Influence of meteorological conditions on hospital admission in patients with acute coronary syndrome with and without ST-segment elevation: Results of the AIRACOS study

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"apellidos" => "Avanzas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Department of Cardiology, Canarias University Hospital, Santa Cruz de Tenerife, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Health Sciences, European University of Canarias, La Orotava, Santa Cruz de Tenerife, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Izaña Atmospheric Research Center (CIAI), AEMET, Unit Associated to the CSIC, Santa Cruz de Tenerife, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Department of Physiology, University of La Laguna, Santa Cruz de Tenerife, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Department of Cardiology, Asturias Central University Hospital, Oviedo, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Influencia de las condiciones meteorológicas en el ingreso hospitalario en pacientes con síndrome coronario agudo con y sin elevación del segmento ST: resultados del estudio AIRACOS" ] ] "textoCompleto" => "IntroductionMany epidemiological studies point to the existence of an association between exposure to air pollution and harmful health effects, resulting in a significant increase in morbidity-mortality.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Acute coronary syndrome (ACS) constitutes an important public health problem in Spain.<a class="elsevierStyleCrossRefs" href="#bib0010">2,3</a> Although different studies have shown certain meteorological variables such as atmospheric pressure, temperature or wind to exert the greatest impact upon the incidence of acute myocardial infarction, the underlying cause–effect relationship and the reasons for the observed seasonal variations remain unclear.<a class="elsevierStyleCrossRefs" href="#bib0020">4,5</a>The present study explores the possible association between meteorological parameters and hospital admission in patients with (STE-ACS) and without ST-segment elevation ACS (NSTE-ACS).Patients and methodsStudy populationThe AIRACOS (AIR and Acute COronary Syndrome) is an observational study that has been described in detail elsewhere.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> In brief, the AIRCOS was carried out in the Canarias University Hospital Complex (Canary Islands, Spain), which provides medical care for the northern part of the island of Tenerife, with a recruitment population of 343,025 inhabitants. The study included patients with a diagnosis of STE-ACS and NSTE-ACS. Specifically, STE-ACS was defined by the presence of compatible symptoms, persistent (>20min) ST-segment elevation ≥1mm on at least two adjacent leads or in the presence of left bundle block, presumably of new onset, and cardiac troponin I elevation ≥0.5ng/ml (cutoff point ≥0.5ng/ml for the diagnosis of acute myocardial infarction [AMI]; immune reagents of the Vitros 5100 system from Orthoclinical Diagnostics, USA). In turn, NSTE-ACS was defined by the presence of compatible symptoms, cardiac troponin I elevation ≥0.5ng/ml or dynamic ST-segment changes (descent ≥1mm or non-persistent elevation on at least two adjacent leads).<a class="elsevierStyleCrossRef" href="#bib0010">2</a>All the patients included in the AIRACOS signed the corresponding informed consent form. The study protocol abided with the guidelines of the Declaration of Helsinki (1975), as reflected in the prior approval obtained from the Clinical Research Ethics Committee of the center. Likewise, the present study has been inscribed in and warranted by the clinical trials registry (<a href="http://www.clinicaltrials.gov/">www.clinicaltrials.gov</a>: <a href="ctgov:NCT01799148">NCT01799148</a>). The main objectives of the AIRACOS were to determine whether there is an association between air pollution levels and inflammatory and oxidative stress markers, and to explore their correlation to the prognosis of patients with ACS.The data presented herein correspond to a substudy of the AIRACOS survey, in which the analysis of atmospheric pressure in relation to ACS was not a pre-specified objective. This is therefore a post hoc and hypothesis-generating analysis. We included those patients that met all the inclusion criteria and none of the exclusion criteria.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> The population of this substudy comprised a total of 307 patients.Methodology of the air pollution dataThe air pollutant measurements were made in a single location representative of the urban background conditions of a metropolitan area (Santa Cruz de Tenerife).<a class="elsevierStyleCrossRefs" href="#bib0035">7,8</a> Previous studies have shown that the pollutants measured simultaneously at different points in the northern part of the island of Tenerife are closely correlated, due to the dominant influence of the meteorological conditions.<a class="elsevierStyleCrossRef" href="#bib0045">9</a>The pollutants whose environmental air concentrations are limited by current legislation were monitored using the European reference techniques<a class="elsevierStyleCrossRef" href="#bib0050">10</a> (European Directive on air quality 2008/50/EC, Spanish Royal Decree [RD] 102/2011): particles with an aerodynamic diameter of under 10 and 2.5μm (gravimetry and beta-attenuation), nitrogen dioxide (IR chemiluminescence), sulfur dioxide (UV fluorescence) and ozone (UV absorption). In addition, a multiple-angle absorption photometer (VIS) was used to determine the concentrations of particulate black carbon–the environmental air concentrations of which have not yet been limited by current legislation but are of great scientific interest due to their potential effects upon health.