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Artículo

Cardiopatía isquémica

REC Interv Cardiol. 2019;3:161-166

Seguridad del cateterismo diagnóstico ambulatorio en pacientes en tratamiento con anticoagulantes orales de acción directa

Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants

Cristina Ramírez Guijarroa,., Antonio Gutiérrez Díezb, Juan Gabriel Córdoba Sorianob, Arsenio Gallardo Lópezb, Driss Melehi El-Assalib, Juan José Portero Portaza, Javier Navarro Cuarteroa y Jesús Jiménez Mazuecosb

aServicio de Cardiología, Hospital General de Albacete, Albacete, España

bUnidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital General de Albacete, Albacete, España

Contenido relacionado

Nuevos anticoagulantes orales, cateterismo diagnóstico e intervencionismo coronario: otro paso hacia la estrategia óptima
Felipe Díez-Delhoyo y Jaime Elízaga

RESUMEN

Introducción y objetivos: Actualmente es cada vez más habitual realizar procedimientos sin retirar la anticoagulación oral (ACO), pero la necesidad o no de suspender la ACO antes del cateterismo cardiaco sigue siendo una cuestión controvertida. Se evalúan la eficacia y la seguridad de la realización de un cateterismo transradial en pacientes ambulatorios sin retirar los anticoagulantes orales de acción directa (ACOD).

Métodos: Estudio observacional, prospectivo, que incluye 270 pacientes sometidos a cateterismo transradial electivo desde enero de 2013 hasta noviembre de 2017, divididos en 3 grupos de 90 pacientes: grupo A (sin ACO), grupo B (con antagonista de la vitamina K), grupo C (con ACOD), emparejados según la fecha de realización del cateterismo. No se suspendió la ACO antes del procedimiento. Se evalúan las complicaciones del acceso radial en las primeras 24 h y un mes después del cateterismo.

Resultados: Había más varones tratados con ACOD que con un antagonista de la vitamina K (71,1 frente a 47,8%; p = 0,01) y los pacientes eran más jóvenes en el grupo sin ACO (63,45 ± 11,47 frente a 70,22 ± 9,35 años; p = 0,03). En el grupo B hubo menos diabéticos (22,2 frente a 36,67% en el grupo C; p = 0,03). En el grupo A, los pacientes tenían más antecedentes de cardiopatía isquémica que los pacientes con anticoagulación (27,84 frente a 14,44% en el grupo C; p = 0,028), además de la toma concomitante de fármacos antiplaquetarios. El acceso fue radial en la mayoría de los pacientes (98,2%). No hubo diferencias significativas en las complicaciones del acceso vascular, con una tasa de hematoma o hemorragia al alta del 1,1% en el grupo con ACOD y tasas de oclusión arterial tanto al alta como al mes del 0-2,2%.

Conclusiones: En nuestra experiencia, la realización de un cateterismo diagnóstico transradial sin interrupción de los ACOD es seguro, con tasas bajas de complicaciones trombóticas y hemorrágicas, sin diferencias respecto a los pacientes en tratamiento con un antagonista de la vitamina K o sin ACO.

Palabras clave: ACOD. NACO. Anticoagulantes de acción directa. Anticoagulantes no antagonistas de la vitamina K. Cateterismo cardiaco. Transradial.

ABSTRACT

Introduction and objectives: Today it has become increasingly common to perform procedures without withdrawing oral anticoagulation. However, the need to withdraw oral anticoagulants prior to cardiac catheterization in patients chronically anticoagulated (OACs) remains controversial. We evaluated the efficacy and safety of performing transradial catheterization in outpatients without withdrawing direct-action oral anticoagulants (DOACs).

Methods: Prospective and observational study where 270 patients who underwent elective transradial cardiac catheterization were included from January 2013 through November 2017, divided into 3 groups of 90 patients based on their anticoagulant intake: group A (without OAC), with group B (with vitamin K antagonist), and group C (with DOACs), and matched according to the date of completion. In no case was the OAC discontinued before the procedure. We evaluated the complications of radial access within the first 24 h and 1 month after the procedure.

Results: The group of patients on DOACs had a higher proportion of men compared to the vitamin K antagonist group (71.1% vs 47.8%; p = .01) and patients were younger in the group without OAC (63.45 ± 11.47 vs 70.22 ± 9.35; p = .03). Group B had a lower percentage of diabetic patients (22.2% vs 36.67% in group C, p = .03). In group A, patients were more prone to having a history of ischemic heart disease compared to the groups of anticoagulated patients (27.84% vs 14.44% in group C, p = .028) in addition to a more frequent intake of antiplatelet drugs. Radial access was the access of choice in most patients (98.2%). There were no significant differences when it comes to vascular access complications among the groups being the rate of hematoma and/or bleeding at discharge equal to 1.1% in the DOACs group and the arterial occlusion rates both at discharge and at 1 month between 0% and 2.2%.

Conclusions: In our experience performing transradial diagnostic cardiac catheterizations without discontinuation of DOACs is safe, with low rates of thrombotic and hemorrhagic complications, without any differences with vitamin K antagonist and no OAC.

Keywords: DOACs. NOACs. Direct vitamin K anticoagulants. Non-vitamin K anticoagulants. Cardiac catheterization. Transradial.

Abreviaturas

ACOD: anticoagulante oral de acción directa. ACOP: anticoagulación oral prolongada. AVK: antagonistas de la vitamina K. TP: tratamiento puente.

INTRODUCCIÓN

El número de pacientes que reciben anticoagulación oral prolongada (ACOP) es amplio y se espera que aumente en el futuro debido al envejecimiento de la población y a la cada vez mayor incidencia de enfermedades que precisarán ACOP.

La prevalencia de ACOP entre pacientes con enfermedad coronaria que se someten a intervenciones coronarias percutáneas está entre el 6 y el 8%1. La mayoría de los casos se deben a la presencia concomitante de fibrilación auricular con riesgo embólico entre moderado y alto.

Por otro lado, hasta un 20-30% de los pacientes con fibrilación auricular y una indicación de ACOP debutan con enfermedad coronaria2. Si tenemos en cuenta que la prevalencia de la fibri­lación auricular entre la población está entre el 1 y el 2%, hasta 1-2 millones de pacientes anticoagulados en Europa precisarán realización de una angiografía coronaria.

