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Artículo

Cardiopatía isquémica

REC Interv Cardiol. 2022;4:115-122

Inhibidores selectivos de la recaptación de serotonina y riesgo hemorrágico tras ICP. Un estudio con puntuación de propensión

Selective serotonin reuptake inhibitors and bleeding risk after PCI. A propensity score matching study

Rafael González-Manzanaresa, Soledad Ojedaa,., Francisco Hidalgoa, Marina Ruiz-Morenob, Consuelo Fernández-Avilésa, Francesco Costac, Guisela Flores-Vergaraa, Javier Suárez de Lezoa, Luz Carmona-Artimeb y Manuel Pana

aServicio de Cardiología, Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España

bFacultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, España

cDepartment of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, A.O.U. Policlinic G. Martino, Messina, Italia

RESUMEN

Introducción y objetivos: La cardiopatía isquémica y la enfermedad mental coexisten a menudo. Los inhibidores selectivos de la recaptación de serotonina (ISRS) se utilizan con frecuencia en este contexto, pero se han asociado con un incremento en el riesgo hemorrágico. Los estudios previos han evaluado este fenómeno en pacientes tratados con clopidogrel, con resultados contradictorios. No hay datos sobre el uso de ISRS e inhibidores del P2Y12 potentes o triple terapia antitrombótica. El objetivo de este estudio fue examinar el impacto de los ISRS en los eventos hemorrágicos en pacientes tratados con doble (incluyendo clopidogrel, prasugrel o ticagrelor) o triple terapia antitrombótica tras una intervención coronaria percutánea (ICP).

Métodos: Estudio retrospectivo en el que se incluyeron todos los pacientes tratados con ICP en un centro de alto volumen durante 2018. Los pacientes en tratamiento con ISRS fueron emparejados mediante puntaje de propensión con pacientes sin ISRS. El objetivo primario fue el sangrado mayor al año de seguimiento (BARC 3 o 5). Los objetivos secundarios fueron un combinado de sangrado mayor o menor clínicamente relevante (BARC 2, 3 o 5) y un combinado de eventos cardiovasculares adversos mayores.

Resultados: De los 1.063 pacientes tratados con ICP durante el periodo del estudio, 1.002 cumplieron los criterios de selección y 139 (13,9%) recibían ISRS. Los pacientes con ISRS tenían un mayor riesgo de sangrado antes del emparejamiento (PRECISE-DAPT: 16 [10-24] frente a 13 [9-21]; p = 0,040). No hubo diferencias en el objetivo primario (2,9% frente a 2,9%; p = 0,991) ni en los objetivos secundarios de sangrado mayor o menor clínicamente relevante (2,9 frente a 7,2%; p = 0,120) y eventos cardiovasculares adversos mayores (7,9 frente a 7,9%; p = 0,979).

Conclusiones: El uso de ISRS fue frecuente en los pacientes tratados con ICP, y aunque fue un marcador de riesgo hemorrágico basal, no se asoció con un mayor riesgo de sangrado en el seguimiento.

Palabras clave: Sangrado. Enfermedad coronaria. Intervencionismo coronario percutáneo. Inhibidores selectivos de la recaptación de serotonina. Terapia antitrombótica.

ABSTRACT

Introduction and objectives: Coronary artery disease and mental health disorders are often coexistent. Selective serotonin reuptake inhibitors (SSRIs) are often used in this context but have been associated with an increased risk of bleeding due to platelet dysfunction. Previous studies have assessed this risk in patients treated with clopidogrel-based dual antiplatelet therapy (DAPT) with contradictory results. However, there is no data regarding the use of SSRIs and potent P2Y12 inhibitors or triple antithrombotic therapy after percutaneous coronary intervention (PCI). The purpose of this study was to assess the impact of SSRIs on bleeding outcomes after PCI in patients treated with clopidogrel, prasugrel or ticagrelor-based DAPT or triple antithrombotic therapy.

Methods: Retrospective study including all patients undergoing PCI at a high-volume center during 2018. Patients on SSRIs were propensity-score-matched on a 1:1 ratio with patients naive to SSRIs adjusting for the baseline differences. The primary endpoint was major bleeding (BARC type 3 or 5 bleeding) at the 1-year follow-up. Secondary endpoints were a composite of major/non-major clinically relevant bleeding (BARC type 2, 3 or 5 bleeding), and a composite of major adverse cardiovascular events.

Results: Out of a total of 1063 patients treated with PCI during the study period, 1002 met the selection criteria, and 139 (13.9%) were on SSRIs. The latter had a higher bleeding risk before matching [PRECISE-DAPT, 16 [10-24] vs 13 [9-21]; P = .040]. No differences were reported in major bleeding (2.9% vs 2.9%, P = .991), major/non-major clinically relevant bleeding (2.9% vs 7.2%, P = .120) or in major adverse cardiovascular events (7.9% vs 7.9%, P = .979) in patients treated with SSRIs.

Conclusions: The use of SSRIs was frequent in patients treated with PCI, and although it was a marker of a higher bleeding risk at baseline, this was not associated with an additional bleeding liability.

Keywords: Bleeding. Coronary artery disease. Percutaneous coronary intervention. Selective serotonin reuptake inhibitors. Antithrombotic therapy.

Abreviaturas ICP: intervencionismo coronario percutáneo. ISRS: inhibidores selectivos de la recaptación de serotonina. TAPD: tratamiento antiagregante plaquetario doble.

INTRODUCCIÓN

La enfermedad coronaria (EC) y los trastornos mentales suelen ir de la mano y guardan, de hecho, una relación bidireccional1,2. Los pacientes que padecen trastornos mentales tienen un riesgo más alto de desarrollar enfermedad coronaria y, a la inversa, no es raro que estos pacientes cursen con síntomas de depresión o ansiedad tras sufrir un evento cardiaco3. De hecho, la depresión en pacientes con EC se asocia a una mala adherencia al tratamiento, a hábitos de vida poco saludables y confiere un peor pronóstico4-8.

Los inhibidores selectivos de la recaptación de serotonina (ISRS) suelen recetarse como agentes de primera línea para tratar la depresión y la ansiedad,9,10 pero se han asociado a un mayor riesgo hemorrágico debido al efecto inhibidor que tienen sobre el transportador de serotonina (5-HTT) plaquetario11. La inhibición del 5-HTT plaquetario se asocia a una menor activación y agregación plaquetarias y a un alargamiento de los tiempos de coagulación13. Por otro lado, algunos estudios vinculan el riesgo hemorrágico asociado a los ISRS a la edad avanzada, las comorbilidades o a la polifarmacia14,15.

El riesgo hemorrágico secundario al tratamiento antitrombótico es algo que preocupa enormemente tras una intervención coronaria percutánea (ICP) ya que los eventos hemorrágicos ensombrecen el pronóstico tanto o más que los eventos isquémicos recurrentes17. Aunque el riesgo hemorrágico depende de múltiples características clínicas y de laboratorio18,19, identificar factores modificables es clave para tratar de optimizar el equilibrio entre riesgo isquémico y hemorrágico20. Algunos estudios publicados hasta la fecha han valorado el riesgo hemorrágico de pacientes en tratamiento concomitante con ISRS y tratamiento antiagregante plaquetario doble (TAPD) basado en ácido acetilsalicílico y clopidogrel con resultados contradictorios21-23. No obstante, el efecto de la asociación de ISRS con inhibidores más potentes del receptor P2Y12 (por ejemplo, ticagrelor o prasugrel) o tratamiento antitrombótico triple con TAPD y anticoagulación oral (ACO) nunca se ha explorado. En este estudio se comparararon eventos hemorrágicos mayores al año de seguimiento en pacientes tratados con ICP y tratamiento antitrombótico acorde a las guías de práctica clínica (incluyendo TAPD basado en clopidogrel, ticagrelor o prasugrel o tratamiento antitrombótico triple) añadido, o no, a tratamiento con ISRS.

MÉTODOS

Diseño del estudio y contexto

Estudio retrospectivo con todos los pacientes consecutivos dados de alta tras ICP en un único centro durante el año 2018. Los pacientes tratados con ISRS fueron emparejados por puntuación de propensión (EPP) con un grupo de control para comparar eventos hemorrágicos al año de seguimiento. El tratamiento antitrombótico lo decidió un cardiólogo clínico de acuerdo a las actuales guías de práctica clínica24. Este estudio se realizó de conformidad con la Declaración de Helsinki y fue aprobado por el comité de ética de la investigación del centro. Todos los pacientes dieron su consentimiento informado antes de la ICP.

Población

Se consideraron elegibles aquellos pacientes dados de alta tras la ICP realizada durante el periodo de estudio. Se excluyó a los pacientes con tratamiento antiagregante plaquetario simple y TAPD sin ácido acetilsalílico, así como aquellos que, por alguna razón, recibieron al alta tratamiento anticoagulante con heparinas de bajo peso molecular También se excluyó a aquellos pacientes con pérdida de información en el seguimiento. Los datos clínicos y de la intervención, el tratamiento al alta y los resultados clínicos durante el primer año fueron obtenidos de la historia clínica electrónica. Se incluyó en el grupo de ISRS a aquellos pacientes en los que la lista de fármacos recetados al alta incluía a alguno de los siguientes: citalopram, escitalopram, fluoxetina, fluvoxamina, paroxetina o sertralina.

Objetivos

El objetivo primario de seguridad fueron las hemorragias mayores al año de seguimiento. Los objetivos secundarios fueron un compuesto de hemorragia mayor o no mayor clínicamente relevante y un compuesto de eventos cardiovasculares adversos mayores (MACE). Las hemorragias mayores se definieron como todo evento hemorrágico tipo 3 o 5 según los criterios del Bleeding Academic Research Consortium (BARC). Las hemorragias mayores/no mayores clínicamente relevantes se definieron como eventos hemorrágicos tipo 2, 3 o 5 según el BARC25. Los MACE se definieron como un compuesto de muerte cardiovascular, infarto de miocardio no fatal o revascularización no programada. Dos cardiólogos desconocedores del grupo de tratamiento con ISRS adjudicaron los eventos de manera independiente.