<a class="elsevierStyleCrossRefs" href="#bib0040">8,9</a> The meteorological variables were recorded by means of standard electronic sensors and techniques used in meteorology (temperature, relative humidity, air speed and atmospheric pressure determined with a thermometer, hygrometer, anemometer and barometer, respectively). All the equipment recorded data with a time resolution of one minute.Study variablesA number of clinical variables were recorded in each patient, including coronary risk factors, age, gender, body mass index (BMI), previous vascular disease, and medication at hospital discharge. The following laboratory test parameters were also documented: blood count with leukocyte formula, renal function, total cholesterol, triglycerides, troponin I, C-reactive protein and malondialdehyde. The number of diseased coronary vessels were recorded from the coronariographic studies, and the left ventricular ejection fraction was registered.With regard to the air pollutants and meteorological variables, each patient was associated to the mean daily exposure values (24h) recorded from the day before (lag 1) to day 7 (lag 7) prior to admission.<a class="elsevierStyleCrossRef" href="#bib0030">6</a>Statistical analysisA time series analysis was made with interaction between contamination and the modifier (STE-ACS and NSTE-ACS). Continuous variables are reported as the mean±standard deviation (SD), and as the median (interquartile range [IQR]) in the case of a non-normal distribution. Qualitative variables in turn are presented as absolute frequencies and percentages. The baseline characteristics in the two patient groups were compared by means of the chi-squared test for categorical variables. In the case of continuous quantitative variables with a normal distribution, we used the Student's t-test, or the equivalent nonparametric tests, as applicable (Mann–Whitney U-test or Kruskal–Wallis test). A multivariate analysis was performed based on a binary logistic regression model in which the dependent variables were STE-ACS (value 1) and NSTE-ACS (value 0), and the independent variables were those parameters yielding a p-value <0.05 in the univariate analysis. The results are expressed with the odds ratio (OR), with the 95% confidence interval (95%CI). Statistical significance was considered for p<0.05 in all cases. The SPSS version 20.0 statistical package (Chicago, IL, USA) was used throughout.ResultsOf the 307 patients participating in the study, 138 (45%) belonged to the STE-ACS group and 169 (55%) to the NSTE-ACS group. In the STE-ACS group, 51 patients suffered acute thrombotic occlusion of the anterior descending artery, 55 of the right coronary artery, and 32 of the circumflex artery. The mean age was 63±12 years, and 76.2% of the subjects were males (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The characteristics of both groups are summarized in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. Significant differences were observed between the two groups in terms of age and the number of diseased coronary vessels–the patients in the NSTE-ACS group being older, with a larger proportion of two and three diseased vessels, and lower troponin I levels.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The meteorological data, gaseous pollutants and atmospheric particles are reported in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. The meteorological variables showed the patients in the STE-ACS group to be exposed to higher atmospheric pressure than those in the NSTE-ACS group. On comparing the concentrations of the gaseous pollutants with exposure in both groups, the patients with STE-ACS were seen to be less exposed to sulfur dioxide. With regard to exposure to the different atmospheric particles, no statistically significant differences were observed between the two groups.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In a multivariate model (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>), atmospheric pressure (OR: 1.14; 95%CI: 1.04–1.24; p=0.004) was found to be an independent predictor of the presentation of STE-ACS.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>DiscussionTo our knowledge, this is the first study in Spain to analyze the relationship between meteorological conditions and hospital admission due to STE-ACS and NSTE-ACS. The results of our study, which serve to generate hypotheses, indicate that patients with STE-ACS have been exposed to higher atmospheric pressure values during the previous days.The impact of atmospheric pressure upon cardiovascular disease has been studied in different European countries, with contradictory results. In effect, while some studies have found no association between atmospheric pressure and the incidence of acute myocardial infarction,<a class="elsevierStyleCrossRefs" href="#bib0025">5,11–13</a> other studies have indeed reported a correlation.<a class="elsevierStyleCrossRefs" href="#bib0070">14,15</a>A prospective study<a class="elsevierStyleCrossRef" href="#bib0075">15</a> involving a 10-year follow-up of 257,000 males between 25 and 64 years of age detected a V-form relationship between atmospheric pressure and the rate of coronary episodes – the incidence being lowest when the atmospheric pressure was 1016mbar, i.e., approximately the separating point between high and low pressures. This study<a class="elsevierStyleCrossRef" href="#bib0075">15</a> was carried out in the city of Lille (France), where in the course of its 10-year duration the highest recorded atmospheric pressure was 1044mbar, the minimum pressure 991mbar, and the mean pressure 1017. According to the results of the study, an increase of 10mbar above a pressure of 1016mbar was associated to an 11% increase in total coronary episodes, an 18% increase in coronary deaths, a 7% increase in myocardial infarctions, and a 30% increase in relapse rate. In turn, with a 10mbar decrease below 1016mbar, these increments were found to be 12%, 13%, 8% and 30%, respectively. In our study, with each mbar increase in atmospheric pressure during the week before the event, the risk of admission due to STE-ACS versus NSTE-ACS was found to increase 14%.Differences in climate, orography and data analyzing methodology must be taken into account on comparing our results with those of the study conducted in Lille. Firstly, the present study was carried out in Tenerife, corresponding to a subtropical region with practically permanent high pressures due to the Azores anti-cyclonic effect. In contrast, Lille is characterized by greater meteorological variability, with the alternation of winter and summer high pressure periods due to anti-cyclonic situations versus low pressure periods in spring and autumn due to the passing of showers typical of such middle latitudes.