Por lo tanto, nos encontramos con un importante número de pacientes en tratamiento con ACOP con antagonistas de la vitamina K (AVK) o uno de los anticoagulantes orales de acción directa (ACOD) aparecidos más recientemente (apixabán, rivaroxabán, dabigatrán o edoxabán) que deben ser sometidos a una angiografía coronaria. La práctica habitual con estos pacientes varía enormemente, si bien tradicionalmente los pacientes con ACOP interrumpen el tratamiento y pasan a un a tratamiento puente (TP) con heparina de bajo peso molecular unos días antes y unos días después de someterse a la intervención3. No obstante, se ha descrito un aumento de los eventos hemorrágicos con esta estrategia en los procedimientos intervencionistas, así como una mayor morbilidad y mortalidad de estos pacientes secundarias a situaciones hemorrágicas o protrombóticas debido a la interrupción y reinicio del tratamiento anticoagulante2,4-7.

El perfil de seguridad del cateterismo diagnóstico mediante abordaje radial bajo tratamiento con acenocoumarol (AVK) ya ha quedado demostrado con anterioridad. En nuestro grupo, el perfil de seguridad de los AVK ya ha sido evaluado con este tipo de pacientes en el pasado8. Como disponemos de menos evidencias en pacientes con ACOD, con este trabajo pretendemos ofrecer nuevas evidencias a este respecto ante el cada vez mayor número de pacientes anticoagulados con estos nuevos fármacos durante los últimos años.

En este estudio, ofrecemos nuestra propia experiencia y evaluamos el perfil de seguridad de procedimientos de cateterismo cardiaco diagnóstico mediante abordaje transradial en pacientes en tratamiento con ACOD dados de alta el mismo día de la intervención. También, realizamos una comparativa entre estos pacientes y otros tratados con heparina durante el procedimiento de cateterismo y con pacientes en tratamiento con ACOP con AVK.

MÉTODOS

Población del estudio

Estudio prospectivo y observacional de 270 pacientes sometidos a intervenciones electivas de cateterismo cardiaco transradial entre enero de 2013 y noviembre de 2017 y divididos en 3 grupos de 90 pacientes cada uno en base a la ingesta de AVK, ACOD o en ausencia de tratamiento anticoagulante oral y luego comparados en función de la fecha de realización. Se reclutó a todos aquellos pacientes sometidos a cateterismo diagnóstico que estaban en tratamiento con ACOD durante este periodo. Como grupos de control, optamos por reclutar al siguiente paciente al que se realizaba cateterismo diagnóstico sin tratamiento anticoagulante y al siguiente paciente en tratamiento con acenocumarol sin retirada del fármaco.

En ningún caso se retiró el tratamiento anticoagulante antes de la intervención.

En aquellos pacientes en tratamiento con ACOD, 20 recibieron dabigatrán (22,22%), 38 pacientes rivaroxabán (42,22%), 29 apixabán (32,22%) y 3 pacientes edoxabán (3,33%).

A aquellos pacientes en tratamiento con AVK y valores de cociente internacional normalizado (INR) < 2 (infradosificación) y a aquellos en tratamiento con ACOD que se olvidaron de tomar la última dosis por error, se les administró heparina sódica intraoperatoria en dosis de 2.500-5.000 unidades internacionales mediante un bolo intraarterial. En nuestra serie, el 21,3% de los pacientes en tratamiento con AVK estaban infradosificados (INR < 2) y, por lo tanto, precisaron heparina. En este grupo de pacientes, el INR medio fue 2,5 ± 0,06. Los valores medios del INR se situaron entre el 1,3 y el 4,3 (75% INR > 2,1).

En otro artículo publicado por nuestro grupo8, describimos la metodología empleada en los cateterismos ambulatorios realizados en nuestro centro que detallamos a continuación.

Los pacientes sin ACOP recibieron tratamiento anticoagulante estándar a través de un bolo intraarterial de 5.000 UI de heparina no fraccionada (la práctica clínica habitual en nuestro centro). También se les administraron 2,5 mg de verapamilo por vía intraarterial a todos los pacientes para minimizar los espasmos radiales.

Estos pacientes fueron sometidos a un cateterismo cardiaco electivo por vía transradial con alta el mismo día de la intervención tras retirar el vendaje de compresión y alcanzar la homeostasia. En todos los casos se utilizó una vaina introductora de 5 Fr con revestimiento hidrofílico. Los pacientes hospitalizados sometidos a cateterismos diagnósticos y todos aquellos pacientes en quienes se preveía realización de angioplastia fueron excluidos.

Todas las intervenciones se llevaron a cabo en un único laboratorio de cateterismo cardiaco con enorme experiencia en el uso del abordaje transradial (más del 90% de casos anuales realizados de este modo) y un programa activo de cateterismos cardiacos ambulatorios con alta el mismo día de la intervención8,9.

Características del procedimiento

Todos los pacientes son recibidos en una sala próxima al laboratorio de cateterismo cardiaco y examinados por una enfermera especializada en la monitorización y seguimiento de este tipo de pacientes. Esta enfermera es la encargada de informar al paciente, recopilar la historia clínica de éste, verificar las dosis administradas, el tiempo transcurrido desde la última toma de ACOP y calcular el INR de los pacientes a tratamiento con acenocumarol. Después de informar al paciente y de obtener el consentimiento informado, se decide cuál es el abordaje vascular óptimo para cada paciente teniendo en cuenta la calidad del pulso y los resultados del test de flujo inverso (Barbeau).

Una vez se ha completado el procedimiento, se realiza compresión radial utilizando la técnica de hemostasia permeable durante al menos 2 h. Es en esta sala donde se hace una valoración de la permeabilidad radial y de cualquier posible complicación antes de proceder al alta del paciente. Estos son los resultados y complicaciones del abordaje vascular que analizamos: hemorragias agudas (que precisaron alargar la duración de la compresión), hematomas de entre 5 y 10 cm en el momento del alta hospitalaria, permeabilidad radial en el momento del alta, hemorragias y/o hematomas a las 24 h, permeabilidad radial al cabo de 1 mes y presencia de otras complicaciones poco frecuentes (tales como seudoaneurismas, fístulas, perforaciones arteriales o síndrome compartimental). Se utilizaron los criterios EASY para clasificar los hematomas10. La compresión del abordaje vascular se llevó a cabo con vendas elásticas de algodón durante 2 h utilizando la técnica de hemostasia permeable11 y verificándose la permeabilidad distal mediante pletismografía. También se prolongó la compresión durante otros 30 min ante la presencia de sangrado en la punción en el momento de retirar el vendaje. Para valorar la permeabilidad radial con posterioridad a la retirada del vendaje, se utilizó el test descrito por Barbeau et al.12. La oclusión arterial se definió como una respuesta tipo D (no recuperación de la curva de pulso en 2 min). Todos los pacientes fueron contactados por vía telefónica durante las 24 h posteriores a la intervención para determinar cualquier posible complicación local tardía y fueron sometidos a seguimiento durante 1 mes para detectar la oclusión del punto de acceso.