Análisis estadístico

Las variables categóricas se expresaron como recuentos (porcentajes) y las continuas como media ± desviación estándar o mediana [rango intercuartil] según su distribución, que fue evaluada mediante la prueba de Shapiro-Wilk. Los valores de significación se obtuvieron empleando X2 o U de Mann-Whitney, según procediera. El EPP se llevó a cabo para reducir el sesgo debido a variables de confusión 26. Se empleó la regresión logística para determinar la probabilidad de ser tratado con ISRS y se incluyeron las siguientes covariables asociadas, potencialmente, tanto al tratamiento con ISRS como al objetivo primario27: edad, sexo, antecedente de hemorragias relevantes, hipertensión, cáncer, historia clínica de enfermedad hematológica o anemia, enfermedad hepática, aclaramiento de creatinina, tratamiento con inhibidores potentes del receptor plaquetario P2Y12 o con ACO concomitante. Para el EPP en proporción 1:1 se empleó la técnica del vecino más cercano, sin reemplazo y con un calibrador de 0,1. Se emplearon histogramas de la puntuación de propensión y diferencias de medias estandarizadas antes y después del EPP para valorar el balance de los grupos con respecto a las covariables28. Los análisis de tiempo hasta el evento se realizaron empleando curvas de Kaplan-Meier y modelos de riesgos proporcionales de Cox. Para determinar los predictores de hemorragias mayores en la cohorte no emparejada, se realizó un análisis multivariado de regresión de Cox que empleó un modelo de selección intencionada priorizando la parsimonia. En el análisis univariado se incluyeron las variables de importancia clínica y aquellas con valores p < 0,2. Los análisis estadísticos se realizaron empleando los paquetes de software SPSS (versión 24; IBM Corp., Estados Unidos) y R (versión 4.0.3; R Foundation for Statistical Computing, Austria). El emparejamiento se realizó empleando el paquete estadístico MatchIt R (Ho, Imai, King, & Stuart, 2011) y el balance de las covariables se valoró mediante el paquete de software estadístico Cobalt R (Greifer, 2021).

RESULTADOS

Características clínicas basales

Un total de 1.063 pacientes fueron tratados mediante ICP durante el periodo del estudio, de los cuales, 1.002 cumplieron los criterios de selección y fueron incluidos en el análisis. Un total de 139 pacientes (13,9%) fueron tratados con ISRS al alta (figura 1). La mediana de edad se situó en torno a los 66 años (58-75) y 745 pacientes (74,4%) eran varones. La puntuación en la escala PRECISE-DAPT fue de 13 [9-22]. En lo referente al tratamiento antitrombótico, 684 pacientes (68,3%) fueron tratados con inhibidores potentes del P2Y12 y 102 (10,2%) con tratamiento concomitante con ACO. Tanto las características clínicas basales de toda la población como de los grupos no emparejados se muestran en la tabla 1. En el grupo de ISRS había un mayor porcentaje de mujeres y presentaban un mayor porcentaje de hipertensión, diabetes mellitus, cáncer, antecedente de hemorragias relevantes y enfermedad hematológica o anemia. Las escalas de riesgo hemorrágico HAS-BLED y PRECISE-DAPT fueron más altas en el grupo en tratamiento con ISRS.


Figura 1. Diagrama de flujo. ICP: intervención coronaria percutánea; ISRS: inhibidores selectivos de la recaptación de serotonina.

 

Tabla 1. Características clínicas basales de la población total y del los pacientes en tratamiento con y sin ISRS antes del emparejamiento

Variable Población general (n = 1.002) Con ISRS (n = 139) Sin ISRS (m = 863) p
Edad, Años 66 [58-75] 67 [60-76] 66 [57-75] 0,530
Sexo, varón 745 (74,4) 76 (54,7) 669 (77,5) 0,001*
IMC 28,7 [25,9-31,8] 30,0 [25,8-32,0] 28,6 [25,9-31,7] 0,067
Hipertensión 688 (68,7) 112 (80,6) 576 (66,7) 0,001*
Diabetes mellitus 370 (36,9) 64 (46,0) 306 (35,5) 0,017*
Hiperlipemia 525 (52,4) 83 (59,7) 442 (51,2) 0,059
Hábito tabáquico (activo o pasado) 260 (25,9) 34 (24,5) 226 (26,2) 0,709
Revascularización previa 248 (24,8) 41 (29,5) 207 (24,0) 0,174
EPOC 67 (6,7) 10 (7,2) 57 (6,6) 0,740
Insuficiencia renal crónica 115 (11,5) 17 (12,2) 98 (11,4) 0,774
Cáncer 98 (9,8) 20 (14,4) 78 (9,0) 0,044*
Enfermedad hepática 37 (3,7) 8 (5,8) 29 (3,4) 0,166
Enfermedad hematológica o anemia 99 (9,9) 25 (18) 74 (8,6) 0,001*
Hemorragia relevante previa por motivos clínicos 31 (3,1) 9 (6,5) 22 (2,5) 0,010*
Fibrilación auricular 87 (8,7) 11 (7,9) 76 (8,8) 0,871
Anticoagulante oral 102 (10,2) 9 (6,5) 93 (10,8) 0,119
Inhibidores potentes del receptor plaquetario P2Y12 684 (68,3) 90 (64,7) 594 (68,8) 0,323
Ticagrelor, n (%) 660 (65,9) 86 (61,8) 574 (66,5) 0,543
Prasugrel 24 (2,4) 4 (2,9) 20 (2,3) 0,543
Duración del TAPD (meses) 8 [6-12] 6 [6-12] 8 [6-12] 0,440
PRECISE-DAPT 13 [9-22] 16 [10-24] 13 [9-21] 0,040*
PRECISE-DAPT ≥ 25 195 [19,5] 34 [24,5] 161 [18,7] 0,109
HAS-BLED 2 (2-3) 3 (2-3) 2 (2-3) 0,034*
Aclaramiento de creatinina, ml/min/1,73 m2 100 [82,3-124,1] 94,8 [72,9-125,2] 100 [82,7-124,1] 0,154
Presentación clínica
 SCC 441 (44,0) 66 (47,5) 375 (43,5) 0,375
 SCA 561 (56,0) 73 (52,5) 488 (56,5)

SCA: síndrome coronario agudo; SCC: síndrome coronario crónico; EPOC: enfermedad pulmonar obstructiva crónica; TAPD: tratamiento antiagregante plaquetario doble; ISRS: inhibidores selectivos de la recaptación de serotonina; IMC: índice de masa corporal (kg/m2).

Los datos expresan n (%), media ± desviación estándar o mediana [rango intercuartílico].

* Indica una diferencia estadísticamente significativa con valores p < 0,05.

 

Estudio no emparejado

En la cohorte general se observaron un total de 19 eventos hemorrágicos mayores al año de seguimiento: 4 (2,9%) en el grupo tratado con ISRS y 15 (1,7%) en el grupo sin ISRS (p = 0,350). Cuatro de estos eventos (21,1%) fueron mortales, 10 (52,6%) hemorragias gastrointestinales, 4 (21,1%) hemorragias intracraneales y los restantes ocurrieron en otras localizaciones.

Se empleó el modelo multivariable de Cox para identificar los siguientes predictores independientes para el objetivo primario de hemorragias mayores: puntuación ≥ 25 en la escala PRECISE-TAPD y anticoagulación concomitante. La tabla 2 muestra los predictores univariables y multivariables de Cox para el objetivo primario.

Tabla 2. Predictores univariables y multivariables de Cox para las hemorragias mayores

Variable Análisis univariable Análisis multivariable
HR (IC95%) p HR (IC95%) p
Edad, años 1,06 (1,02-1,11) 0,008    
Sexo, varón 0,47 (0,19-1,18) 0,107    
IMC 0,98 (0,89-1,09) 0,756    
Hipertensión 0,99 (0,38-2,61) 0,989    
Diabetes mellitus 1,91 (0,78-4,79) 0,160    
Hiperlipemia 0,82 (0,33-2,01) 0,664    
Insuficiencia renal crónica 3,67 (1,39-9,66) 0,008    
Cáncer 2,47 (0,82-7,46) 0,107    
Enfermedad hepática 1,48 (0,19-11,05) 0,705    
Enfermedad hematológica o anemia 2,47 (0,82-7,46) 0,107    
Hemorragia relevante previa por motivos clínicos 3,91 (0,90-16,91) 0,068    
Fibrilación auricular 5,45 (2,05-14,53) 0,001    
Anticoagulante oral 8,22 (3,34-20,23) 0,001 6,99 (2,78-17,64) 0,001
Inhibidores potentes del receptor plaquetario P2Y12 0,16 (0,06-0,45) 0,001    
PRECISE-DAPT ≥ 25 4,77 (1,94-11,75) 0,001 3,59 (1,44-8,98) 0,006
HAS-BLED 1,69 (1,17-2,43) 0,005    
Aclaramiento de reatinina 0,98 (0,97-0,99) 0,024    
ISRS 1,68 (0,56-5,07) 0,356 1,95 (0,64-5,93) 0,241

IC95%: intervalo de confianza del 95%; HR: hazard ratio; ISRS: inhibidores selectivos de la recaptación de serotonina; IMC: índice de masa corporal (kg/m2).

 

El objetivo de hemorragias mayores/no mayores clínicamente relevantes ocurrió en 4 pacientes (2,9%) del grupo de ISRS y en 43 pacientes (4,9%) del grupo sin ISRS (p = 0,290). La incidencia de MACE fue similar en los 2 grupos: 11 eventos (7,9%) en el grupo de ISRS y 50 (5,8%) en el grupo sin ISRS.

Tanto las curvas de Kaplan-Meier como las tablas de riesgo asociados para cada objetivo de las cohortes no emparejadas se muestran en la figura 2.


Figura 2. Curvas de Kaplan-Meier para el objetivo primario hemorrágico (A), el objetivo secundario compuesto hemorrágico (B) y los eventos isquémicos (C). Cohorte no emparejada. ISRS: inhibidores selectivos de la recaptación de serotonina.

 

Estudio con puntuación de propensión

Las variables empleadas en el EPP, las diferencias de medias estandarizadas y las distribuciones de la puntuación de la propensión de las muestras emparejadas y no emparejadas se muestran en la figura 3. El EPP confirmó el excelente balance de las covariables con diferencias de medias estandarizadas ≤ 10% en todas las variables incluidas en la puntuación de la propensión. También se observó un balance adecuado en el resto de características basales y en las escalas de riesgo, salvo para diabetes mellitus e hiperlipemia, que fueron más prevalentes en el grupo de tratamiento con ISRS (tabla 3).


Figura 3. Variables utilizadas en el puntaje de propensión y sus diferencias estandarizadas antes y después del emparejamiento (A). Distribuciones de la puntuación de propensión de las cohortes emparejadas y no emparejadas (B). ACO: anticoagulante oral.

