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    "titulo" => "Experiencia local con el uso de anticoagulantes orales de acci&#243;n directa en pacientes con fibrilaci&#243;n auricular y valvulopat&#237;a significativa o pr&#243;tesis biol&#243;gica"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Los anticoagulantes orales de acci&#243;n directa &#40;ACOD&#41; se indican en pacientes con fibrilaci&#243;n auricular &#40;FA&#41; no valvular en funci&#243;n del riesgo tromb&#243;tico y hemorr&#225;gico definido por las diferentes escalas de riesgo&#46; Que estas recomendaciones se circunscriban a pacientes con FA no valvular obliga a identificar correctamente esta poblaci&#243;n&#46; Seg&#250;n las gu&#237;as europeas se considera pacientes con FA valvular aquellos con enfermedad reum&#225;tica o portadores de pr&#243;tesis valvulares<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a>&#46; En el informe de posicionamiento terap&#233;utico del Ministerio de Sanidad de diciembre de 2013 se define FA no valvular como aquella no asociada a estenosis mitral &#40;EM&#41; o a valvulopat&#237;a significativa que requiera tratamiento espec&#237;fico &#40;pr&#243;tesis&#44; valvuloplastia&#41;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a>&#46; Sin embargo&#44; introduci&#233;ndonos en los 4 grandes ensayos cl&#237;nicos donde se evalu&#243; el uso de ACOD en FA&#44; observamos que en el estudio RE-LY fueron excluidos solo los pacientes portadores de pr&#243;tesis o con antecedentes de enfermedad valvular significativa<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">3</span></a>&#59; en el estudio ROCKET-AF se excluy&#243; a los pacientes con EM reum&#225;tica significativa y pr&#243;tesis valvulares &#40;permiti&#233;ndose reparaciones valvulares&#41;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a>&#44;y ARISTOTLE o ENGAGE-AF excluyeron solo pacientes con pr&#243;tesis mitral mec&#225;nica o EM moderada&#47;severa&#44; incluy&#233;ndose pacientes con pr&#243;tesis biol&#243;gicas o reparaciones valvulares<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; En definitiva&#44; en estos estudios fueron incluidos pacientes con enfermedad valvular&#44; salvo aquellos con pr&#243;tesis mec&#225;nicas o EM significativa&#46; As&#237;&#44; en el estudio ROCKET se incluyeron 1992 pacientes con lesiones valvulares &#40;14&#44;1&#37; del total&#41;&#44; con similar eficacia en reducci&#243;n de eventos tromboemb&#243;licos&#44; pero m&#225;s hemorragias mayores&#46; En ARISTOTLE 4&#46;808 pacientes &#40;26&#44;4&#37; del total&#41; ten&#237;an afectaci&#243;n valvular&#44; incluidos 131 pacientes con EM&#44; apreci&#225;ndose similar evoluci&#243;n que en la poblaci&#243;n total analizada&#44; y menores tasas de eventos tromboemb&#243;licos y hemorr&#225;gicos que con warfarina&#46; La raz&#243;n de no incluir pacientes con EM reum&#225;tica es la exclusi&#243;n de esta poblaci&#243;n de los ensayos cl&#225;sicos de warfarina frente a placebo o &#225;cido acetilsalic&#237;lico por su alto riesgo embol&#237;geno&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Realizamos este estudio con objeto de conocer la evoluci&#243;n de los pacientes con valvulopat&#237;a significativa o pr&#243;tesis biol&#243;gica en tratamiento con ACOD&#46; Fueron analizados retrospectivamente todos los pacientes en seguimiento por cardiolog&#237;a de nuestro hospital con FA y enfermedad valvular significativa&#44; o portadores de pr&#243;tesis biol&#243;gica&#44; en los que se instaur&#243; tratamiento con ACOD por mal control del INR&#44; contraindicaci&#243;n al uso de acenocumarol&#47;warfarina o rechazo al mismo&#46; Todos los pacientes presentaban una tasa de filtrado glomerular &#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#46; Fueron registradas caracter&#237;sticas cl&#237;nicas&#44; escalas CHADS2&#44; CHA2DS2-VASc y HASBLED&#46; Se definieron como eventos tras el inicio del tratamiento&#58; mortalidad global&#44; ictus isqu&#233;mico&#44; embolismo sist&#233;mico y episodios de sangrado mayor y menor de acuerdo con los criterios de la Sociedad Internacional de Trombosis y Hemostasia<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a>&#46; Se analizaron 3 poblaciones diferentes&#58; a&#41; con lesiones valvulares moderadas&#47;severas&#44; excluyendo la EM reum&#225;tica&#59; b&#41; con EM reum&#225;tica significativa&#59; y c&#41; portadores de pr&#243;tesis biol&#243;gicas&#46; Todos los resultados fueron analizados mediante SPSS versi&#243;n 19&#46;0&#46; El nivel de significaci&#243;n estad&#237;stica se adopt&#243; para p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se registr&#243; el inicio del tratamiento con ACOD en 179 pacientes &#40;74 a&#241;os&#44; 65&#37; mujeres&#41; con FA y enfermedad valvular significativa &#40;91&#37;&#41; o portadores de pr&#243;tesis biol&#243;gica &#40;9&#37;&#41;&#46; Los pacientes presentaban CHA2DS2-VASc<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2 en el 93&#44;3&#37; y HASBLED<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>1 el 90&#44;5&#37; &#40;siendo<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3 puntos el 12&#44;9&#37;&#41;&#46; El 52&#37; no hab&#237;a recibido anticoagulaci&#243;n previa&#44; siendo dabigatr&#225;n el ACOD pautado en el 73&#37; de los casos&#44; y rivaroxab&#225;n en el 27&#37;&#46; La mediana de seguimiento fue de 12 meses &#40;RIC&#58; 7-16&#41;&#44; registrando 25 eventos&#58; 8 fallecimientos &#40;2 por causa infecciosa&#44; uno cardiovascular&#44; uno oncol&#243;gico y 4 de origen desconocido&#41;&#44; 6 ictus isqu&#233;micos&#44; 2 episodios de embolismo sist&#233;mico&#44; 8 episodios de sangrado mayor &#40;2 hemorragias intracraneales y 6 digestivas&#41; y un episodio de sangrado menor &#40;epistaxis&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se describen las caracter&#237;sticas basales&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">El an&#225;lisis de los subgrupos revel&#243; que de los 146 pacientes con cardiopat&#237;a valvular significativa el 90&#37; se mantuvo libre de eventos tromboemb&#243;licos o muerte a los 12 meses&#44; presentando una incidencia de sangrado mayor de 2&#44;05 por 100 pacientes-a&#241;o&#46; En el grupo de EM reum&#225;tica no se registraron muertes ni eventos tromboemb&#243;licos&#44; teniendo una incidencia de sangrado mayor de 5&#44;89 por 100 pacientes-a&#241;o&#46; Por &#250;ltimo&#44; en los 16 portadores de pr&#243;tesis biol&#243;gica se registraron 3 fallecimientos&#44; ning&#250;n evento tromboemb&#243;lico y un episodio de sangrado mayor &#40;6&#44;25 por 100 pacientes-a&#241;o&#41;&#59; presentando este grupo una edad significativamente mayor &#40;81 vs 73 a&#241;os&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y mayor comorbilidad &#40;&#237;ndice de Charlson 5&#44;5 vs 4&#44;4 puntos&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">No hay dudas sobre la contraindicaci&#243;n de indicar ACOD en pacientes con pr&#243;tesis mec&#225;nicas&#44; los datos del estudio RE-ALIGN demuestran que dabigatr&#225;n no es efectivo en la prevenci&#243;n de eventos tromboemb&#243;licos con pr&#243;tesis valvulares mec&#225;nicas&#44; asoci&#225;ndose incluso con m&#225;s eventos hemorr&#225;gicos<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a>&#46; Sin embargo&#44; no existe informaci&#243;n cl&#237;nica que contraindique el uso de los ACOD en pacientes con valvulopat&#237;a significativa&#59; es m&#225;s&#44; la mayor&#237;a de los estudios incluyeron a esta poblaci&#243;n sin diferencias en sus resultados&#46; Por otro lado&#44; las pr&#243;tesis biol&#243;gicas o la EM reum&#225;tica no deber&#237;an suponer una contraindicaci&#243;n desde un punto de vista fisiopatol&#243;gico&#44; aunque es cierto que disponemos de escasa evidencia publicada&#46; Nuestros resultados&#44; aunque con una muestra peque&#241;a&#44; apoyan esta hip&#243;tesis&#46; Se presentan pacientes del mundo real&#44; con mayor puntuaci&#243;n de CHADS2 &#40;CHADS2<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#44; 40&#44;8&#37; frente al 32&#44;1&#37; del estudio RE-LY&#41; y prevalencia de comorbilidades que los pacientes incluidos en los ensayos cl&#237;nicos&#44; sin embargo la incidencia de eventos tromboemb&#243;licos no fue elevada&#44; aunque s&#237; superior a la presentada en el estudio RE-LY &#40;4&#44;4 por 100 pacientes-a&#241;o frente 1&#44;69 del grupo de tratamiento con warfarina&#41;&#44; pudiendo estar justificado por el mayor riesgo tromboemb&#243;lico de nuestra poblaci&#243;n&#46; La incidencia de sangrado mayor fue similar&#44; o ligeramente superior en algunos grupos&#44; que en el estudio RE-LY &#40;3&#44;35 por 100 pacientes-a&#241;o&#44; frente 3&#44;36 del grupo de tratamiento con warfarina&#41;&#44; datos similares a los publicados recientemente en pacientes portadores de pr&#243;tesis biol&#243;gicas<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Como conclusi&#243;n&#44; el uso de los ACOD en pacientes con FA y enfermedad valvular significativa incluyendo EM reum&#225;tica y portadores de pr&#243;tesis biol&#243;gica puede ser una alternativa segura y eficaz comparable a la anticoagulaci&#243;n oral convencional&#46; No obstante&#44; para confirmar estos datos son necesarios estudios a largo plazo&#44; con mayor tama&#241;o muestral&#44; bien dise&#241;ados y en los que se defina de forma precisa FA valvular&#46;</p></span>"