Análisis estadístico

Los datos de las variables cualitativas se expresaron como tasas absolutas y porcentajes. Por su parte, las variables cuantitativas se expresaron como medias (desviación estándar) o rangos intercuartílicos 25-75 medios en función de la distribución de las variables. Las comparativas entre los distintos grupos se llevaron a cabo utilizando la prueba de la t de Student o su equivalente no paramétrico; la prueba U de Whitney se utilizó para las variables continuas y la prueba de la X2 o la prueba exacta de Fisher para las variables categóricas. Valores p < 0,05 se consideraron significativos desde el punto de vista estadístico. El análisis estadístico se llevó a cabo utilizando el programa estadístico SPSS 19.0 (SPSS, Inc.; Chicago, Illinois, Estados Unidos).

RESULTADOS

Los pacientes incluidos en el estudio fueron asignados a 3 grupos de 90 sujetos cada grupo: un grupo sin anticoagulación oral (grupo A), otro grupo a tratamiento con un antagonista de la vitamina K (grupo B) y el último grupo en tratamiento con anticoagulantes orales de acción directa (grupo C).

La indicación de anticoagulación oral en el grupo B corresponde, en buena parte, a pacientes con fibrilación auricular (74,4%), el 26,7% de los cuales presentaban alguna valvulopatía y el 5,6% eran portadores de prótesis mecánicas; los pacientes restantes recibían anticoagulación debido a su historial médico de embolismos (5,6%), miocardiopatía dilatada (1,1%) y otras causas.

Las características basales de nuestros pacientes pueden consultarse en la tabla 1. En el grupo en tratamiento con ACOD había una proporción más alta de varones que en el grupo en tratamiento con AVK (71,1 frente al 47,8%; p = 0,01) y los pacientes del grupo sin anticoagulación oral eran más jóvenes (63,4 ± 11,5 frente a 70,2 ± 9,3; p = 0,03). En el grupo B había un porcentaje más bajo de pacientes diabéticos (22,2 frente al 36,67% en el grupo C, p = 0,03). Los pacientes del grupo A tenían antecedentes médicos de cardiopatía isquémica más frecuentemente que los grupos de pacientes anticoagulados (27,84 frente al 14,44% en el grupo C, p = 0,028) y, por lo tanto, se habían sometido a un cateterismo previo con el mismo abordaje en porcentajes más altos (20% en el grupo A frente al 5,5% del grupo C, p = 0,04).

Tabla 1. Características demográficas y operatorias basales

Variable Total Grupo A: sin ACO (n = 90) Grupo B: AVK (n = 90) Grupo C: ACOD (n = 90) p
Edad (años), mediana ± DE 68,59 ± 10,63 63,45 ± 11,47 72,09 ± 8,97 70,22 ± 9,35 0,03a
NSb
NSc
Varones (%) 62,6 68,9 47,78 71,1 NSa
0,001b
0,041c
Hipertensión (%) 75,9 83,33 67,78 76,67 NSa
NSb
NSc
Diabetes mellitus (%) 32,2 37,78 22,22 36,67 NSa
0,03b
0,048c
Dislipemia (%) 48,5 53,33 52,22 40 NSa
NSb
NSc
Tabaquismo (%) 10 10 10 10 NSa
NSb
NSc
IMC (kg/m2), mediana ± DE 30,10 ± 4,62 30,11 ± 4,45 29,22 ± 4,77 30,98 ± 4,51 NSa
NSb
NSc
Antecedente de cardiopatía isquémica 17 27,78 8,89 14,44 0,028a
NSb
NSc
Tratamiento con AAS 79 65 3 11 < 0,0005a
0,048b
< 0,0005c
Tratamiento con clopidogrel 25 21 0 4 < 0,0005a
NSb
NSc
Cateterismo previo con el mismo abordaje (%) 11,5 20 8,89 5,55 0,04a
NSb
0,031c

AAS: ácido acetilsalicílico; ACO: anticoagulación oral; ACOD: anticoagulantes orales de acción directa; AVK: antagonistas de la vitamina K; DE: desviación estándar; IMC: índice de masa corporal; NS: no significativo.
a Sin ACO (grupo A) frente a ACOD (grupo C).
b AVK (grupo B) frente a ACOD (grupo C).
c ACOD (grupo C) frente a grupos A+B.

En lo que se refiere al tratamiento concomitante con agentes antiplaquetarios, los pacientes sin ACOP eran más propensos a tomar ácido acetilsalicílico (72,2 frente al 12,2%; p < 0,005) y clopidogrel (23,3 frente al 4,4%; p < 0,0005) que los pacientes del grupo con ACOD. El ácido acetilsalicílico también se utilizó más en el grupo ACOD que en el grupo AVK (12,2 frente al 3,3%; p = 0,048). Todo esto probablemente se deba a una mayor sospecha de cardiopatía isquémica en estos pacientes. Solo 2 pacientes del grupo sin ACOP recibieron prasugrel y uno ticagrelor.

No se observó ninguna otra diferencia significativa en las restantes características basales (hipertensión arterial, dislipemia, índice de masa corporal, tabaquismo…)

El abordaje radial fue el abordaje elegido en la mayoría de los pacientes (98,2%) seguido del abordaje ulnar en los pacientes restantes. En lo que se refiere a las complicaciones (tabla 2) del abordaje vascular durante la intervención y durante el seguimiento que se hizo de 24 horas y 1 mes, no se observó diferencia significativa alguna, arrojando una tasa de hematomas y/o hemorragias en el momento del alta hospitalaria del 1,1% en el grupo ACOD y tasas de oclusión arterial al alta y al cabo de 1 mes, de entre el 0-2 y el 2% en este grupo. Solo un paciente hubo de ser hospitalizado con un cuadro de hemorragia radial prolongada.