 

Tabla 3. Características clínicas basales de pacientes en tratamiento con y sin ISRS después del emparejamiento

Variable Con ISRS (n = 139) Sin ISRS (n = 139) p
Edad, Años 68 [60-76] 67 [58-75] 0,757
Sexo, varón 76 (54,7) 73 (52,5) 0,810
IMC 30,0 [25,8-32,0] 28,4 [25,3-32,4] 0,143
Hipertensión 112 (80,6) 109 (78,4) 0,656
Diabetes mellitus 64 (46,0) 48 (34,5) 0,050
Hiperlipemia 83 (59,7) 67 (48,2) 0,045
Hábito tabáquico (activo o pasado) 34 (24,5) 28 (20,1) 0,330
Revascularización previa 41 (29,5) 30 (21,6) 0,153
EPOC 10 (7,2) 9 (6,5) 0,816
Insuficiencia renal crónica 17 (12,2) 19 (13,7) 0,721
Cáncer 20 (14,4) 18 (12,9) 0,727
Enfermedad hepática 8 (5,8) 10 (7,2) 0,626
Enfermedad hematológica o anemia 25 (18) 21 (15,1) 0,519
Hemorragia relevante previa por motivos clínicos 9 (6,5) 10 (7,2) 0,812
Fibrilación auricular 11 (7,9) 11 (7,9) 1,000
Anticoagulante oral 9 (6,5) 9 (6,5) 1,000
Inhibidores potentes del receptor plaquetario P2Y12 90 (64,7) 97 (69,8) 0,371
Ticagrelor, n (%) 86 (61,8) 91 (65,5) 0,749
Prasugrel 4 (2,9) 6 (4,3) 0,749
Duración del TAPD (meses) 6 [6-12] 6 [6-12] 0,810
PRECISE-TAPD 16 [10-24] 15 [10-24] 0,863
PRECISE-TAPD ≥ 25 34 (24,5) 32 (23,0) 0,778
HAS-BLED 3 [2-3] 3 [2-3] 0,560
Aclaramiento de creatinina, ml/min/1,73 m2 94,8 [72,9-125,2] 100 [82,7-114,0] 0,747
Presentación clínica      
 SCC 66 (47,5) 63 (45,3) 0,718
 SCA 73 (52,5) 76 (54,7)  

SCA: síndrome coronario agudo; SCC: síndrome coronario crónico; EPOC: enfermedad pulmonar obstructiva crónica; TAPD: tratamiento antiagregante plaquetario doble; ISRS: inhibidores selectivos de la recaptación de serotonina; IMC: índice de masa corporal (kg/m2).

Los datos expresan n (%), media ± desviación estándar o mediana [rango intercuartil].

 

La incidencia de hemorragias mayores al año de seguimiento se situó en torno al 2,9% tanto en los pacientes tratados con ISRS como en los pacientes sin ISRS emparejados (HR = 1.01; IC95%, 0.25-4.03; p = 0,991). No se observaron hemorragias no mayores clínicamente relevantes en el grupo de ISRS pero sí 6 (4,3%) en el grupo sin ISRS (HR = 0.39; IC95%, 0.16-1.27; p = 0,120). No se observaron diferencias en los MACE entre los grupos (HR = 1.01; IC95%, 0.44-2.33; p = 0,979) (figura 4).


Figura 4. Curvas de Kaplan-Meier para el objetivo primario hemorrágico (A), el objetivo secundario compuesto hemorrágico (B) y los eventos isquémicos (C). Cohorte emparejadas. ISRS: inhibidores selectivos de la recaptación de serotonina.

 

DISCUSIÓN

Los principales hallazgos de este estudio son: a) el uso de ISRS fue habitual en pacientes dados de alta tras ICP; b) los pacientes tratados con ISRS tenían un riesgo hemorrágico basal más alto; c) a pesar de las diferencias en las características basales, tras el emparejamiento, el tratamiento con ISRS no se asoció a un exceso significativo de hemorragias mayores al año de seguimiento.

Existe una asociación bidireccional entre la enfermedad coronaria y los trastornos mentales. En nuestro estudio recibían tratamiento con ISRS el 13,9% de los pacientes dados de alta tras ICP. Se trata de un grupo con más comorbilidades y factores de riesgo hemorrágico, lo cual puede llegar a complicar el proceso de toma de decisiones clínicas a la hora de optar por un tratamiento antitrombótico u otro. Si los ISRS determinan o no un mayor riesgo hemorrágico por el efecto biológico que ejercen sobre los receptores 5-HTT plaquetarios o son un marcador de mayor riesgo hemorrágico por las comorbilidades concomitantes es algo que ya ha sido objeto de debate en anteriores estudios.

Labos et al.21 observaron un incremento del riesgo hemorrágico en pacientes tratados con ISRS y ácido acetilsalicílico o TAPD con clopidogrel tras un infarto de miocardio. Por el contrario, Lasella et al.22 evaluaron el impacto del tratamiento con ISRS en pacientes con TAPD tras ICP sin hallar un dicho incremento. No obstante, objetivaron un menor riesgo de MACE en pacientes tratados con ISRS frente a aquellos en tratamiento con mirtazapina, pero un mayor riesgo que en pacientes en tratamiento con ninguno de los 2 antidepresivos. Esto podría ser debido a que el efecto protector de los ISRS frente a los MACE29 sería sobrepasado por el efecto desfavorable que tienen los trastornos mentales sobre los eventos cardiovasculares30. Otra interpretación podría estar en la farmacocinética del clopidogrel ya que se trata de un profármaco que precisa de metabolización a través del citocromo P450 (CYP)31. Bykov et al.23 describieron un mayor riesgo de eventos isquémicos en pacientes tratados con clopidogrel y un ISRS inhibidor del CYP2C19 que en aquellos tratados con ISRS no inhibidores. No se observaron diferencias en lo referente a las hemorragias mayores. Este estudio no incluyó a un grupo de pacientes sin ISRS.

Se debe mencionar que ninguno de los estudios citados incluyó a pacientes en tratamiento con inhibidores potentes del receptor P2Y12 que son, en la actualidad, el tratamiento estándar en pacientes con SCA. Que sepamos, este es el primer estudio en valorar el impacto de los ISRS en pacientes tratados con inhibidores potentes del receptor P2Y12, prasugrel o ticagrelor. En nuestra población, dos terceras partes de los pacientes recibieron tratamiento con inhibidores potentes del P2Y12, lo cual está más en consonancia con las estrategias antiagregantes plaquetarias recomendadas por las actuales guías de práctica clínica32,33. En este contexto clínico, y a pesar del desequilibrio respecto al mayor riesgo hemorrágico basal en el análisis no emparejado, no hallamos diferencias en los eventos hemorrágicos mayores o no mayores clínicamente relevantes entre pacientes tratados con ISRS y el grupo emparejado sin ISRS. Así pues, aunque la prescripción de ISRS pueda ser un marcador de una población de mayor riesgo hemorrágico con más comorbilidades y factores de riesgo, quizás esto no se traduzca en un predictor independiente de eventos hemorrágicos tras tener en cuenta los posibles factores de confusión. Esto coincide con la literatura médica previamente publicada al respecto. En el estudio realizado por Labos et al.21 los pacientes en tratamiento con ISRS presentaban un mayor porcentaje de hipertensión, insuficiencia renal, anemia o cualquier otra enfermedad hematológica, así como hemorragias no gastrointestinales. Lasella et al.22 describieron que los pacientes en tratamiento con ISRS eran más propensos a tener diabetes, hipertensión, dislipemia, EPOC e insuficiencia renal crónica.

Nuestros hallazgos son relevantes a nivel clínico por varias razones. Aunque los ISRS se han vinculado a un potencial mayor riesgo hemorrágico, todavía no se ha podido confirmar que esto se traduzca en un exceso de eventos adversos. Nuestros datos sugieren un relativo perfil de seguridad de la asociación entre tratamientos antiplaquetarios potentes e ISRS en vida real al constatar que el riesgo hemorrágico no aumentó significativamente durante el primer año tras la ICP, que es cuando la decisión del tratamiento se basa en una evaluación concienzuda del balance entre el riesgo hemorrágico e isquémico.

Nuestro estudio también incluyó a una proporción de pacientes en tratamiento concomitante con antiagregantes plaquetarios y ACO (~10%), lo cual coincide con la práctica clínica habitual34. El impacto que ejercen los ISRS sobre los eventos hemorrágicos de pacientes con FA en tratamiento con ACO también ha sido objeto de estudio con anterioridad. Son varios los autores que han descrito un mayor riesgo hemorrágico en pacientes en tratamiento concomitante con ISRS y warfarina35,36. Al contrario, Quinn et al.37 no hallaron un riesgo hemorrágico mucho mayor entre los pacientes del estudio ROCKET AF aleatorizados a warfarina o rivaroxabán, y que también estaban en tratamiento ISRS. No obstante, sí se observó un modesto mayor riesgo de hemorragias mayores, que, sin embargo, no fue significativo a nivel estadístico, en el grupo de tratamiento con warfarina. Como los ISRS inhiben el CYP2C9, un aumento de las concentraciones plasmáticas de warfarina podría explicar estos hallazgos38. Esto confirma la importancia de los anticoagulantes orales directos para reducir el riesgo hemorrágico también en esta población, dada la necesidad de administrar múltiples agentes antitrombóticos tras la ICP y el mayor riesgo hemorrágico basal descrito39.

Limitaciones

Este estudio tiene varias limitaciones. En primer lugar, su diseño retrospectivo y observacional. También un tamaño muestral relativamente pequeño que limita la generalización de conclusiones al existir la posibilidad residual de error tipo 2. En segundo lugar, a pesar de que el EPP resultó en un buen balance entre los potenciales factores de confusión seleccionados y las demás características basales, la presencia de confusión residual no puede descartarse del todo. Por ejemplo, algunas variables asociadas a hemorragias tales como la presencia de diabetes mellitus o de enfermedad arterial periférica no fueron incluidas en el modelo de la puntuación de propensión. Aun así, se observaron hallazgos similares en los análisis ajustados y no ajustados. En tercer lugar, la clasificación de pacientes tratados con ISRS se basó en la lista de tratamiento al alta, con independencia de la adherencia a este o la interrupción del mismo en el seguimiento.

CONCLUSIONES

En este estudio de vida real, la combinación de ISRS y tratamientos antitrombóticos fue frecuente tras intervencionismo coronario percutáneo. Aunque el tratamiento con ISRS se asoció a un riesgo hemorrágico basal más alto en el análisis no ajustado, no se observó un exceso de hemorragias mayores o no mayores clínicamente relevantes en el seguimiento.

FINANCIACIÓN

Ninguna

CONTRIBUCIÓN DE LOS AUTORES

R. González-Manzanares y S. Ojeda idearon y diseñaron el estudio. R. González-Manzanares, M. Ruiz-Moreno, C. Fernández-Avilés, L. Carmona-Artime, G. Flores-Vergara y F. Costa recopilaron y analizaron los datos e interpretaron los resultados obtenidos. R. González-Manzanares, M. Ruiz-Moreno, S. Ojeda y F. Hidalgo redactaron el manuscrito y completaron las revisiones críticas del mismo. S. Ojeda, F. Hidalgo, G. Flores-Vergara, F. Costa, J. Suárez de Lezo y M. Pan llevaron a cabo el proceso de revisión del manuscrito y aprobaron la versión definitiva antes de enviarlo. Todos los autores dieron su aprobación final a la versión publicada.