<a class="elsevierStyleCrossRef" href="#bib0075">15</a> Accordingly, the pressure variation range differs between the two studies: 28mbar in our study versus 53mbar in the study published by Danet et al.<a class="elsevierStyleCrossRef" href="#bib0075">15</a> Secondly, in our study the orography is abrupt, with a greater time variability in atmospheric pressure than in flatter regions, as is the case of the city of Lille. Lastly, in our study we used the mean pressures during the 7 days prior to patient admission, while Danet et al. employed data recorded during 10 years.<a class="elsevierStyleCrossRef" href="#bib0075">15</a>The physiopathological mechanisms of STE-ACS and NSTE-ACS may be superimposable. Both conditions are characterized by atheroma plaque rupture, fissure or erosion, with the generation of an overlying thrombus–the latter being occlusive in the case of STE-ACS and non-occlusive or intermittently occlusive in the case of NSTE-ACS.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>The results of our study serve to generate hypotheses; as a result, such small differences in atmospheric pressure may at least in part have clinical consequences based on the concept of extra-arterial dynamic pressure.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> This concept was introduced by Saul<a class="elsevierStyleCrossRef" href="#bib0080">16</a> as pressure proportional to atmospheric pressure and counter to transmural pressure. An increase in extra-arterial dynamic pressure<a class="elsevierStyleCrossRef" href="#bib0080">16</a> acts against arterial dilatation, with a decrease in vessel lumen, and therefore facilitates occlusive atherogenic phenomena resulting in STE-ACS.The originality of our study focuses on three aspects: (a) It is the first study in Spain to prospectively analyze the effect of atmospheric pressure in patients admitted due to acute ischemic coronary disease; (b) In the study published by Danet et al.,<a class="elsevierStyleCrossRef" href="#bib0075">15</a> the analysis was population based, in contrast to our own study, where the analysis focused on hospital admissions due to ACS; and (c) In the patients who suffered ACS, increased atmospheric pressure in the week prior to admission was found to be a predictor of the presentation of STE-ACS.Recently in Spain, and specifically in the region of Galicia, a retrospective study showed the incidence of acute myocardial infarction to be associated to atmospheric pressure.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> The difference with respect to our study is that we used a retrospective design and for the first time showed the presence of elevated atmospheric pressure values during the week prior to the event to increase the risk that ACS will manifest as STE-ACS (i.e., acute coronary syndrome with ST-segment elevation).Determining the influence of the variations in atmospheric pressure upon the physiopathological aspects of ACS could improve our understanding of the underlying cause–effect relationship and help to identify patients at risk, as well as design individualized preventive strategies. In this regard, the best preventive measure is adequate education of patients referred to the meteorological conditions of the region in which they live.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> Accordingly, patients at risk should be made aware that sudden changes in atmospheric pressure are fundamentally caused by changes in altitude.Meteorological variables are not independent but inter-relate with each other; it therefore seems reasonable to assume that atmospheric pressure, humidity and other factors might contribute to variations in the incidence of ACS and explain the heterogeneity of the results found in the literature.<a class="elsevierStyleCrossRef" href="#bib0095">19</a>LimitationsOur study has a number of limitations that should be commented:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">(a)A problem inherent to studies of this kind on the effects of air pollution is error in the measurement of exposure, mainly as a result of the differences between what is measured by the recording stations and the actual exposure of each individual in the population (inter-individual variability).<a class="elsevierStyleCrossRefs" href="#bib0100">20,21</a></li><li class="elsevierStyleListItem" id="lsti0010">(b)Different population-based studies<a class="elsevierStyleCrossRefs" href="#bib0025">5,12–17</a> have analyzed the influence of meteorological parameters upon the incidence of ACS. In all these studies the analysis has been made at population level, al contrast to our study, where analysis focuses on the hospital admissions due to ACS.</li><li class="elsevierStyleListItem" id="lsti0015">(c)The climate of a given region depends on a series of geographical factors: latitude, orography and the geographical setting. Our region is located between 28 and 29°N of the equator, and is therefore close to the tropic of cancer, which as a result of the prevailing winds is characterized by a uniform environmental temperature. Consequently, the results of our study should be confirmed by establishing comparisons with the data obtained in other geographical areas presenting climatic conditions different from our own.</li><li class="elsevierStyleListItem" id="lsti0020">(d)The present study has conducted a post hoc analysis of atmospheric pressure in relation to the type of ACS, with the inherent possibility of findings attributable to chance.