Tabla 2. Complicaciones (hemorragias y oclusiones) y eventos durante el abordaje vascular

Variable Grupo A: sin ACO (n = 90) Grupo B: AVK (n = 90) Grupo C: ACOD (n = 90) p
Hemorragia precoz o hematoma (%) 2,2 1,1 1,1 NSa
NSb
Hemorragia tardía o hematoma (%) 0 0 1,1 NSa
NSb
Acceso ocluido precozmente (%) 3,3 3,3 2,2 NSa
NSb
Acceso ocluido tardíamente (%) 3 2,9 0 NSa
NSb
Otras complicaciones (disecciones, fístulas, perforaciones) 0 0 0  

ACO: anticoagulación oral; ACOD: anticoagulantes orales de acción directa; AVK: antagonistas de la vitamina K; NS: no significativo.
a Sin ACO (grupo A) frente a ACOD (grupo C).
b AVK (grupo B) frente a ACOD (grupo C).

DISCUSIÓN

La realización de cateterismos cardiacos diagnósticos sin retirada de la ACOP está recomendada en las guías de práctica clínica13 y la rutina estándar que seguimos en nuestra unidad de hemodinámica y cardiología intervencionista es utilizar, principalmente, el abordaje radial (95%) con excelentes resultados de seguridad8,9.

La información procede fundamentalmente de estudios realizados en pacientes en tratamiento con AVK. Dos metaanálisis que abordaron esta cuestión14,15 concluyeron que realizar cateterismos sin retirar la ACOP es una práctica segura y eficaz. Un estudio publicado por el grupo finlandés dirigido por Karjalainen16 también analizó el perfil de seguridad y lo comparó al de un grupo de pacientes en tratamiento con ACOP y TP con heparina. Halla- ron una tasa de hemorragias mucho más alta en este último grupo (1,7 frente al 8,3%) que fue, si cabe, más alta en el grupo en el que se retiró la ACOP-TP que en el que se retiró la ACOP sin TP (2,5 frente al 8,3%). Además, si la intervención se realiza mediante abordaje radial, los resultados hemorrágicos son todavía mejores17.

No obstante, cuando hablamos de pacientes en tratamiento con ACOD, las evidencias que hay son escasas y todavía no se ha llegado a un consenso a este respecto. Las actuales guías de práctica clínica sobre el manejo de la revascularización18 no incluyen la recomendación de mantener el tratamiento anticoagulante oral durante la intervención, aunque en recientes documentos de consenso publicados por diferentes sociedades internacionales, este asunto sigue siendo objeto de controversia. Así pues, debido a la falta de evidencias al respecto, el documento europeo de consenso antitrombótico19 recomienda no interrumpir la anticoagulación en el caso de AVK, pero sí suspender los ACOD por espacio de 12-24 h (24-48 h en el caso del dabigatrán) en pacientes que van a ser intervenidos. Por otro lado, en el documento sobre manejo antitrombótico pre y perioperatorio20 recomiendan no retirar el tratamiento antitrombótico con ACOD en intervenciones hemorrágicas de bajo riesgo como, por ejemplo, en los cateterismos diagnósticos transradiales por su tasa más baja de complicaciones vasculares, sobre todo, hemorrágicas.

A pesar de todo esto, la práctica estándar con estos pacientes es heterogénea, si bien, por regla general, la mayoría de los laboratorios de cateterismo cardiaco de todo el mundo retiran la ACOP y pasan a TP con heparina de bajo peso molecular unos cuantos días antes y después de la intervención3. No obstante, se producen más eventos hemorrágicos con esta estrategia cuando se realizan procedimientos intervencionistas, y hay una mayor morbilidad y mortalidad en estos pacientes debido a las situaciones protrombóticas que se crean al retirar y reiniciar el tratamiento anticoagulante2,4-7.

Con el cada vez mayor uso de los ACOD, van surgiendo nuevos problemas en nuestra práctica clínica habitual cuando tenemos que retirarlos antes de realizar una intervención y es habitual ver cómo en estos pacientes, en muchas especialidades médicas y quirúrgicas, se prescribe TP igual que se hace en pacientes en tratamiento con AVK aunque su uso no está recomendado por los últimos documentos de consenso publicados20.

En lo referente a la relación coste-efectividad, la estrategia de TP supone un enorme sobrecoste por diferentes razones: por la mayor incidencia de complicaciones hemorrágicas en pacientes que precisarán atención médica, por el alto coste de la heparina de bajo peso molecular, por las estancias hospitalarias más largas y por la necesidad de analizar los niveles de anticoagulación en pacientes a tratamiento con AVK. En otras áreas de la cardiología intervencionista, se han hecho progresos a este respecto e incluso se han llevado a cabo estudios de coste-efectividad sobre esta cuestión, como el realizado por Coyle et al.21 que reveló que no prescribir TP ahorra 1.800 dólares por paciente en algunas de las cuestiones ya mencionadas. Además, si realizamos una comparativa entre ACOD y AVK, un reciente estudio realizado por Shah et al.22 en pacientes con fibrilación auricular permanente reveló que todos los ACOD demostraron ser superiores en un modelo de coste-efectividad que incluyó la supervivencia ajustada por la calidad de vida, siendo dabigatrán el fármaco con el mejor perfil coste-efectividad en pacientes con el riesgo tromboembólico más alto de todos.

La conclusión más importante que podemos extraer de este estudio es que es seguro realizar cateterismos cardiacos diagnósticos mediante abordaje transradial en pacientes en tratamiento con anticoagulación crónica con ACOD. Por lo general, estos pacientes no presentan más complicaciones vasculares ni hemorrágicas que pacientes con tratamiento estándar.

En lo que respecta a las complicaciones hemorrágicas, se observó una tasa de incidencia baja en todos los grupos y ninguna diferencia significativa. Otra cuestión a tener en cuenta en lo referente a los ACOD es la posibilidad de reversión de la anticoagulación con el antídoto específico (en la actualidad, disponible solo para dabigatrán y en vías de comercialización para los inhibidores del factor Xa) ante la presencia de complicaciones graves, lo cual nos ofrece un mayor perfil de seguridad a la hora de realizar intervenciones invasivas con estos fármacos23.

En nuestra población, la incidencia de oclusiones radiales fue excepcionalmente baja en todos los grupos. Sobrevinieron oclusiones precoces (< 24 h) y tardías (1 mes) en el 2,2 y 0% de los pacientes del grupo ACOD; en el 3,3 y 2,9% de los pacientes del grupo en tratamiento con acenocumarol frente al 3,3%; y en el 3% de los pacientes del grupo a tratamiento con heparina no observándose diferencias estadísticamente significativas . Anteriores estudios han descrito tasas de oclusiones extremadamente bajas, incluso por debajo del 1%24.

No hemos encontrado en la literatura médica ninguna serie parecida a la nuestra, aunque sí muchas series en las que se realizaron angiografías coronarias sin retirada de la ACOP con AVK, con resultados que coinciden con los nuestros8,25,26.