CONFLICTO DE INTERESES

S. Ojeda es editora asociada de REC: Interventional Cardiology. Se ha seguido el procedimiento editorial establecido en la revista para garantizar la gestión imparcial del manuscrito. S. Ojeda y M. Pan declararon haber recibido honorarios como conferenciantes de Abbott, Boston, World Medical y Terumo. J Suárez de Lezo también declaró haber recibido honorarios como conferenciante de Abbott. Los demás autores no han declarado ningún conflicto de intereses.

¿QUÉ SE SABE DEL TEMA?

  • La enfermedad coronaria y los trastornos mentales coexisten con frecuencia. El tratamiento concomitante con ISRS y tratamientos antitrombóticos es frecuente.
  • Los eventos hemorrágicos tras una ICP empeoran el pronóstico de forma similar a los eventos isquémicos recurrentes.
  • Los ISRS se han asociado a un potencial mayor riesgo hemorrágico. Los datos existentes respecto al uso concomitante de ISRS y tratamientos antitrombóticos potentes son escasos y poco concluyentes.

¿QUÉ APORTA DE NUEVO?

  • Se trata del primer estudio en valorar el impacto de los ISRS en los eventos hemorrágicos en pacientes de la práctica clínica habitual tratados mediante intervencionismo coronaria percutáneo e inhibidores potentes del receptor P2Y12 o tratamiento antitrombótico triple.
  • El perfil de riesgo hemorrágico de los pacientes tratados con ISRS es más alto.
  • El uso de ISRS no se asoció a un mayor riesgo de hemorragias mayores tras ajustar por los potenciales factores de confusión.

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* Autor para correspondencia: Servicio de Cardiología, Hospital Universitario Reina Sofía, Av. Menéndez Pidal s/n, 14004 Córdoba, España.

Correo electrónico: soledad.ojeda18@gmail.com (S. Ojeda).