</li></ul>In conclusion, the present study shows that in patients with ACS, the presence of increased atmospheric pressure during the week prior to the event increases the risk that such ACS will manifest as STE-ACS (i.e., acute coronary syndrome with ST-segment elevation).Financial supportThis project was financed by the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III and FEDER (PI12/00092).Conflicts of interestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres822425" "titulo" => "Abstract" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Design" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Setting" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Patients" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Interventions" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Variables of interest" ] 6 => array:2 [ "identificador" => "abst0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec819271" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres822424" "titulo" => "Resumen" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "abst0045" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0050" "titulo" => "Diseño" ] 2 => array:2 [ "identificador" => "abst0055" "titulo" => "Ámbito" ] 3 => array:2 [ "identificador" => "abst0060" "titulo" => "Pacientes" ] 4 => array:2 [ "identificador" => "abst0065" "titulo" => "Intervenciones" ] 5 => array:2 [ "identificador" => "abst0070" "titulo" => "Variables de interés principales" ] 6 => array:2 [ "identificador" => "abst0075" "titulo" => "Resultados" ] 7 => array:2 [ "identificador" => "abst0080" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec819270" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patients and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study population" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Methodology of the air pollution data" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Study variables" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Limitations" ] 9 => array:2 [ "identificador" => "sec0050" "titulo" => "Financial support" ] 10 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflicts of interest" ] 11 => array:2 [ "identificador" => "xack275977" "titulo" => "Acknowledgement" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-03-07" "fechaAceptado" => "2015-04-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec819271" "palabras" => array:4 [ 0 => "Meteorological variables" 1 => "Air pollution" 2 => "Population exposure" 3 => "Acute myocardial infarction" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec819270" "palabras" => array:4 [ 0 => "Variables meteorológicas" 1 => "Contaminación atmosférica" 2 => "Exposición poblacional" 3 => "Infarto agudo de miocardio" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveEvaluate whether the meterological parameters affecting revenues in patients with ST-segment and non-ST-segment elevation ACS. DesignA prospective cohort study was carried out. SettingCoronary Care Unit of Hospital Universitario de Canarias. PatientsWe study a total of 307 consecutive patients with a diagnosis of ST-segment and non-ST-segment elevation ACS. We analyze the average concentrations of particulate smaller than 10 and 2.5μm diameter, particulate black carbon, the concentrations of gaseous pollutants and meteorological parameters (wind speed, temperature, relative humidity and atmospheric pressure) that were exposed patients from one day up to 7 days prior to admission. InterventionsNone. Variables of interestDemographic, clinical, atmospheric particles, concentrations of gaseous pollutants and meterological parameters. ResultsA total of 138 (45%) patients were classified as ST-segment and 169 (55%) as non-ST-segment elevation ACS. No statistically significant differences in exposure to atmospheric particles in both groups. Regarding meteorological data, we did not find statistically significant differences, except for higher atmospheric pressure in ST-segment elevation ACS (999.6±2.6 vs. 998.8±2.5mbar, p=.008). Multivariate analysis showed that atmospheric pressure was significant predictor of ST-segment elevation ACS presentation (OR: 1.14, 95% CI: 1.04–1.24, p=.004). ConclusionsIn the patients who suffer ACS, the presence of higher number of atmospheric pressure during the week before the event increase the risk that the ST-segment elevation ACS." "secciones" => array:8 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Design" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Setting" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Patients" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Interventions" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Variables of interest" ] 6 => array:2 [ "identificador" => "abst0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoEvaluar si los parámetros meteorológicos influyen en los ingresos de pacientes con síndrome coronario agudo (SCA) con y sin elevación del ST. DiseñoCohorte prospectiva. ÁmbitoUnidad Coronaria del Hospital Universitario de Canarias. PacientesSe estudió un total de 307 pacientes consecutivos con el diagnóstico de SCA con y sin elevación del ST. Analizamos las concentraciones medias de partículas con tamaño inferior a 10 y 2,5 μm de diámetro, partículas de carbono negro, concentraciones de gases contaminantes y los parámetros meteorológicos a los que estuvieron expuestos los pacientes desde el día anterior hasta 7 días previos al ingreso. IntervencionesNinguna. Variables de interés principalesDemográficas, clínicas, partículas atmosféricas, contaminantes en fase gas y parámetros meteorológicos. ResultadosDel total, 138 (45%) pacientes fueron clasificados como SCA con elevación del ST y 169 (55%) sin elevación del ST. No encontramos diferencias estadísticamente significativas en la exposición a partículas atmosféricas entre ambos grupos. Respecto a los datos meteorológicos, no encontramos diferencias estadísticamente significativas, a excepción de una mayor presión atmosférica en el SCA con elevación del ST (999,6±2,6 vs. 998,8±2,5mbar, p=0,008). El análisis multivariante mostró que la presión atmosférica fue predictor significativo de presentación del SCA con elevación del ST (OR: 1,14 IC 95%: 1,04 a 1,24; p=0,004). ConclusionesEn