Se han llevado a cabo estudios con ACOD en intervenciones coronarias percutáneas que no han encontrado diferencia alguna en los eventos adversos clínicos (hemorragias, embolismos, isquemia) en pacientes en quienes se realizaron intervenciones coronarias percutáneas bajo diferentes estrategias de anticoagulación27,28.

Limitaciones del estudio y rumbo a seguir en el futuro

La baja incidencia de complicaciones y el pequeño tamaño de la muestra no nos permitieron concluir que había diferencias estadísticas significativas entre los distintos grupos. Haría falta una muestra de mayor tamaño, lo cual es difícil en un único centro. Quizá un registro multicéntrico arroje más luz a este respecto.

En la actualidad, son cada vez menos los pacientes en tratamiento con acenocumarol o warfarina debido al uso exponencial de nuevos fármacos anticoagulantes tales como dabigatrán, apixabán, rivaroxabán y edoxabán. En resumen, habrá que realizar nuevos y más extensos estudios sobre anticoagulantes orales de acción directa que aporten evidencias sobre esta cuestión.

CONCLUSIONES

La realización de cateterismos diagnósticos ambulatorios mediante abordaje radial sin retirada del tratamiento ACOD parece ser segura y no presenta mayor número de complicaciones en relación a los pacientes bajo tratamiento con acenocumarol o sin tratamiento anticoagulante. No obstante, sería recomendable realizar estudios aleatorizados que nos ayuden a confirmar estos datos.

CONFLICTO DE INTERESES

Los autores no han declarado ningún conflicto de intereses.

¿QUÉ SE SABE DEL TEMA?

  • En la actualidad todavía no hay consenso sobre el manejo de la anticoagulación oral en pacientes en tratamiento con anticoagulantes orales de acción directa que son sometidos a intervenciones tales como cateterismos coronarios diagnósticos. En algunos centros se mantiene la anticoagulación, en otros se retira y se realiza terapia puente con heparina como se ha venido haciendo en pacientes en tratamiento con antagonistas de la vitamina K, siendo la práctica clínica muy heterogénea. Ni las guías de práctica clínica ni los documentos de consenso que se manejan en la actualidad se ponen de acuerdo sobre cuál debería ser el abordaje a seguir en estos pacientes por las escasas evidencias que hay a este respecto.

¿QUÉ APORTA DE NUEVO?

  • Creemos que nuestro estudio es de gran interés para la práctica clínica debido al cada vez mayor uso de anticoagulantes orales de acción directa en la práctica clínica de todos los médicos, incluidos cardiólogos y cardiólogos intervencionistas. El uso de estos fármacos se ha incrementado exponencialmente, y no es extraño encontrarnos con pacientes que van a someterse a una angiografía coronaria y toman ACOD. Por eso queríamos compartir la experiencia de nuestro laboratorio de hemodinámica con este tipo de pacientes y mostrar los perfiles de seguridad y eficacia de estos fármacos en este campo.

BIBLIOGRAFÍA

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Autor para correspondencia: Alcalde Virgilio Martínez Gutiérrez, 2-2ºE, 02006 Albacete, España.
Correo electrónico: cristinaramirezguijarro@hotmail.com (C. Ramírez Guijarro).