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  • afterRenderRawModule mod_custom (Home Concurso Hemodinamica) (928B) (79μs)
  • beforeRenderModule mod_custom (Home Concurso Hemodinamica) (736B) (3μs)
  • afterRenderModule mod_custom (Home Concurso Hemodinamica) (6.23KB) (443μs)
  • beforeRenderRawModule mod_menu (Sidebar Menú ES) (768B) (21μs)
  • afterRenderRawModule mod_menu (Sidebar Menú ES) (9.75KB) (636μs)
  • beforeRenderModule mod_menu (Sidebar Menú ES) (720B) (4μs)
  • afterRenderModule mod_menu (Sidebar Menú ES) (2.7KB) (127μs)
  • beforeRenderRawModule mod_menu (Sidebar - REC: Publications) (1.61KB) (21μs)
  • afterRenderRawModule mod_menu (Sidebar - REC: Publications) (16.07KB) (517μs)
  • beforeRenderModule mod_menu (Sidebar - REC: Publications) (736B) (4μs)
  • afterRenderModule mod_menu (Sidebar - REC: Publications) (3.23KB) (122μs)
  • beforeRenderRawModule mod_custom (Lo más leído) (2.39KB) (18μs)
  • afterRenderRawModule mod_custom (Lo más leído) (912B) (75μs)
  • beforeRenderModule mod_custom (Lo más leído) (720B) (3μs)
  • afterRenderModule mod_custom (Lo más leído) (1.31MB) (355ms)
  • beforeRenderRawModule mod_custom (Lo más compartido) (1.13KB) (34μs)
  • afterRenderRawModule mod_custom (Lo más compartido) (912B) (89μs)
  • beforeRenderModule mod_custom (Lo más compartido) (720B) (3μs)
  • afterRenderModule mod_custom (Lo más compartido) (578.61KB) (419ms)
  • beforeRenderRawModule mod_custom (Separador) (2.04KB) (951μs)
  • afterRenderRawModule mod_custom (Separador) (1.13KB) (105μs)
  • beforeRenderModule mod_custom (Separador) (720B) (4μs)
  • afterRenderModule mod_custom (Separador) (128.77KB) (4.13ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Descargar) (1.45KB) (23μs)
  • afterRenderRawModule mod_custom (Article Herramientas Descargar) (992B) (80μs)
  • beforeRenderModule mod_custom (Article Herramientas Descargar) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Descargar) (127.94KB) (3.98ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Traducción) (1.48KB) (22μs)
  • afterRenderRawModule mod_custom (Article Herramientas Traducción) (1.16KB) (79μs)
  • beforeRenderModule mod_custom (Article Herramientas Traducción) (736B) (2μs)
  • afterRenderModule mod_custom (Article Herramientas Traducción) (276.34KB) (7.47ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Traducción) (2.11KB) (24μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Traducción) (1.03KB) (81μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Traducción) (736B) (2μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Traducción) (151.14KB) (4.2ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Imprimir) (1.52KB) (22μs)
  • afterRenderRawModule mod_custom (Article Herramientas Imprimir) (928B) (80μs)
  • beforeRenderModule mod_custom (Article Herramientas Imprimir) (736B) (2μs)
  • afterRenderModule mod_custom (Article Herramientas Imprimir) (128.43KB) (4.06ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (1.48KB) (24μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (8.91KB) (81μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Imprimir) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Imprimir) (128.27KB) (3.97ms)
  • beforeRenderRawModule mod_custom (EMAIL Y TWITTER) (1.41KB) (22μs)
  • afterRenderRawModule mod_custom (EMAIL Y TWITTER) (1.02KB) (78μs)
  • beforeRenderModule mod_custom (EMAIL Y TWITTER) (720B) (3μs)
  • afterRenderModule mod_custom (EMAIL Y TWITTER) (129.35KB) (3.99ms)
  • beforeRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (2.83KB) (20μs)
  • afterRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (103.57KB) (9.31ms)
  • beforeRenderModule mod_dms3_refs (Article Herramientas Exportar) (736B) (7μs)
  • afterRenderModule mod_dms3_refs (Article Herramientas Exportar) (3.36KB) (164μs)
  • beforeRenderRawModule mod_custom (Article Herramientas Compartir) (432B) (27μs)
  • afterRenderRawModule mod_custom (Article Herramientas Compartir) (928B) (86μs)
  • beforeRenderModule mod_custom (Article Herramientas Compartir) (736B) (2μs)
  • afterRenderModule mod_custom (Article Herramientas Compartir) (342.7KB) (7.23ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Compartir) (6.36KB) (29μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Compartir) (928B) (86μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Compartir) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Compartir) (218.51KB) (5.41ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Estadísticas) (3.52KB) (29μs)
  • afterRenderRawModule mod_custom (Article Herramientas Estadísticas) (928B) (85μs)
  • beforeRenderModule mod_custom (Article Herramientas Estadísticas) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Estadísticas) (738.55KB) (21.54ms)
  • beforeRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (5.47KB) (32μs)
  • afterRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (928B) (87μs)
  • beforeRenderModule mod_custom (Innovacion Herramientas Estadísticas) (736B) (3μs)
  • afterRenderModule mod_custom (Innovacion Herramientas Estadísticas) (137.62KB) (4.21ms)
  • beforeRenderRawModule mod_custom (Article Herramientas Material Adicional) (3.53KB) (26μs)
  • afterRenderRawModule mod_custom (Article Herramientas Material Adicional) (944B) (81μs)
  • beforeRenderModule mod_custom (Article Herramientas Material Adicional) (736B) (3μs)
  • afterRenderModule mod_custom (Article Herramientas Material Adicional) (182.01KB) (5.02ms)
  • beforeRenderRawModule mod_menu (Contenido) (5.19KB) (725μs)
  • afterRenderRawModule mod_menu (Contenido) (18.63KB) (715μs)
  • beforeRenderModule mod_menu (Contenido) (704B) (4μs)
  • afterRenderModule mod_menu (Contenido) (3.08KB) (140μs)
  • beforeRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (2.36KB) (20μs)
  • afterRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (7.09KB) (284μs)
  • beforeRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (752B) (3μs)
  • afterRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (5.48KB) (144μs)
  • beforeRenderRawModule mod_menu (Publicar) (1.61KB) (136μs)
  • afterRenderRawModule mod_menu (Publicar) (29.84KB) (834μs)
  • beforeRenderModule mod_menu (Publicar) (704B) (4μs)
  • afterRenderModule mod_menu (Publicar) (3.33KB) (126μs)
  • beforeRenderRawModule mod_menu (Sobre nosotros) (160B) (113μs)
  • afterRenderRawModule mod_menu (Sobre nosotros) (22.34KB) (752μs)
  • beforeRenderModule mod_menu (Sobre nosotros) (720B) (4μs)
  • afterRenderModule mod_menu (Sobre nosotros) (3.2KB) (129μs)
  • beforeRenderRawModule mod_menu (Publicaciones Permanyer) (144B) (110μs)
  • afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.24KB) (452μs)
  • beforeRenderModule mod_menu (Publicaciones Permanyer) (720B) (4μs)
  • afterRenderModule mod_menu (Publicaciones Permanyer) (2.89KB) (124μs)
  • beforeRenderRawModule mod_menu (Footer Final ES) (4.92KB) (797μs)
  • afterRenderRawModule mod_menu (Footer Final ES) (28.11KB) (783μs)
  • beforeRenderModule mod_menu (Footer Final ES) (720B) (4μs)
  • afterRenderModule mod_menu (Footer Final ES) (3.33KB) (129μs)
  • afterRender (1.06MB) (86.05ms)
  • 1 x afterRenderModule mod_custom (Lo más compartido) (578.61KB) (34.22%)
    419ms
    1 x afterRenderModule mod_custom (Lo más leído) (1.31MB) (28.96%)
    355ms
    1 x afterRender (1.06MB) (7.02%)
    86.05ms
    1 x afterRenderComponent com_content (315.43KB) (5.1%)
    62.49ms
    1 x Before Access::getAssetRules (id:8 name:com_content) (1.39MB) (3.26%)
    39.88ms
    1 x afterInitialise (3.55MB) (2.88%)
    35.22ms
    1 x afterRenderModule mod_custom (Article Herramientas Estadísticas) (738.55KB) (1.76%)
    21.54ms
    1 x beforeRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (1.11MB) (1.43%)
    17.56ms
    1 x afterRoute (544.83KB) (1.19%)
    14.62ms
    1 x afterRenderModule mod_custom (Header Article) (548.07KB) (1.08%)
    13.29ms
    1 x afterRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (103.57KB) (0.76%)
    9.31ms
    1 x afterRenderModule mod_custom (Article Herramientas Traducción) (276.34KB) (0.61%)
    7.47ms
    1 x afterRenderModule mod_custom (Article - Referencia ) (300.08KB) (0.59%)
    7.27ms
    1 x afterRenderModule mod_custom (Article Herramientas Compartir) (342.7KB) (0.59%)
    7.23ms
    1 x Before Access::getAssetRules (id:1 name:root.1) (327.47KB) (0.54%)
    6.66ms
    1 x afterRenderModule mod_custom (Debate Title) (421.35KB) (0.54%)
    6.64ms
    1 x afterRenderModule mod_custom (Article DOI activo) (258.31KB) (0.54%)
    6.58ms
    1 x afterRenderModule mod_custom (Article Translated Title) (1.47MB) (0.52%)
    6.37ms
    1 x afterDispatch (396.59KB) (0.48%)
    5.90ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Compartir) (218.51KB) (0.44%)
    5.41ms
    1 x afterRenderModule mod_custom (Article Category) (255.75KB) (0.42%)
    5.12ms
    1 x afterRenderModule mod_custom (Article Herramientas Material Adicional) (182.01KB) (0.41%)
    5.02ms
    1 x afterRenderModule mod_custom (Article Authors) (165.91KB) (0.41%)
    4.97ms
    1 x afterRenderModule mod_custom (Article Related contents) (180.89KB) (0.4%)
    4.89ms
    1 x afterRenderModule mod_custom (Foto Autor) (162.19KB) (0.39%)
    4.76ms
    1 x afterRenderModule mod_custom (Article Subtitulo) (161.82KB) (0.37%)
    4.54ms
    1 x afterRenderModule mod_custom (Article Title) (150.27KB) (0.35%)
    4.23ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Estadísticas) (137.62KB) (0.34%)
    4.21ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Traducción) (151.14KB) (0.34%)
    4.20ms
    1 x afterRenderModule mod_custom (Separador) (128.77KB) (0.34%)
    4.13ms
    1 x afterRenderModule mod_custom (Article Herramientas Imprimir) (128.43KB) (0.33%)
    4.06ms
    1 x afterRenderModule mod_custom (EMAIL Y TWITTER) (129.35KB) (0.33%)
    3.99ms
    1 x afterRenderModule mod_custom (Article Herramientas Descargar) (127.94KB) (0.32%)
    3.98ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Imprimir) (128.27KB) (0.32%)
    3.97ms
    1 x After Access::preloadPermissions (com_content) (988.5KB) (0.29%)
    3.55ms
    1 x afterLoad (74.89KB) (0.2%)
    2.47ms
    1 x beforeRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (14.23KB) (0.19%)
    2.27ms
    1 x afterRenderRawModule mod_languages (Cambiar Idioma) (34.71KB) (0.12%)
    1.51ms
    1 x afterRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (34.63KB) (0.1%)
    1.17ms
    1 x beforeRenderRawModule mod_custom (Separador) (2.04KB) (0.08%)
    951μs
    1 x afterRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (13.98KB) (0.08%)
    931μs
    1 x afterRenderRawModule mod_menu (Publicar) (29.84KB) (0.07%)
    834μs
    1 x beforeRenderRawModule mod_menu (Footer Final ES) (4.92KB) (0.07%)
    797μs
    1 x After Access::preloadComponents (all components) (125.96KB) (0.06%)
    796μs
    1 x afterRenderRawModule mod_menu (Footer Final ES) (28.11KB) (0.06%)
    783μs
    1 x afterRenderRawModule mod_menu (Sobre nosotros) (22.34KB) (0.06%)
    752μs
    1 x beforeRenderRawModule mod_menu (Contenido) (5.19KB) (0.06%)
    725μs
    1 x afterRenderRawModule mod_menu (Contenido) (18.63KB) (0.06%)
    715μs
    1 x Before Access::preloadComponents (all components) (36.7KB) (0.05%)
    667μs
    1 x afterRenderRawModule mod_menu (Sidebar Menú ES) (9.75KB) (0.05%)
    636μs
    1 x afterRenderRawModule mod_menu (Sidebar - REC: Publications) (16.07KB) (0.04%)
    517μs
    1 x afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.24KB) (0.04%)
    452μs
    1 x afterRenderModule mod_custom (Home Concurso Hemodinamica) (6.23KB) (0.04%)
    443μs
    1 x afterRenderRawModule mod_custom (Header Article) (4.19KB) (0.03%)
    366μs
    1 x afterRenderModule mod_breadcrumbs (Breadcrumbs ES) (3.88KB) (0.03%)
    325μs
    1 x beforeRenderComponent com_content (12.66KB) (0.03%)
    313μs
    1 x afterRenderRawModule mod_lightbox (Lightbox) (72.07KB) (0.02%)
    300μs
    1 x afterRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (7.09KB) (0.02%)
    284μs
    1 x beforeRenderRawModule mod_custom (Debate Title) (560B) (0.02%)
    270μs
    1 x beforeRenderRawModule mod_custom (Header Article) (2.04KB) (0.02%)
    206μs
    1 x beforeRenderRawModule mod_custom (Home Concurso Hemodinamica) (80B) (0.02%)
    196μs
    1 x afterRenderModule mod_articles_good_search (Articles Good Search Total (Lateral)) (10.48KB) (0.01%)
    165μs
    1 x afterRenderModule mod_dms3_refs (Article Herramientas Exportar) (3.36KB) (0.01%)
    164μs
    1 x afterRenderModule mod_languages (Cambiar Idioma) (3.97KB) (0.01%)
    144μs
    1 x afterRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (5.48KB) (0.01%)
    144μs
    1 x afterRenderModule mod_menu (Contenido) (3.08KB) (0.01%)
    140μs
    1 x beforeRenderRawModule mod_menu (Publicar) (1.61KB) (0.01%)
    136μs
    1 x afterRenderModule mod_custom (Publicación de la Sociedad Española de Cardiología) (2.81KB) (0.01%)
    134μs
    1 x afterRenderModule mod_lightbox (Lightbox) (4.45KB) (0.01%)
    132μs
    1 x afterRenderModule mod_menu (Sobre nosotros) (3.2KB) (0.01%)
    129μs
    1 x afterRenderModule mod_menu (Footer Final ES) (3.33KB) (0.01%)
