [
                        "tituloSerie" => "Heart"
                        "fecha" => "2007"
                        "volumen" => "93"
                        "paginaInicial" => "1137"
                        "paginaFinal" => "1146"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17699180"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Rodr&#237;guez-Artalejo"
                            1 => "J&#46;R&#46; Banegas Banegas"
                            2 => "P&#46; Guallar-Castill&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cardiol"
                        "fecha" => "2004"
                        "volumen" => "57"
                        "paginaInicial" => "163"
                        "paginaFinal" => "170"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14967113"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Home hospitalization in light of demographic changes and new health challenges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Cotta"
                            1 => "M&#46; Morales Su&#225;rez-Varela"
                            2 => "J&#46;S&#46; Cotta Filho"
                            3 => "A&#46; Llopis Gonz&#225;lez"
                            4 => "J&#46;A&#46; D&#237;as Ric&#243;s"
                            5 => "E&#46;R&#46; Real"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s1020-49892002000400007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Panam Salud Publica"
                        "fecha" => "2002"
                        "volumen" => "11"
                        "paginaInicial" => "253"
                        "paginaFinal" => "261"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12049034"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Mir&#243; &#210;&#44; L&#243;pez D&#237;ez MP&#44; Llorens P&#44; Mir M&#44; L&#243;pez Grima ML&#44; Alonso H&#44; et al&#46; Frecuencia&#44; perfil y resultados de los pacientes con insuficiencia card&#237;aca aguda que ingresan directamente en hospitalizaci&#243;n a domicilio desde urgencias&#46; Rev Clin Esp&#46; doi&#58; <a target="_blank" href="https://doi.org/10.1016/j.rce.2020.02.007">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;rce&#46;2020&#46;02&#46;007</a>&#46;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics and clinical course of patients with acute heart failure and the therapeutic measures applied in Spanish emergency departments&#58; based on the EAHFE registry &#40;Epidemiology of Acute Heart Failure in Emergency Departments&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Llorens"
                            1 => "R&#46; Escoda"
                            2 => "&#210;&#46; Mir&#243;"
                            3 => "P&#46; Herrero-Puente"
                            4 => "F&#46;J&#46; Mart&#237;n-S&#225;nchez"
                            5 => "J&#46; 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"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Un perfil de las personas mayores en Espa&#241;a&#44; 2019&#46; Indicadores estad&#237;sticos b&#225;sicos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Abell&#225;n Garc&#237;a"
                            1 => "P&#46; Aceituno Nieto"
                            2 => "J&#46; P&#233;rez D&#237;az"
                            3 => "D&#46; Ramiro Fari&#241;as"
                            4 => "A&#46; Ayala Garc&#237;a"
                            5 => "R&#46; Pujol Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2019"
                        "editorial" => "Informes Envejecimiento en red n&#46;&#176; 22"
                        "editorialLocalizacion" => "Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Home health care after skilled nursing facility discharge following heart failure hospitalization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Weerahandi"
                            1 => "H&#46; Bao"
                            2 => "J&#46; Herrin"
                            3 => "K&#46; Dharmarajan"
                            4 => "J&#46;S&#46; Ross"
                            5 => "S&#46; Jones"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jgs.16179"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2020"
                        "volumen" => "68"
                        "paginaInicial" => "96"
                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31603248"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MAGIC &#40;Meta-analysis And oriGinal Investigation in Cardiology&#41; investigators Effect of home-based follow-up intervention on readmissions and mortality in heart failure patients&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;H&#46; Malik"
                            1 => "S&#46;S&#46; Malik"
                            2 => "W&#46;S&#46; Aronow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2217/fca-2018-0061"
                      "Revista" => array:6 [
                        "tituloSerie" => "Future Cardiol"
                        "fecha" => "2019"
                        "volumen" => "15"
                        "paginaInicial" => "377"
                        "paginaFinal" => "386"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31502879"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of infections and patient risk factors in home health care&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Shang"
                            1 => "C&#46; Ma"
                            2 => "L&#46; Poghosyan"
                            3 => "D&#46; Dowding"
                            4 => "P&#46; Stone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajic.2013.12.018"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Infect Control"
                        "fecha" => "2014"
                        "volumen" => "42"
                        "paginaInicial" => "479"
                        "paginaFinal" => "484"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24656786"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of nosocomial infection and antibiotic use in german hospitals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Behnke"
                            1 => "S&#46;J&#46; Aghdassi"
                            2 => "S&#46; Hansen"
                            3 => "L&#46;A&#46; Pe&#241;a Diaz"
                            4 => "P&#46; Gastmeier"
                            5 => "B&#46; Piening"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3238/arztebl.2017.0851"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dtsch Arztebl Int"
                        "fecha" => "2017"
                        "volumen" => "114"
                        "paginaInicial" => "851"
                        "paginaFinal" => "857"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29271343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure&#58; The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology &#40;ESC&#41; developed with the special contribution of the Heart Failure Association &#40;HFA&#41; of the ESC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Ponikowski"
                            1 => "A&#46;A&#46; Voors"
                            2 => "S&#46;D&#46; Anker"
                            3 => "H&#46; Bueno"
                            4 => "J&#46;G&#46; Cleland"
                            5 => "A&#46;J&#46; Coats"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ejhf.592"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2016"
                        "volumen" => "18"
                        "paginaInicial" => "891"
                        "paginaFinal" => "975"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27207191"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implementation of home hospitalization and early discharge as an integrated care service&#58; a ten years pragmatic assessmentint"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Hern&#225;ndez"
                            1 => "J&#46; Aibar"
                            2 => "N&#46; Seijas"
                            3 => "I&#46; Puig"
                            4 => "A&#46; Alonso"
                            5 => "J&#46; Garcia-Aymerich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5334/ijic.3431"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Integr Care"
                        "fecha" => "2018"
                        "volumen" => "18"
                        "paginaInicial" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Integraci&#243;n entre cardiolog&#237;a y atenci&#243;n primaria&#58; impacto sobre la pr&#225;ctica cl&#237;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Falces"
                            1 => "R&#46; Andrea"
                            2 => "M&#46; Heras"
                            3 => "C&#46; Veh&#237;"
                            4 => "M&#46; Sorribes"
                            5 => "L&#46; Sanchis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.recesp.2011.02.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cardiol"
                        "fecha" => "2011"
                        "volumen" => "64"
                        "paginaInicial" => "564"
                        "paginaFinal" => "571"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21640459"
                            "web" => "Medline"
                          ]
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Editorial
New challenges in acute heart failure. Beyond hospital care
Nuevos retos en insuficiencia cardíaca aguda. Más allá de la atención hospitalaria
T. López-Sobrino, R. Andrea
Corresponding author
randrea@clinic.cat

Corresponding author.
Instituto Clínico Cardiovascular, Hospital Clínic Barcelona, IDIBAPS. Barcelona, Spain
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