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  • beforeRenderRawModule mod_menu (Publicaciones Permanyer) (144B) (106μs)
  • afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.24KB) (455μs)
  • beforeRenderModule mod_menu (Publicaciones Permanyer) (720B) (4μs)
  • afterRenderModule mod_menu (Publicaciones Permanyer) (2.89KB) (124μs)
  • beforeRenderRawModule mod_menu (Footer Final ES) (4.92KB) (716μs)
  • afterRenderRawModule mod_menu (Footer Final ES) (28.11KB) (774μs)
  • beforeRenderModule mod_menu (Footer Final ES) (720B) (4μs)
  • afterRenderModule mod_menu (Footer Final ES) (3.33KB) (129μs)
  • afterRender (1.03MB) (78.57ms)
  • 1 x afterRenderModule mod_custom (Lo más leído) (1.31MB) (33.14%)
    423ms
    1 x afterRenderModule mod_custom (Lo más compartido) (578.61KB) (32.35%)
    413ms
    1 x afterRender (1.03MB) (6.16%)
    78.57ms
    1 x afterRenderComponent com_content (291.88KB) (4.42%)
    56.44ms
    1 x Before Access::getAssetRules (id:8 name:com_content) (1.35MB) (3.17%)
    40.52ms
    1 x afterInitialise (3.53MB) (2.83%)
    36.17ms
    1 x afterRenderModule mod_custom (Article Herramientas Estadísticas) (738.55KB) (1.63%)
    20.77ms
    1 x beforeRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (1.11MB) (1.39%)
    17.71ms
    1 x afterRoute (384.83KB) (1.2%)
    15.29ms
    1 x afterRenderModule mod_custom (Header Article) (548.07KB) (1.06%)
    13.50ms
    1 x afterRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (95.54KB) (0.64%)
    8.23ms
    1 x afterRenderModule mod_custom (Article - Referencia ) (300.12KB) (0.58%)
    7.40ms
    1 x afterRenderModule mod_custom (Article Herramientas Traducción) (276.52KB) (0.57%)
    7.29ms
    1 x afterRenderModule mod_custom (Article DOI activo) (258.31KB) (0.57%)
    7.25ms
    1 x afterRenderModule mod_custom (Debate Title) (421.29KB) (0.55%)
    6.96ms
    1 x Before Access::getAssetRules (id:1 name:root.1) (322KB) (0.54%)
    6.89ms
    1 x afterRenderModule mod_custom (Article Translated Title) (1.47MB) (0.53%)
    6.74ms
    1 x afterRenderModule mod_custom (Article Herramientas Compartir) (350.66KB) (0.51%)
    6.54ms
    1 x afterRenderModule mod_custom (Article Category) (255.75KB) (0.46%)
    5.84ms
    1 x afterRenderModule mod_custom (Article Related contents) (190.95KB) (0.44%)
    5.67ms
    1 x afterDispatch (396.66KB) (0.44%)
    5.57ms
    1 x afterRenderModule mod_custom (Article Authors) (164.91KB) (0.41%)
    5.27ms
    1 x afterRenderModule mod_custom (Article Herramientas Material Adicional) (182.01KB) (0.39%)
    4.94ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Compartir) (218.51KB) (0.38%)
    4.89ms
    1 x afterRenderModule mod_custom (Foto Autor) (162.19KB) (0.38%)
    4.86ms
    1 x afterRenderModule mod_custom (Article Subtitulo) (161.82KB) (0.37%)
    4.68ms
    1 x afterRenderModule mod_custom (Article Title) (150.24KB) (0.35%)
    4.46ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Estadísticas) (137.62KB) (0.33%)
    4.24ms
    1 x afterRenderModule mod_custom (Separador) (128.77KB) (0.32%)
    4.11ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Traducción) (151.14KB) (0.32%)
    4.09ms
    1 x afterRenderModule mod_custom (Innovacion Herramientas Imprimir) (128.27KB) (0.31%)
    3.92ms
    1 x afterRenderModule mod_custom (EMAIL Y TWITTER) (129.35KB) (0.31%)
    3.91ms
    1 x afterRenderModule mod_custom (Article Herramientas Descargar) (127.94KB) (0.3%)
    3.88ms
    1 x afterRenderModule mod_custom (Article Herramientas Imprimir) (128.43KB) (0.3%)
    3.87ms
    1 x After Access::preloadPermissions (com_content) (987.52KB) (0.28%)
    3.57ms
    1 x afterLoad (74.89KB) (0.2%)
    2.53ms
    1 x beforeRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (13.77KB) (0.18%)
    2.29ms
    1 x afterRenderRawModule mod_languages (Cambiar Idioma) (34.73KB) (0.14%)
    1.75ms
    1 x afterRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (34.63KB) (0.1%)
    1.24ms
    1 x afterRenderRawModule mod_breadcrumbs (Breadcrumbs ES) (13.98KB) (0.07%)
    935μs
    1 x afterRenderRawModule mod_menu (Publicar) (29.84KB) (0.07%)
    848μs
    1 x beforeRenderRawModule mod_custom (Separador) (2.04KB) (0.06%)
    796μs
    1 x afterRenderRawModule mod_menu (Footer Final ES) (28.11KB) (0.06%)
    774μs
    1 x After Access::preloadComponents (all components) (125.96KB) (0.06%)
    762μs
    1 x Before Access::preloadComponents (all components) (196.7KB) (0.06%)
    739μs
    1 x beforeRenderRawModule mod_menu (Footer Final ES) (4.92KB) (0.06%)
    716μs
    1 x afterRenderRawModule mod_menu (Sobre nosotros) (22.34KB) (0.06%)
    709μs
    1 x afterRenderRawModule mod_menu (Contenido) (18.63KB) (0.05%)
    694μs
    1 x afterRenderRawModule mod_menu (Sidebar Menú ES) (9.75KB) (0.05%)
    672μs
    1 x beforeRenderRawModule mod_menu (Contenido) (5.19KB) (0.05%)
    622μs
    1 x afterRenderRawModule mod_menu (Sidebar - REC: Publications) (16.07KB) (0.04%)
    528μs
    1 x afterRenderRawModule mod_menu (Publicaciones Permanyer) (10.24KB) (0.04%)
    455μs
    1 x afterRenderModule mod_custom (Home Concurso Hemodinamica) (6.23KB) (0.04%)
    451μs
    1 x afterRenderRawModule mod_custom (Header Article) (4.19KB) (0.03%)
    368μs
    1 x beforeRenderComponent com_content (12.66KB) (0.03%)
    359μs
    1 x afterRenderModule mod_breadcrumbs (Breadcrumbs ES) (3.88KB) (0.03%)
    331μs
    1 x beforeRenderRawModule mod_custom (Debate Title) (560B) (0.02%)
    314μs
    1 x afterRenderRawModule mod_lightbox (Lightbox) (72.07KB) (0.02%)
    310μs
    1 x afterRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (7.09KB) (0.02%)
    275μs
    1 x beforeRenderRawModule mod_custom (Home Concurso Hemodinamica) (80B) (0.02%)
    241μs
    1 x afterRenderModule mod_articles_good_search (Articles Good Search Total (Lateral)) (10.48KB) (0.02%)
    236μs
    1 x afterRenderModule mod_languages (Cambiar Idioma) (4.22KB) (0.02%)
    216μs
    1 x beforeRenderRawModule mod_custom (Header Article) (2.04KB) (0.02%)
    202μs
    1 x afterRenderModule mod_custom (Publicación de la Sociedad Española de Cardiología) (2.81KB) (0.01%)
    164μs
    1 x afterRenderModule mod_custom (Article - Disponible Online) (2.67KB) (0.01%)
    145μs
    1 x afterRenderModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (5.48KB) (0.01%)
    139μs
    1 x beforeRenderRawModule mod_lightbox (Lightbox) (7.17KB) (0.01%)
    138μs
    1 x afterRenderModule mod_lightbox (Lightbox) (4.45KB) (0.01%)
    137μs
    1 x afterRenderModule mod_menu (Contenido) (3.08KB) (0.01%)
    130μs
    1 x afterRenderModule mod_menu (Footer Final ES) (3.33KB) (0.01%)
    129μs
    1 x afterRenderModule mod_menu (Publicar) (3.33KB) (0.01%)
    125μs
    1 x afterRenderModule mod_menu (Sidebar - REC: Publications) (3.23KB) (0.01%)
    125μs
    1 x afterRenderModule mod_menu (Publicaciones Permanyer) (2.89KB) (0.01%)
    124μs
    1 x afterRenderRawModule mod_custom (Separador) (1.13KB) (0.01%)
    124μs
    1 x afterRenderModule mod_custom (Factor de Impacto) (2.84KB) (0.01%)
    123μs
    1 x afterRenderModule mod_menu (Sidebar Menú ES) (2.7KB) (0.01%)
    123μs
    1 x afterRenderModule mod_menu (Sobre nosotros) (3.2KB) (0.01%)
    122μs
    1 x afterRenderModule mod_dms3_refs (Article Herramientas Exportar) (3.36KB) (0.01%)
    121μs
    1 x beforeRenderRawModule mod_menu (Publicar) (1.61KB) (0.01%)
    118μs
    1 x afterRenderRawModule mod_custom (Article DOI activo) (1.02KB) (0.01%)
    116μs
    1 x After Access::getAssetRules (id:1760 name:com_content.article.212) (9.4KB) (0.01%)
    109μs
    1 x afterRenderRawModule mod_custom (Publicación de la Sociedad Española de Cardiología) (1.09KB) (0.01%)
    109μs
    1 x beforeRenderRawModule mod_menu (Sobre nosotros) (160B) (0.01%)
    107μs
    1 x beforeRenderRawModule mod_menu (Publicaciones Permanyer) (144B) (0.01%)
    106μs
    1 x beforeRenderRawModule mod_languages (Cambiar Idioma) (5.38KB) (0.01%)
    104μs
    1 x afterRenderRawModule mod_custom (Debate Title) (976B) (0.01%)
    93μs
    1 x afterRenderRawModule mod_custom (Lo más compartido) (912B) (0.01%)
    91μs
    1 x afterRenderRawModule mod_custom (Article - Disponible Online) (3.48KB) (0.01%)
    89μs
    1 x afterRenderRawModule mod_custom (Article Related contents) (11.91KB) (0.01%)
    89μs
    1 x afterRenderRawModule mod_custom (Article - Referencia ) (1.02KB) (0.01%)
    88μs
    1 x afterRenderRawModule mod_custom (Article Authors) (976B) (0.01%)
    88μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Material Adicional) (944B) (0.01%)