    129μs
    1 x afterRenderModule mod_menu (Sidebar Menú ES) (2.7KB) (0.01%)
    127μs
    1 x afterRenderModule mod_menu (Publicar) (3.33KB) (0.01%)
    126μs
    1 x afterRenderModule mod_menu (Publicaciones Permanyer) (2.89KB) (0.01%)
    124μs
    1 x afterRenderModule mod_custom (Article - Disponible Online) (2.67KB) (0.01%)
    123μs
    1 x afterRenderModule mod_menu (Sidebar - REC: Publications) (3.23KB) (0.01%)
    122μs
    1 x afterRenderModule mod_custom (Factor de Impacto) (2.84KB) (0.01%)
    120μs
    1 x beforeRenderRawModule mod_menu (Sobre nosotros) (160B) (0.01%)
    113μs
    1 x beforeRenderRawModule mod_lightbox (Lightbox) (7.17KB) (0.01%)
    110μs
    1 x beforeRenderRawModule mod_menu (Publicaciones Permanyer) (144B) (0.01%)
    110μs
    1 x afterRenderRawModule mod_custom (Separador) (1.13KB) (0.01%)
    105μs
    1 x afterRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (1.09KB) (0.01%)
    104μs
    1 x beforeRenderRawModule mod_languages (Cambiar Idioma) (5.38KB) (0.01%)
    103μs
    1 x After Access::getAssetRules (id:963 name:com_content.article.831) (9.4KB) (0.01%)
    93μs
    1 x afterRenderRawModule mod_custom (Lo más compartido) (912B) (0.01%)
    89μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (928B) (0.01%)
    87μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Compartir) (928B) (0.01%)
    86μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Compartir) (928B) (0.01%)
    86μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Estadísticas) (928B) (0.01%)
    85μs
    1 x afterRenderRawModule mod_custom (Debate Title) (976B) (0.01%)
    84μs
    1 x afterRenderRawModule mod_custom (Article Authors) (976B) (0.01%)
    82μs
    1 x afterRenderRawModule mod_custom (Article Related contents) (11.91KB) (0.01%)
    81μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Traducción) (1.03KB) (0.01%)
    81μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Material Adicional) (944B) (0.01%)
    81μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (8.91KB) (0.01%)
    81μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Descargar) (992B) (0.01%)
    80μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Imprimir) (928B) (0.01%)
    80μs
    1 x afterRenderRawModule mod_custom (Home Concurso Hemodinamica) (928B) (0.01%)
    79μs
    1 x afterRenderRawModule mod_custom (Article DOI activo) (1.02KB) (0.01%)
    79μs
    1 x afterRenderRawModule mod_custom (Factor de Impacto) (976B) (0.01%)
    79μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Traducción) (1.16KB) (0.01%)
    79μs
    1 x afterRenderRawModule mod_custom (Article - Disponible Online) (3.48KB) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Article - Referencia ) (1.02KB) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Article Translated Title) (992B) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (EMAIL Y TWITTER) (1.02KB) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Foto Autor) (1.02KB) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Article Title) (976B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Article Subtitulo) (976B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Lo más leído) (912B) (0.01%)
    75μs
    1 x afterRenderRawModule mod_custom (Article Category) (1.02KB) (0.01%)
    74μs
    1 x Before Access::getAssetRules (id:963 name:com_content.article.831) (66.8KB) (0%)
    44μs
    1 x beforeRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (9.73KB) (0%)
    36μs
    1 x beforeRenderRawModule mod_custom (Lo más compartido) (1.13KB) (0%)
    34μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (5.47KB) (0%)
    32μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Compartir) (6.36KB) (0%)
    29μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Estadísticas) (3.52KB) (0%)
    29μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Compartir) (432B) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (Article Authors) (1.5KB) (0%)
    26μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Material Adicional) (3.53KB) (0%)
    26μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Traducción) (2.11KB) (0%)
    24μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (1.48KB) (0%)
    24μs
    1 x beforeRenderRawModule mod_custom (Article Related contents) (1.64KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article - Disponible Online) (1.98KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Descargar) (1.45KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article Subtitulo) (1.44KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Traducción) (1.48KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (EMAIL Y TWITTER) (1.41KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article DOI activo) (1.22KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Foto Autor) (1.69KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article Translated Title) (1.11KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Factor de Impacto) (13.19KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Imprimir) (1.52KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_custom (Article - Referencia ) (1.61KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Title) (1.44KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_menu (Sidebar Menú ES) (768B) (0%)
    21μs
    1 x beforeRenderRawModule mod_menu (Sidebar - REC: Publications) (1.61KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (2.83KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (2.36KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Lo más leído) (2.39KB) (0%)
    18μs
    1 x beforeRenderRawModule mod_custom (Article Category) (832B) (0%)
    17μs
    1 x After Access::getAssetRules (id:1 name:root.1) (7.41KB) (0%)
    15μs
    1 x Before Access::preloadPermissions (com_content) (4.16KB) (0%)
    10μs
    1 x After Access::getAssetRules (id:8 name:com_content) (1.59KB) (0%)
    8μs
    1 x beforeRenderModule mod_dms3_refs (Article Herramientas Exportar) (736B) (0%)
    7μs
    1 x beforeRenderModule mod_breadcrumbs (Breadcrumbs ES) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Header Article) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Debate Title) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Publicación de la Sociedad Española de Cardiología) (752B) (0%)
    4μs
    1 x beforeRenderModule mod_languages (Cambiar Idioma) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_articles_good_search (Articles Good Search Total (Lateral)) (752B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sidebar Menú ES) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sidebar - REC: Publications) (736B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Separador) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Publicar) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sobre nosotros) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Publicaciones Permanyer) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Footer Final ES) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Contenido) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Article DOI activo) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article - Disponible Online) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Foto Autor) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Title) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Translated Title) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Factor de Impacto) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Lo más leído) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Imprimir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Compartir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Estadísticas) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Subtitulo) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_lightbox (Lightbox) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Home Concurso Hemodinamica) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Lo más compartido) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Descargar) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (EMAIL Y TWITTER) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Estadísticas) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Material Adicional) (736B) (0%)
    3μs
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    3μs
    1 x beforeRenderModule mod_custom (Article Category) (720B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article - Referencia ) (720B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Authors) (720B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Herramientas Compartir) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Related contents) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Herramientas Traducción) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Traducción) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Herramientas Imprimir) (736B) (0%)
    2μs
99 statements were executed, 25 of which were duplicates, 74 unique788ms2.22MB
  • SELECT @@SESSION.sql_mode;108μs1.57KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:308Copy
  • SELECT `data` FROM `yzfp0_session` WHERE `session_id` = ?153μs1.63KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:250Copy
  • SELECT `session_id` FROM `yzfp0_session` WHERE `session_id` = :session_id LIMIT 1121μs1.63KBParams/libraries/src/Session/MetadataManager.php:187Copy
  • UPDATE `yzfp0_session` SET `guest` = :guest , `time` = :time , `userid` = :user_id , `username` = :username , `client_id` = :client_id WHERE `session_id` = :session_id146μs992BParams/libraries/src/Session/MetadataManager.php:316Copy
  • SELECT `extension_id` AS `id`,`element` AS `option`,`params`,`enabled` FROM `yzfp0_extensions` WHERE `type` = 'component' AND `state` = 0 AND `enabled` = 1239μs2.31KB/libraries/src/Component/ComponentHelper.php:399Copy
  • SELECT `id`,`rules` FROM `yzfp0_viewlevels`131μs976B/libraries/src/Access/Access.php:955Copy
  • SELECT `b`.`id` FROM `yzfp0_usergroups` AS `a` LEFT JOIN `yzfp0_usergroups` AS `b` ON `b`.`lft` <= `a`.`lft` AND `b`.`rgt` >= `a`.`rgt` WHERE `a`.`id` = :guest174μs1.64KBParams/libraries/src/Access/Access.php:868Copy
  • SELECT `folder` AS `type`,`element` AS `name`,`params` AS `params`,`extension_id` AS `id` FROM `yzfp0_extensions` WHERE `enabled` = 1 AND `type` = 'plugin' AND `state` IN (0,1) AND `access` IN (:preparedArray1,:preparedArray2) ORDER BY `ordering`681μs21.8KBParams/libraries/src/Plugin/PluginHelper.php:294Copy
  • SELECT * FROM `yzfp0_languages` WHERE `published` = 1 ORDER BY `ordering` ASC196μs3.48KB/libraries/src/Language/LanguageHelper.php:177Copy
  • SELECT `element`,`name`,`client_id`,`extension_id` FROM `yzfp0_extensions` WHERE `type` = 'language' AND `state` = 0 AND `enabled` = 1179μs1.08KB/libraries/src/Language/LanguageHelper.php:250Copy
  • SELECT `m`.`id`,`m`.`menutype`,`m`.`title`,`m`.`alias`,`m`.`note`,`m`.`link`,`m`.`type`,`m`.`level`,`m`.`language`,`m`.`browserNav`,`m`.`access`,`m`.`params`,`m`.`home`,`m`.`img`,`m`.`template_style_id`,`m`.`component_id`,`m`.`parent_id`,`m`.`path` AS `route`,`e`.`element` AS `component` FROM `yzfp0_menu` AS `m` LEFT JOIN `yzfp0_extensions` AS `e` ON `m`.`component_id` = `e`.`extension_id` WHERE ( (`m`.`published` = 1 AND `m`.`parent_id` > 0 AND `m`.`client_id` = 0) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :currentDate1)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :currentDate2) ORDER BY `m`.`lft`1.08ms200.55KBParams/libraries/src/Menu/SiteMenu.php:166Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray1,:preparedArray2)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`330μs5.17KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `id` FROM `yzfp0_content` WHERE `alias` = :alias AND `catid` = :catid203μs1.65KBParams/components/com_content/src/Service/Router.php:263Copy
  • SELECT `id`,`home`,`template`,`s`.`params`,`inheritable`,`parent` FROM `yzfp0_template_styles` AS `s` LEFT JOIN `yzfp0_extensions` AS `e` ON `e`.`element` = `s`.`template` AND `e`.`type` = 'template' AND `e`.`client_id` = `s`.`client_id` WHERE `s`.`client_id` = 0 AND `e`.`enabled` = 1278μs1.55KB/administrator/components/com_templates/src/Model/StyleModel.php:775Copy
  • SELECT s.id, s.template, s.home, s.title AS long_title, s.params FROM yzfp0_template_styles AS s WHERE s.client_id = 0 AND s.template = 'g5_helium' ORDER BY s.id220μs1.48KB/libraries/gantry5/src/classes/Gantry/Joomla/StyleHelper.php:69Copy
  • SELECT `id`,`name`,`rules`,`parent_id` FROM `yzfp0_assets` WHERE `name` IN (:preparedArray1,:preparedArray2,:preparedArray3,:preparedArray4,:preparedArray5,:preparedArray6,:preparedArray7,:preparedArray8,:preparedArray9,:preparedArray10,:preparedArray11,:preparedArray12,:preparedArray13,:preparedArray14,:preparedArray15,:preparedArray16,:preparedArray17,:preparedArray18,:preparedArray19,:preparedArray20,:preparedArray21,:preparedArray22,:preparedArray23,:preparedArray24,:preparedArray25,:preparedArray26,:preparedArray27,:preparedArray28,:preparedArray29,:preparedArray30,:preparedArray31,:preparedArray32,:preparedArray33,:preparedArray34,:preparedArray35,:preparedArray36,:preparedArray37,:preparedArray38,:preparedArray39,:preparedArray40,:preparedArray41,:preparedArray42,:preparedArray43,:preparedArray44,:preparedArray45,:preparedArray46)476μs8.12KBParams/libraries/src/Access/Access.php:357Copy