los pacientes que sufren un SCA, la presencia de cifras más elevadas de presión atmosférica durante la semana previa al evento incrementa el riesgo de que dicho SCA sea con elevación del ST." "secciones" => array:8 [ 0 => array:2 [ "identificador" => "abst0045" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0050" "titulo" => "Diseño" ] 2 => array:2 [ "identificador" => "abst0055" "titulo" => "Ámbito" ] 3 => array:2 [ "identificador" => "abst0060" "titulo" => "Pacientes" ] 4 => array:2 [ "identificador" => "abst0065" "titulo" => "Intervenciones" ] 5 => array:2 [ "identificador" => "abst0070" "titulo" => "Variables de interés principales" ] 6 => array:2 [ "identificador" => "abst0075" "titulo" => "Resultados" ] 7 => array:2 [ "identificador" => "abst0080" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Dominguez-Rodriguez A, Juarez-Prera RA, Rodríguez S, Abreu-Gonzalez P, Avanzas P. Influencia de las condiciones meteorológicas en el ingreso hospitalario en pacientes con síndrome coronario agudo con y sin elevación del segmento ST: resultados del estudio AIRACOS. Med Intensiva. 2016. http://dx.doi.org/10.1016/j.medin.2015.04.007" ] ] "multimedia" => array:4 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "ARA-II, angiotensin-II receptor antagonists; LVEF, left ventricular ejection fraction; ACEIs, angiotensin-converting enzyme inhibitors; STE-ACS, acute coronary syndrome with ST-segment elevation; NSTE-ACS, acute coronary syndrome without ST-segment elevation.Values expressed as n (%), mean±standard deviation or median [interquartile range]." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">(n=307) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63±12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender (males) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">234 (76.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body mass index (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28±4.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous cerebrovascular event \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (4.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Clinical condition</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">STE-ACS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">138 (45) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">NSTE-ACS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">169 (55) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Cardiovascular risk factors</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arterial hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">173 (64.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smoking \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">129 (56.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypercholesterolemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">187 (60.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98 (31.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Medication at discharge</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aspirin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">307 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clopidogrel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">283 (92.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Beta-blockers \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">273 (88.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ACEIs/ARA-II drugs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">217 (70.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Statins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">307 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antidiabetic medication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98 (31.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Coronary angiography</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal coronary arteries \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (4.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Single-vessel lesion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">150 (48.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Two-vessel lesion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">88 (28.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Three-vessel lesion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 (27.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEF (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57±10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Blood test parameters upon admission</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.4±7.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hematocrit (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.6±4.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leukocytes (109/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11±3.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neutrophils (109/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.1±1.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.9±0.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Troponin I (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.1±22.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total cholesterol (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">175 (147–201) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Triglycerides (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">135 (107–174) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C-reactive protein (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.3 (5–17.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Malondialdehyde (nmol/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.2 (1.7–2.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1382964.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline characteristics of the study population." ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "ARA-II, angiotensin-II receptor antagonists; LVEF, left ventricular ejection fraction; ACEIs, angiotensin-converting enzyme inhibitors.Values expressed as n (%), mean±standard deviation or median [interquartile range]." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">STE-ACS (n=138) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NSTE-ACS (n=169) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62±12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65±11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender (males) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106 (45.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">128 (54.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body mass index (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.71±4.25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.19±4.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous cerebrovascular event \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (2.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (5.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.29 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Cardiovascular risk factors</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arterial hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">104 (61.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smoking \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 (43.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 (40.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypercholesterolemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81 (58.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106 (62.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.47 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 (28.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 (34.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Medication at discharge</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aspirin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">138 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">169 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clopidogrel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">133 (96.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">150 (88.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Beta-blockers \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">123 (89.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">150 (88.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.91 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ACEIs/ARA-II drugs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94 (68.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">123 (72.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.37 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Statins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">138 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">169 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Antidiabetic medication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 (28.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 (34.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Coronary angiography</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal coronary arteries \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (8.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Single-vessel lesion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85 (61.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 (38.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Two-vessel lesion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 (22.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 (33.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Three-vessel lesion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (15.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 (18.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEF (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57±10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59±9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Blood test parameters upon admission</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.03±1.69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.79±9.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.37 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hematocrit (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.63±4.79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.51±4.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leukocytes (109/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.7±3.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.6±3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.85 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neutrophils (109/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.0±1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.8±1.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.85±0.28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.91±0.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.28 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Troponin I (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.17±29.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.21±9.58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total cholesterol (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">178 (150–204) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">171.5 (145–200.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.86 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Triglycerides (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">134.5 (104.7–158.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">136.5 (111–200.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C-reactive protein (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.9 (5–16.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.6 (5–17.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.27 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Malondialdehyde (nmol/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.235 (1.742–2.815) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.230 (1.607–2.875) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.44 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1382967.