    87μs
    1 x afterRenderRawModule mod_custom (Home Concurso Hemodinamica) (928B) (0.01%)
    83μs
    1 x afterRenderRawModule mod_custom (Article Subtitulo) (976B) (0.01%)
    82μs
    1 x afterRenderRawModule mod_custom (Article Translated Title) (992B) (0.01%)
    82μs
    1 x afterRenderRawModule mod_custom (Factor de Impacto) (976B) (0.01%)
    82μs
    1 x afterRenderRawModule mod_custom (Foto Autor) (1.02KB) (0.01%)
    82μs
    1 x afterRenderRawModule mod_custom (Article Title) (976B) (0.01%)
    81μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (928B) (0.01%)
    80μs
    1 x afterRenderRawModule mod_custom (Article Category) (1.02KB) (0.01%)
    79μs
    1 x afterRenderRawModule mod_custom (Lo más leído) (912B) (0.01%)
    78μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Descargar) (992B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Traducción) (1.03KB) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Imprimir) (928B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Compartir) (928B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Estadísticas) (928B) (0.01%)
    77μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Traducción) (1.16KB) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (8.91KB) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (EMAIL Y TWITTER) (1.02KB) (0.01%)
    76μs
    1 x afterRenderRawModule mod_custom (Article Herramientas Compartir) (928B) (0.01%)
    76μs
    1 x Before Access::getAssetRules (id:1760 name:com_content.article.212) (66.8KB) (0%)
    48μs
    1 x beforeRenderRawModule mod_articles_good_search (Articles Good Search Total (Lateral)) (9.48KB) (0%)
    42μs
    1 x beforeRenderRawModule mod_custom (Lo más compartido) (1.13KB) (0%)
    35μs
    1 x beforeRenderRawModule mod_custom (Article Related contents) (2.14KB) (0%)
    33μs
    1 x beforeRenderRawModule mod_custom (Article - Disponible Online) (1.98KB) (0%)
    32μs
    1 x beforeRenderRawModule mod_custom (Article Authors) (1.5KB) (0%)
    32μs
    1 x beforeRenderRawModule mod_custom (Article DOI activo) (1.22KB) (0%)
    31μs
    1 x beforeRenderRawModule mod_custom (Article - Referencia ) (1.61KB) (0%)
    29μs
    1 x beforeRenderRawModule mod_custom (Foto Autor) (1.69KB) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (Article Subtitulo) (1.44KB) (0%)
    27μs
    1 x beforeRenderRawModule mod_custom (Article Translated Title) (1.11KB) (0%)
    26μs
    1 x beforeRenderRawModule mod_custom (Factor de Impacto) (13.19KB) (0%)
    25μs
    1 x beforeRenderRawModule mod_custom (Article Title) (1.44KB) (0%)
    25μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Estadísticas) (5.47KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Material Adicional) (3.53KB) (0%)
    23μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Imprimir) (1.48KB) (0%)
    22μs
    1 x beforeRenderRawModule mod_menu (Sidebar Menú ES) (768B) (0%)
    22μs
    1 x beforeRenderRawModule mod_menu (Sidebar - REC: Publications) (1.61KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Category) (832B) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Descargar) (1.45KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Traducción) (1.48KB) (0%)
    21μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Compartir) (6.36KB) (0%)
    21μs
    1 x After Access::getAssetRules (id:1 name:root.1) (7.41KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Lo más leído) (2.39KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Innovacion Herramientas Traducción) (2.23KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Imprimir) (1.27KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (EMAIL Y TWITTER) (1.66KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Estadísticas) (3.52KB) (0%)
    20μs
    1 x beforeRenderRawModule mod_custom (Article Herramientas Compartir) (432B) (0%)
    19μs
    1 x beforeRenderRawModule mod_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (2.36KB) (0%)
    19μs
    1 x beforeRenderRawModule mod_dms3_refs (Article Herramientas Exportar) (2.83KB) (0%)
    18μs
    1 x Before Access::preloadPermissions (com_content) (4.16KB) (0%)
    11μs
    1 x After Access::getAssetRules (id:8 name:com_content) (1.59KB) (0%)
    10μs
    1 x beforeRenderModule mod_breadcrumbs (Breadcrumbs ES) (704B) (0%)
    5μs
    1 x beforeRenderModule mod_languages (Cambiar Idioma) (704B) (0%)
    5μs
    1 x beforeRenderModule mod_custom (Article DOI activo) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_lightbox (Lightbox) (720B) (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_menu (Contenido) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Sobre nosotros) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Footer Final ES) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_dms3_refs (Article Herramientas Exportar) (736B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Publicar) (704B) (0%)
    4μs
    1 x beforeRenderModule mod_menu (Publicaciones Permanyer) (720B) (0%)
    4μs
    1 x beforeRenderModule mod_custom (Header Article) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Debate Title) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Category) (720B) (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 (Article Authors) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Publicación de la Sociedad Española de Cardiología) (752B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Factor de Impacto) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Lo más compartido) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Separador) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Descargar) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Traducción) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Herramientas Imprimir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Innovacion Herramientas Imprimir) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (EMAIL Y TWITTER) (720B) (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_esmedicodisclaimer (esmedicodisclaimer esmedicodisclaimer) (752B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article - Disponible Online) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article - Referencia ) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Subtitulo) (720B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Article Related contents) (736B) (0%)
    3μs
    1 x beforeRenderModule mod_custom (Home Concurso Hemodinamica) (736B) (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
    1 x beforeRenderModule mod_custom (Lo más leído) (720B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Herramientas Traducción) (736B) (0%)
    2μs
    1 x beforeRenderModule mod_custom (Article Herramientas Compartir) (736B) (0%)
    2μs
99 statements were executed, 25 of which were duplicates, 74 unique839ms2.13MB
  • SELECT @@SESSION.sql_mode;127μs1.57KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:308Copy
  • SELECT `data` FROM `yzfp0_session` WHERE `session_id` = ?163μs1.63KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:250Copy
  • SELECT `session_id` FROM `yzfp0_session` WHERE `session_id` = :session_id LIMIT 1125μs1.63KBParams/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_id143μs992BParams/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` = 1256μs2.31KB/libraries/src/Component/ComponentHelper.php:399Copy
  • SELECT `id`,`rules` FROM `yzfp0_viewlevels`121μs976B/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` = :guest169μs1.64KBParams/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`666μs21.8KBParams/libraries/src/Plugin/PluginHelper.php:294Copy
  • SELECT * FROM `yzfp0_languages` WHERE `published` = 1 ORDER BY `ordering` ASC204μs3.48KB/libraries/src/Language/LanguageHelper.php:177Copy
  • SELECT `element`,`name`,`client_id`,`extension_id` FROM `yzfp0_extensions` WHERE `type` = 'language' AND `state` = 0 AND `enabled` = 1192μs1.08KB/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`1.12ms200.55KBParams/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`356μs5.17KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `id` FROM `yzfp0_content` WHERE `alias` = :alias AND `catid` = :catid195μs1.65KBParams/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` = 1288μs1.55KB/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.id248μs1.48KB/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)375μs8.12KBParams/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` = 02.43ms96.3KBParams/libraries/src/Access/Access.php:301Copy