  • SELECT `id`,`name`,`rules`,`parent_id` FROM `yzfp0_assets` WHERE `name` LIKE :asset OR `name` = :extension OR `parent_id` = 02.47ms96.3KBParams/libraries/src/Access/Access.php:301Copy
  • SHOW FULL COLUMNS FROM `yzfp0_content`368μs2.39KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
  • UPDATE `yzfp0_content` SET `hits` = (`hits` + 1) WHERE `id` = '831'848μs48B/libraries/src/Table/Table.php:1348Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)485μs120.69KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`316μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)394μs5.23KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SHOW FULL COLUMNS FROM `yzfp0_users`269μs2.2KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
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  • SELECT `g`.`id`,`g`.`title` FROM `yzfp0_usergroups` AS `g` INNER JOIN `yzfp0_user_usergroup_map` AS `m` ON `m`.`group_id` = `g`.`id` WHERE `m`.`user_id` = :muserid196μs1.68KBParams/libraries/src/Table/User.php:134Copy
  • SELECT * FROM `yzfp0_users` WHERE `id` = :userid173μs4.41KBParams/libraries/src/Table/User.php:106Copy
  • SELECT `g`.`id`,`g`.`title` FROM `yzfp0_usergroups` AS `g` INNER JOIN `yzfp0_user_usergroup_map` AS `m` ON `m`.`group_id` = `g`.`id` WHERE `m`.`user_id` = :muserid174μs1.68KBParams/libraries/src/Table/User.php:134Copy
  • SELECT `b`.`id` FROM `yzfp0_user_usergroup_map` AS `map` LEFT JOIN `yzfp0_usergroups` AS `a` ON `a`.`id` = `map`.`group_id` LEFT JOIN `yzfp0_usergroups` AS `b` ON `b`.`lft` <= `a`.`lft` AND `b`.`rgt` >= `a`.`rgt` WHERE `map`.`user_id` = :userId161μs1.64KBParams/libraries/src/Access/Access.php:868Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'articles' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id260μs2.11KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`330μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM yzfp0_fields AS a LEFT JOIN `yzfp0_languages` AS l ON l.lang_code = a.language LEFT JOIN yzfp0_users AS uc ON uc.id=a.checked_out LEFT JOIN yzfp0_viewlevels AS ag ON ag.id = a.access LEFT JOIN yzfp0_users AS ua ON ua.id = a.created_user_id LEFT JOIN yzfp0_fields_groups AS g ON g.id = a.group_id LEFT JOIN `yzfp0_fields_categories` AS fc ON fc.field_id = a.id WHERE ( (`a`.`context` = :context AND (`fc`.`category_id` IS NULL OR `fc`.`category_id` IN (:preparedArray1,:preparedArray2,:preparedArray3)) AND `a`.`access` IN (:preparedArray4,:preparedArray5)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray6,:preparedArray7)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray8,:preparedArray9) ORDER BY a.ordering ASC1.18ms54.94KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:164Copy
  • SELECT `field_id`,`value` FROM `yzfp0_fields_values` WHERE `field_id` IN (:preparedArray1,:preparedArray2,:preparedArray3,:preparedArray4,:preparedArray5,:preparedArray6,:preparedArray7,:preparedArray8,:preparedArray9,:preparedArray10,:preparedArray11,:preparedArray12,:preparedArray13,:preparedArray14,:preparedArray15,:preparedArray16,:preparedArray17,:preparedArray18,:preparedArray19,:preparedArray20,:preparedArray21,:preparedArray22,:preparedArray23,:preparedArray24,:preparedArray25,:preparedArray26,:preparedArray27,:preparedArray28,:preparedArray29,:preparedArray30,:preparedArray31,:preparedArray32,:preparedArray33,:preparedArray34,:preparedArray35,:preparedArray36,:preparedArray37,:preparedArray38,:preparedArray39,:preparedArray40,:preparedArray41,:preparedArray42,:preparedArray43,:preparedArray44,:preparedArray45,:preparedArray46,:preparedArray47,:preparedArray48,:preparedArray49) AND `item_id` = :itemid503μs7.77KBParams/administrator/components/com_fields/src/Model/FieldModel.php:747Copy
  • SELECT a.id,a.asset_id,a.title,a.alias,a.introtext,a.fulltext,a.state,a.catid,a.created,a.created_by,a.created_by_alias,CASE WHEN a.modified = '0000-00-00 00:00:00' THEN a.created ELSE a.modified END as modified,a.modified_by,a.checked_out,a.checked_out_time,a.publish_up,a.publish_down,a.images,a.urls,a.attribs,a.version,a.ordering,a.metakey,a.metadesc,a.access,a.hits,a.metadata,a.featured,a.language,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`lft` AS `category_lft`,`c`.`lft` AS `category_ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,ROUND(v.rating_sum / v.rating_count, 0) AS rating,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `v`.`content_id` = `a`.`id` WHERE `a`.`id` = 806 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2024-11-29 11:20:06') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2024-11-29 11:20:06'))394μs122.44KB/libraries/regularlabs/src/Article.php:94Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`329μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)388μs120.73KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)304μs5.23KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT c.id FROM yzfp0_content AS c LEFT JOIN yzfp0_fields_values AS f1 ON c.id = f1.item_id AND f1.field_id = (SELECT id FROM yzfp0_fields WHERE name = "orden-nuevo") LEFT JOIN yzfp0_fields_values AS f2 ON c.id = f2.item_id AND f2.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-volumen") LEFT JOIN yzfp0_fields_values AS f3 ON c.id = f3.item_id AND f3.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-numero") WHERE c.language = 'es-ES' AND f1.value = '7' AND f2.value = '4' AND f3.value = '2' LIMIT 111.92ms856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
  • SELECT c.id FROM yzfp0_content AS c LEFT JOIN yzfp0_fields_values AS f1 ON c.id = f1.item_id AND f1.field_id = (SELECT id FROM yzfp0_fields WHERE name = "orden-nuevo") LEFT JOIN yzfp0_fields_values AS f2 ON c.id = f2.item_id AND f2.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-volumen") LEFT JOIN yzfp0_fields_values AS f3 ON c.id = f3.item_id AND f3.field_id = (SELECT id FROM yzfp0_fields WHERE name = "dms3-numero") WHERE c.language = 'es-ES' AND f1.value = '5' AND f2.value = '4' AND f3.value = '2' LIMIT 113.14ms856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
  • SELECT `catid`,`alias`,`language` FROM `yzfp0_content` WHERE `id` = '737'165μs976B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:227Copy
  • SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '38'229μs856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
  • SELECT `catid`,`alias`,`language` FROM `yzfp0_content` WHERE `id` = '789'151μs976B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:227Copy
  • SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '36'153μs856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`410μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'component' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id388μs2.11KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `language`,`id` FROM `yzfp0_menu` WHERE `home` = '1' AND `published` = 1 AND `client_id` = 0347μs944B/libraries/src/Language/Multilanguage.php:123Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id184μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id150μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `c2`.`language`,CONCAT_WS(':', `c2`.`id`, `c2`.`alias`) AS `id`,CONCAT_WS(':', `ca`.`id`, `ca`.`alias`) AS `catid` FROM `yzfp0_content` AS `c` INNER JOIN `yzfp0_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `yzfp0_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `yzfp0_content` AS `c2` ON `a2`.`id` = `c2`.`id` INNER JOIN `yzfp0_categories` AS `ca` ON `c2`.`catid` = `ca`.`id` AND `ca`.`extension` = :extension2 WHERE `c`.`id` = :id AND c2.access IN (1,5) AND c2.language != 'es-ES' AND (c2.publish_up IS NULL OR c2.publish_up <= '2024-11-29 11:20:06') AND (c2.publish_down IS NULL OR c2.publish_down >= '2024-11-29 11:20:06') AND c2.state = 1377μs1.8KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `m`.`id`,`m`.`title`,`m`.`module`,`m`.`position`,`m`.`content`,`m`.`showtitle`,`m`.`params`,`mm`.`menuid` FROM `yzfp0_modules` AS `m` LEFT JOIN `yzfp0_modules_menu` AS `mm` ON `mm`.`moduleid` = `m`.`id` LEFT JOIN `yzfp0_extensions` AS `e` ON `e`.`element` = `m`.`module` AND `e`.`client_id` = `m`.`client_id` WHERE ( ( (`m`.`published` = 1 AND `e`.`enabled` = 1 AND `m`.`client_id` = :clientId AND `m`.`access` IN (:preparedArray1,:preparedArray2)) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :publishUp)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :publishDown)) AND (`mm`.`menuid` = :itemId OR `mm`.`menuid` <= 0) AND `m`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY `m`.`position`,`m`.`ordering`1.34ms180.16KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
  • SELECT `a`.`menutype`,`a`.`title` FROM `yzfp0_menu_types` AS `a` WHERE `a`.`client_id` = 0169μs1.31KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:138Copy
  • SELECT m.id, m.alias, m.path AS route, m.level, m.parent_id FROM yzfp0_menu AS m WHERE m.menutype = 'menu-es-new' AND m.parent_id > 0 AND m.client_id = 0 AND m.published >= 0 ORDER BY m.lft296μs1.92KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:791Copy
  • SHOW FULL COLUMNS FROM `yzfp0_content`311μs2.39KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[779] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 831 LIMIT 1196μs912B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT category.id,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[263] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getUnpublishedCategoryIds\n[668] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_categories` AS `category` LEFT JOIN `yzfp0_categories` AS `parent` ON `category`.`parent_id` = `parent`.`id` WHERE `category`.`extension` = 'com_content' AND (category.published IN (0,-1,-2) OR parent.published IN (0,-1,-2)) GROUP BY category.id272μs896B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[840] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByFilters\n[324] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE ((`article`.`state` = 1 AND (`article`.`publish_up` IS NULL OR `article`.`publish_up` <= '2024-11-29 11:20:06') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2024-11-29 11:20:06')) AND article.access IN (1,5) AND article.language IN ('es-ES','*')) AND `article`.`id` = 831125μs912B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 831 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1123μs976B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)339μs5.23KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)298μs5.23KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id130μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id118μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT field.name,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[804] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getFieldNames\n[799] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_fields` AS `field` WHERE field.context = 'com_content.article'204μs34.13KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[779] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 831 LIMIT 1179μs1KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 831 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1183μs1.06KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 831 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1189μs1KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`category`.`id` AS `category.id`,`category`.`title` AS `category.title`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` LEFT JOIN `yzfp0_categories` AS `category` ON `category`.`id` = `article`.`catid` WHERE `article`.`id` = 831 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1155μs9.13KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)424μs5.23KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `m`.`tag_id`,`t`.* FROM `yzfp0_contentitem_tag_map` AS `m` INNER JOIN `yzfp0_tags` AS `t` ON `m`.`tag_id` = `t`.`id` WHERE `m`.`type_alias` = :contentType AND `m`.`content_item_id` = :id AND `t`.`published` = 1 AND `t`.`access` IN (:preparedArray1,:preparedArray2)403μs5.23KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `c2`.`language`,`c2`.`id` FROM `yzfp0_menu` AS `c` INNER JOIN `yzfp0_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `yzfp0_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `yzfp0_menu` AS `c2` ON `a2`.`id` = `c2`.`id` WHERE `c`.`id` = :id269μs1.72KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT * FROM `yzfp0_fields` AS `a` WHERE a.state IN (:preparedArray1,:preparedArray2) AND `a`.`context` = 'com_content.article'406μs54.11KBParams/plugins/system/articlesanywhere/src/DataGroups/Helpers/Fields.php:105Copy