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Comparison of the clinical and laboratory test data between the two groups." ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "PM, particle material with aerodynamic diameter <10μm (PM-10) and <2.5μm (PM-2.5).Values expressed as mean±standard deviation." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">STE-ACS (n=138) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NSTE-ACS (n=169) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Meteorological variables</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wind speed (m/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.1±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.1±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Temperature (°C) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.2±2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.7±2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.06 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Relative humidity (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.2±4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.6±5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atmospheric pressure (mbar) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">999.6±2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">998.8±2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.008 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Gaseous pollutants (μg/m3)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sulfur dioxide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.1±2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.6±2.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nitrogen dioxide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.7±1.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.7±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ozone \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.9±7.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.5±8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Atmospheric particles (μg/m3)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PM-10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.6±5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17±5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PM-2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.6±2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.7±2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Black carbon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">855.8±205.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">872.3±196.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1382965.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Data referred to gaseous pollutants, atmospheric particles and meteorological variables between the day before and the 7 days before admission, in the two study groups. All values are expressed with the mean concentration." ] ] 3 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "CI, confidence interval; OR, odds ratio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95%CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.95–0.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.023 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Atmospheric pressure<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>,<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.04–1.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1382966.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Mean of the last 7 days before admission." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Adjusted for coronary disease (p=0.6), troponin I (p=0.06) and sulfur dioxide (p=0.5)." ] ] ] "descripcion" => array:1 [ "en" => "Independent predictors of the presentation of STE-ACS." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Expert position paper on air pollution and cardiovascular disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.E. 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Influence of meteorological conditions on hospital admission in patients with acute coronary syndrome with and without ST-segment elevation: Results of the AIRACOS study

Influencia de las condiciones meteorológicas en el ingreso hospitalario en pacientes con síndrome coronario agudo con y sin elevación del segmento ST: resultados del estudio AIRACOS

A. Dominguez-Rodrigueza,b,

Corresponding author

adrvdg@hotmail.com

Corresponding author.

, R.A. Juarez-Preraa, S. Rodríguezc, P. Abreu-Gonzalezd, P. Avanzase

a Department of Cardiology, Canarias University Hospital, Santa Cruz de Tenerife, Spain

b Faculty of Health Sciences, European University of Canarias, La Orotava, Santa Cruz de Tenerife, Spain

c Izaña Atmospheric Research Center (CIAI), AEMET, Unit Associated to the CSIC, Santa Cruz de Tenerife, Spain

d Department of Physiology, University of La Laguna, Santa Cruz de Tenerife, Spain

e Department of Cardiology, Asturias Central University Hospital, Oviedo, Spain

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        "titulo" => "Influencia de las condiciones meteorol&#243;gicas en el ingreso hospitalario en pacientes con s&#237;ndrome coronario agudo con y sin elevaci&#243;n del segmento ST&#58; resultados del estudio AIRACOS"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Many epidemiological studies point to the existence of an association between exposure to air pollution and harmful health effects&#44; resulting in a significant increase in morbidity-mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Acute coronary syndrome &#40;ACS&#41; constitutes an important public health problem in Spain&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> Although different studies have shown certain meteorological variables such as atmospheric pressure&#44; temperature or wind to exert the greatest impact upon the incidence of acute myocardial infarction&#44; the