  • SHOW FULL COLUMNS FROM `yzfp0_content`337μs2.39KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
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  • 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)415μs104.69KBParams/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`381μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
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  • SHOW FULL COLUMNS FROM `yzfp0_users`285μs2.2KB/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` = :muserid158μs1.68KBParams/libraries/src/Table/User.php:134Copy
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  • 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` = :userId157μs1.64KBParams/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.id341μs2.11KB/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`389μs5.23KBParams/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 ASC1.21ms54.94KBParams/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` = :itemid622μs7.77KBParams/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` = 157 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2024-11-26 23:14:39') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2024-11-26 23:14:39'))485μs106.44KB/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`377μs5.23KBParams/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)507μs104.73KBParams/components/com_content/src/Model/ArticleModel.php:215Copy
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  • 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 = '9' AND f2.value = '100' AND f3.value = '1' LIMIT 112.73ms856B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
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  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id105μs1.63KBParams/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 <= '2024-11-26 23:14:39') AND (c2.publish_down IS NULL OR c2.publish_down >= '2024-11-26 23:14:39') AND c2.state = 1311μs1.8KBParams/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`1.31ms180.16KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
  • SELECT `a`.`menutype`,`a`.`title` FROM `yzfp0_menu_types` AS `a` WHERE `a`.`client_id` = 0164μs1.31KB/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.lft321μs1.92KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:791Copy
  • SHOW FULL COLUMNS FROM `yzfp0_content`345μs2.39KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:587Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 LIMIT 1183μs912B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT category.id,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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.id251μs896B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` <= '2024-11-26 23:14:39') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2024-11-26 23:14:39')) AND article.access IN (1,5) AND article.language IN ('es-ES','*')) AND `article`.`id` = 212135μs912B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 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 1131μs976B/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)378μs5.25KBParams/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)311μs5.25KBParams/libraries/src/Helper/TagsHelper.php:388Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id149μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id157μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT field.name,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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'250μs34.13KB/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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 LIMIT 1178μs1KB/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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 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 1190μs1KB/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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 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 1218μs9.13KB/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)432μs5.25KBParams/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)336μs5.25KBParams/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` = :id349μs1.72KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT * FROM `yzfp0_fields` AS `a` WHERE a.state IN (:preparedArray1,:preparedArray2) AND `a`.`context` = 'com_content.article'560μs54.11KBParams/plugins/system/articlesanywhere/src/DataGroups/Helpers/Fields.php:105Copy
  • SELECT *,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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'326μs4.09KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT value.item_id,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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'2.77ms468.88KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` <= '2024-11-26 23:14:39') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2024-11-26 23:14:39')) 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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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) 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 31.36ms944B/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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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)260μs1.16KB/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`477μs5.22KBParams/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`378μs5.23KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id180μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `yzfp0_content` WHERE `id` = :id163μs1.63KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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) 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 3392ms944B/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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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)310μs1.16KB/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`547μs5.22KBParams/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`416μs5.23KBParams/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)476μs104.73KBParams/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/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 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 1158μs1.13KB/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT `article`.`id` AS `article.id`,`article`.`hits` AS `article.hits`,'https://recintervcardiol.org/es/cardiopatia-isquemica/seguridad-del-cateterismo-diagnostico-ambulatorio-en-pacientes-en-tratamiento-con-anticoagulantes-orales-de-accion-directa\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` = 212 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 1160μs976B/plugins/system/articlesanywhere/src/Database.php:123Copy
  • SELECT * FROM `yzfp0_schemaorg` WHERE `itemId` = :itemId AND `context` = :context188μs1.86KBParams/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)567μs104.73KBParams/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` = 1160μs1.68KBParams/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.id329μs2.14KB/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` = 1203μs896B/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.id336μs18.42KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '212' AND `field_id` = 30249μs840B/tmp/regularlabs/custom_php/4961_af27ee991d0d77889539c6cba39057bf:36Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `item_id` = '212' AND `field_id` = 19170μs840B/tmp/regularlabs/custom_php/4961_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` = 212 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2024-11-26 23:14:39') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2024-11-26 23:14:39'))424μs103.44KB/libraries/regularlabs/src/Article.php:94Copy
  • SELECT `value` FROM `yzfp0_fields_values` WHERE `field_id` = 18 AND `item_id` = 2121.05ms856B/tmp/regularlabs/custom_php/4961_20d16d1e6db57666571c51c2623628e6:28Copy
  • SELECT COUNT(*) FROM `yzfp0_contentitem_tag_map` WHERE `type_alias` = 'com_content.article' AND `content_item_id` = 212336μs856B/tmp/regularlabs/custom_php/4961_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.id274μs2.19KB/plugins/system/rereplacer/src/Items.php:97Copy
  • SELECT `session_id` FROM `yzfp0_session` WHERE `session_id` = ?204μs1.63KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:277Copy
  • UPDATE `yzfp0_session` SET `data` = ? , `time` = ? WHERE `session_id` = ?696μs912BParams/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