  • SELECT *,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[590] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getFieldFromDatabase\n[770] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_fields` AS `field` WHERE field.context = 'com_content.article' AND `field`.`name` = 'dms3-content-type'275μs4.09KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT value.item_id,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[443] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getWhere\n[670] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_fields_values` AS `value` INNER JOIN `yzfp0_fields` AS `field` ON `field`.`id` = `value`.`field_id` WHERE `field`.`name` = 'dms3-content-type' AND `field`.`state` = 1 AND `field`.`context` = 'com_content.article' AND `value`.`value` = 'dms3_article'1.87ms468.88KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[727] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByFilters\n[324] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` LEFT JOIN `yzfp0_fields` AS `field-dms3-content-type` ON `field-dms3-content-type`.`name` = 'dms3-content-type' AND `field-dms3-content-type`.`state` = 1 AND `field-dms3-content-type`.`context` = 'com_content.article' LEFT JOIN `yzfp0_fields_values` AS `field_value-dms3-content-type` ON `field_value-dms3-content-type`.`field_id` = `field-dms3-content-type`.`id` AND `field_value-dms3-content-type`.`item_id` = article.id WHERE ((`article`.`state` = 1 AND (`article`.`publish_up` IS NULL OR `article`.`publish_up` <= '2024-11-29 11:20:06') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2024-11-29 11:20:06')) AND article.access IN (1,5) AND article.language IN ('es-ES','*')) AND article.id IN 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  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[757] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByArticleIds\n[301] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` IN (1259,3,4,5,6,7,8,9,10,11,12,13,15,16,21,22,23,31,36,37,1288,1287,1286,1279,1278,1277,1276,1303,261,1315,260,753,1053,1272,242,241,240,239,230,229,228,227,226,225,214,213,212,211,210,1309,1310,1311,1314,1322,1323,1324,1331,1332,1335,1298,1297,1293,1292,1291,1290,1265,1264,1263,1262,1258,1257,1256,1255,1251,1244,1234,1230,1229,1227,1224,1223,1222,1220,1214,1212,1211,1210,1209,1208,1207,1206,1205,1204,1199,1195,1190,1185,1184,1179,1178,1174,1165,1164,1163,1159,1158,1157,1156,1154,1153,1152,1151,1149,1148,1147,1144,1139,1138,1137,1135,1123,1119,1118,1117,1116,1115,1113,1107,1105,1104,1098,1097,1096,1095,1094,1091,1084,1083,1082,1081,1076,1075,1074,1073,1072,1066,1065,1060,1057,1052,1047,1046,1045,1044,1043,1037,1033,1032,1031,1027,1025,1024,1022,1020,1019,1016,1012,1010,1008,1007,1004,1003,1000,995,992,984,979,977,976,975,974,973,972,971,970,969,968,967,966,965,964,963,962,961,949,938,935,934,933,927,926,925,923,919,918,917,916,914,908,906,905,904,903,899,897,892,890,884,883,882,881,880,878,877,873,862,861,860,857,856,852,850,849,848,838,837,836,835,833,831,830,829,828,823,821,805,804,803,801,800,799,798,797,793,792,791,790,789,780,779,778,767,55,755,754,752,751,750,749,748,747,746,744,743,742,741,737,735,734,731,729,723,719,718,717,712,711,710,708,707,706,704,689,686,685,683,676,675,672,671,666,665,664,649,648,647,643,642,637,634,633,629,628,622,621,614,613,608,605,604,603,602,561,560,556,547,543,542,540,535,528,520,519,518,509,508,506,505,503,502,484,483,482,479,477,476,460,459,458,457,455,454,453,452,450,433,432,431,430,429,423,422,421,420,413,412,411,410,403,402,401,399,385,384,383,382,381,376,375,374,373,372,371,370,369,361,360,359,358,356,354,353,352,351,350,276,275,274,273,272,271,270,264,54,59,60,253,345,344,339,333,332,331,322,321,320,319,318,317,316,315,314,308,307,305,300,299,298,287,286,285,587,584,572,183,182,181,178,177,175,171,170,169,164,163,161,1261,847,846,1317,1260,663,607,570,569,567,566,565,564,563,562,493,492,491,438,437,436,435,434,283,258,256,255,254,184,174,173,172,166,165,160,159,158,149,148,147,139,138,137,136,134,133,132,131,130,124,121,119,116,115,113,2586,2589,2590,2591,2592,2594,2595,2596,2598,2599,2600,2605,2611,2612) ORDER BY `article`.`hits` IS NULL, CAST(`article`.`hits` AS CHAR(1)) = '', CAST(`article`.`hits` AS CHAR(10)) = '0000-00-00', CAST(`article`.`hits` AS SIGNED INTEGER) = 0, CAST(`article`.`hits` AS SIGNED INTEGER) DESC, `article`.`hits` DESC LIMIT 31.33ms944B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`alias` AS `article.alias`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[765] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` IN (320,344,211) ORDER BY FIELD(article.id,320,344,211)207μs1.16KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`357μs5.22KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`358μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id144μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id199μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[757] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByArticleIds\n[301] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` LEFT JOIN `yzfp0_fields` AS `field-dms3-shares` ON `field-dms3-shares`.`name` = 'dms3-shares' AND `field-dms3-shares`.`state` = 1 AND `field-dms3-shares`.`context` = 'com_content.article' LEFT JOIN `yzfp0_fields_values` AS `field_value-dms3-shares` ON `field_value-dms3-shares`.`field_id` = `field-dms3-shares`.`id` AND `field_value-dms3-shares`.`item_id` = article.id WHERE `article`.`id` IN (1259,3,4,5,6,7,8,9,10,11,12,13,15,16,21,22,23,31,36,37,1288,1287,1286,1279,1278,1277,1276,1303,261,1315,260,753,1053,1272,242,241,240,239,230,229,228,227,226,225,214,213,212,211,210,1309,1310,1311,1314,1322,1323,1324,1331,1332,1335,1298,1297,1293,1292,1291,1290,1265,1264,1263,1262,1258,1257,1256,1255,1251,1244,1234,1230,1229,1227,1224,1223,1222,1220,1214,1212,1211,1210,1209,1208,1207,1206,1205,1204,1199,1195,1190,1185,1184,1179,1178,1174,1165,1164,1163,1159,1158,1157,1156,1154,1153,1152,1151,1149,1148,1147,1144,1139,1138,1137,1135,1123,1119,1118,1117,1116,1115,1113,1107,1105,1104,1098,1097,1096,1095,1094,1091,1084,1083,1082,1081,1076,1075,1074,1073,1072,1066,1065,1060,1057,1052,1047,1046,1045,1044,1043,1037,1033,1032,1031,1027,1025,1024,1022,1020,1019,1016,1012,1010,1008,1007,1004,1003,1000,995,992,984,979,977,976,975,974,973,972,971,970,969,968,967,966,965,964,963,962,961,949,938,935,934,933,927,926,925,923,919,918,917,916,914,908,906,905,904,903,899,897,892,890,884,883,882,881,880,878,877,873,862,861,860,857,856,852,850,849,848,838,837,836,835,833,831,830,829,828,823,821,805,804,803,801,800,799,798,797,793,792,791,790,789,780,779,778,767,55,755,754,752,751,750,749,748,747,746,744,743,742,741,737,735,734,731,729,723,719,718,717,712,711,710,708,707,706,704,689,686,685,683,676,675,672,671,666,665,664,649,648,647,643,642,637,634,633,629,628,622,621,614,613,608,605,604,603,602,561,560,556,547,543,542,540,535,528,520,519,518,509,508,506,505,503,502,484,483,482,479,477,476,460,459,458,457,455,454,453,452,450,433,432,431,430,429,423,422,421,420,413,412,411,410,403,402,401,399,385,384,383,382,381,376,375,374,373,372,371,370,369,361,360,359,358,356,354,353,352,351,350,276,275,274,273,272,271,270,264,54,59,60,253,345,344,339,333,332,331,322,321,320,319,318,317,316,315,314,308,307,305,300,299,298,287,286,285,587,584,572,183,182,181,178,177,175,171,170,169,164,163,161,1261,847,846,1317,1260,663,607,570,569,567,566,565,564,563,562,493,492,491,438,437,436,435,434,283,258,256,255,254,184,174,173,172,166,165,160,159,158,149,148,147,139,138,137,136,134,133,132,131,130,124,121,119,116,115,113,2586,2589,2590,2591,2592,2594,2595,2596,2598,2599,2600,2605,2611,2612) ORDER BY `field_value-dms3-shares`.`value` IS NULL, CAST(`field_value-dms3-shares`.`value` AS CHAR(1)) = '', CAST(`field_value-dms3-shares`.`value` AS CHAR(10)) = '0000-00-00', CAST(`field_value-dms3-shares`.`value` AS SIGNED INTEGER) = 0, CAST(`field_value-dms3-shares`.`value` AS SIGNED INTEGER) DESC, `field_value-dms3-shares`.`value` DESC LIMIT 3399ms944B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`alias` AS `article.alias`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[765] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` IN (543,1314,354) ORDER BY FIELD(article.id,543,1314,354)231μs1.16KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`431μs5.22KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`403μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)507μs120.73KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`alias` AS `article.alias`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 831 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1247μs1.13KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`hits` AS `article.hits`,'https://recintervcardiol.org/es/cardiopatia-isquemica/inhibidores-selectivos-de-la-recaptacion-de-serotonina-y-riesgo-hemorragico-tras-icp-un-estudio-con-puntuacion-de-propension\n[846] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[828] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 831 ORDER BY `article`.`title` IS NULL, CAST(`article`.`title` AS CHAR(1)) = '', CAST(`article`.`title` AS CHAR(10)) = '0000-00-00', CAST(`article`.`title` AS SIGNED INTEGER) = 0, CAST(`article`.`title` AS SIGNED INTEGER) ASC, `article`.`title` ASC LIMIT 1237μs976B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT * FROM `yzfp0_schemaorg` WHERE `itemId` = :itemId AND `context` = :context230μs1.86KBParams/plugins/system/schemaorg/src/Extension/Schemaorg.php:411Copy
  • SELECT `a`.`id`,`a`.`asset_id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`state`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`version`,`a`.`ordering`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`metadata`,`a`.`featured`,`a`.`language`,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`fp`.`ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1) AS `rating`,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE ( (`a`.`id` = :pk AND `c`.`published` > 0 AND `a`.`language` IN (:preparedArray1,:preparedArray2)) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp)) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`state` IN (:preparedArray3,:preparedArray4)472μs120.73KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
  • SELECT SUM(CASE WHEN `a`.`next_execution` <= :now THEN 1 ELSE 0 END) AS due_count,SUM(CASE WHEN `a`.`locked` IS NULL THEN 0 ELSE 1 END) AS locked_count FROM `yzfp0_scheduler_tasks` AS `a` WHERE `a`.`state` = 1232μs1.68KBParams/administrator/components/com_scheduler/src/Model/TasksModel.php:466Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'head' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id348μs2.14KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT m.condition_id,m.item_id FROM yzfp0_conditions_map as m LEFT JOIN yzfp0_conditions as c ON c.id = m.condition_id WHERE `m`.`extension` = 'com_rereplacer' AND `c`.`published` = 1210μs896B/administrator/components/com_conditions/src/Model/ItemModel.php:815Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'body' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id382μs18.42KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '831' AND `field_id` = 30318μs840B/tmp/regularlabs/custom_php/20964_af27ee991d0d77889539c6cba39057bf:36Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '831' AND `field_id` = 19208μs856B/tmp/regularlabs/custom_php/20964_af27ee991d0d77889539c6cba39057bf:61Copy
  • SELECT a.id,a.asset_id,a.title,a.alias,a.introtext,a.fulltext,a.state,a.catid,a.created,a.created_by,a.created_by_alias,CASE WHEN a.modified = '0000-00-00 00:00:00' THEN a.created ELSE a.modified END as modified,a.modified_by,a.checked_out,a.checked_out_time,a.publish_up,a.publish_down,a.images,a.urls,a.attribs,a.version,a.ordering,a.metakey,a.metadesc,a.access,a.hits,a.metadata,a.featured,a.language,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`lft` AS `category_lft`,`c`.`lft` AS `category_ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,ROUND(v.rating_sum / v.rating_count, 0) AS rating,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `v`.`content_id` = `a`.`id` WHERE `a`.`id` = 831 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2024-11-29 11:20:06') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2024-11-29 11:20:06'))465μs119.44KB/libraries/regularlabs/src/Article.php:94Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `field_id` = 18 AND `item_id` = 8311.27ms856B/tmp/regularlabs/custom_php/20964_20d16d1e6db57666571c51c2623628e6:28Copy
  • SELECT COUNT(*) FROM `yzfp0_contentitem_tag_map` WHERE `type_alias` = 'com_content.article' AND `content_item_id` = 831335μs856B/tmp/regularlabs/custom_php/20964_2242f97af332d54d4fb204c150bc00a4:36Copy
  • SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'everywhere' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id342μs2.19KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `session_id` FROM `yzfp0_session` WHERE `session_id` = ?203μs1.63KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:277Copy
  • UPDATE `yzfp0_session` SET `data` = ? , `time` = ? WHERE `session_id` = ?444μs912BParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:301Copy
  • infoplg_system_j2xml - plgSystemJ2xml::__construct
  • infoplg_system_basicauth - plgSystemBasicauth::__construct
  • infoplg_system_basicauth - PHP_SAPI: fpm-fcgi
  • infoplg_system_basicauth - authorization:
  • infoplg_system_basicauth - plgSystemBasicauth::onAfterRoute
  • infoplg_system_j2xml - plgSystemJ2xml::onAfterDispatch
  • infoplg_system_basicauth - plgSystemBasicauth::onBeforeRender