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hombre&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63 &#40;34&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hipertensi&#243;n arterial&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140 &#40;78&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">118 &#40;80&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;52&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;81&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes mellitus&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53 &#40;29&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;29&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;23&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;37&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dislipidemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;45&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 &#40;47&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;41&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;31&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Insuficiencia cardiaca&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;38&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;58&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;37&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Ictus isqu&#233;mico&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;16&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;15&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;23&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;18&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Enfermedad vascular&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47 &#40;26&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;11&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;43&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de Charlson</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CHADS2&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;31<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CHA2DS2-VASc&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">HAS-BLED&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento anticoagulante previo</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acenocumarol&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81 &#40;45&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;44&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;58&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;37&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Warfarina&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otro ACOD&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">ACOD</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dabigatr&#225;n 110<span class="elsevierStyleHsp" style=""></span>mg&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96 &#40;53&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;53&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;47&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;62&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dabigatr&#225;n 150<span class="elsevierStyleHsp" style=""></span>mg&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;18&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;16&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;41&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;12&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rivaroxab&#225;n 15<span class="elsevierStyleHsp" style=""></span>mg&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;9&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;8&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rivaroxab&#225;n 15<span class="elsevierStyleHsp" style=""></span>mg&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;17&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31 &#40;21&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Apixab&#225;n 2&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Seguimiento &#40;meses&#41;&#44; mediana &#40;RIC&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;7-16&#41;&nbsp;\t\t\t\t\t\t\n
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                        "paginaFinal" => "694"
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Vol. 216. Núm. 4.
Páginas 234-236 (mayo 2016)
Correspondencia
DOI: 10.1016/j.rce.2016.01.010
Experiencia local con el uso de anticoagulantes orales de acción directa en pacientes con fibrilación auricular y valvulopatía significativa o prótesis biológica
Local experience with the use of direct-acting oral anticoagulants in patients with atrial fibrillation and significant valvulopathy or biological prosthesis
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M.A. López-Garrido
Autor para correspondencia
milopga@gmail.com

Autor para correspondencia.
, V.M. Becerra-Muñoz, H.N. Orellana-Figueroa, J.J. Gómez-Doblas
UGC del Corazón, Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
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Tabla 1. Características basales de las poblaciones estudiadas

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