underlying cause&#8211;effect relationship and the reasons for the observed seasonal variations remain unclear&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The present study explores the possible association between meteorological parameters and hospital admission in patients with &#40;STE-ACS&#41; and without ST-segment elevation ACS &#40;NSTE-ACS&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Patients and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study population</span><p id="par0015" class="elsevierStylePara elsevierViewall">The AIRACOS &#40;AIR and Acute COronary Syndrome&#41; is an observational study that has been described in detail elsewhere&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In brief&#44; the AIRCOS was carried out in the Canarias University Hospital Complex &#40;Canary Islands&#44; Spain&#41;&#44; which provides medical care for the northern part of the island of Tenerife&#44; with a recruitment population of 343&#44;025 inhabitants&#46; The study included patients with a diagnosis of STE-ACS and NSTE-ACS&#46; Specifically&#44; STE-ACS was defined by the presence of compatible symptoms&#44; persistent &#40;&#62;20<span class="elsevierStyleHsp" style=""></span>min&#41; ST-segment elevation &#8805;1<span class="elsevierStyleHsp" style=""></span>mm on at least two adjacent leads or in the presence of left bundle block&#44; presumably of new onset&#44; and cardiac troponin I elevation &#8805;0&#46;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;cutoff point &#8805;0&#46;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml for the diagnosis of acute myocardial infarction &#91;AMI&#93;&#59; immune reagents of the Vitros 5100 system from Orthoclinical Diagnostics&#44; USA&#41;&#46; In turn&#44; NSTE-ACS was defined by the presence of compatible symptoms&#44; cardiac troponin I elevation &#8805;0&#46;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml or dynamic ST-segment changes &#40;descent &#8805;1<span class="elsevierStyleHsp" style=""></span>mm or non-persistent elevation on at least two adjacent leads&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">All the patients included in the AIRACOS signed the corresponding informed consent form&#46; The study protocol abided with the guidelines of the Declaration of Helsinki &#40;1975&#41;&#44; as reflected in the prior approval obtained from the Clinical Research Ethics Committee of the center&#46; Likewise&#44; the present study has been inscribed in and warranted by the clinical trials registry &#40;<a href="http://www.clinicaltrials.gov/">www&#46;clinicaltrials&#46;gov</a>&#58; <a href="ctgov:NCT01799148">NCT01799148</a>&#41;&#46; The main objectives of the AIRACOS were to determine whether there is an association between air pollution levels and inflammatory and oxidative stress markers&#44; and to explore their correlation to the prognosis of patients with ACS&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The data presented herein correspond to a substudy of the AIRACOS survey&#44; in which the analysis of atmospheric pressure in relation to ACS was not a pre-specified objective&#46; This is therefore a post hoc and hypothesis-generating analysis&#46; We included those patients that met all the inclusion criteria and none of the exclusion criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The population of this substudy comprised a total of 307 patients&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Methodology of the air pollution data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The air pollutant measurements were made in a single location representative of the urban background conditions of a metropolitan area &#40;Santa Cruz de Tenerife&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> Previous studies have shown that the pollutants measured simultaneously at different points in the northern part of the island of Tenerife are closely correlated&#44; due to the dominant influence of the meteorological conditions&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The pollutants whose environmental air concentrations are limited by current legislation were monitored using the European reference techniques<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> &#40;European Directive on air quality 2008&#47;50&#47;EC&#44; Spanish Royal Decree &#91;RD&#93; 102&#47;2011&#41;&#58; particles with an aerodynamic diameter of under 10 and 2&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;m &#40;gravimetry and beta-attenuation&#41;&#44; nitrogen dioxide &#40;IR chemiluminescence&#41;&#44; sulfur dioxide &#40;UV fluorescence&#41; and ozone &#40;UV absorption&#41;&#46; In addition&#44; a multiple-angle absorption photometer &#40;VIS&#41; was used to determine the concentrations of particulate black carbon&#8211;the environmental air concentrations of which have not yet been limited by current legislation but are of great scientific interest due to their potential effects upon health&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a> The meteorological variables were recorded by means of standard electronic sensors and techniques used in meteorology &#40;temperature&#44; relative humidity&#44; air speed and atmospheric pressure determined with a thermometer&#44; hygrometer&#44; anemometer and barometer&#44; respectively&#41;&#46; All the equipment recorded data with a time resolution of one minute&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Study variables</span><p id="par0040" class="elsevierStylePara elsevierViewall">A number of clinical variables were recorded in each patient&#44; including coronary risk factors&#44; age&#44; gender&#44; body mass index &#40;BMI&#41;&#44; previous vascular disease&#44; and medication at hospital discharge&#46; The following laboratory test parameters were also documented&#58; blood count with leukocyte formula&#44; renal function&#44; total cholesterol&#44; triglycerides&#44; troponin <span class="elsevierStyleSmallCaps">I</span>&#44; C-reactive protein and malondialdehyde&#46; The number of diseased coronary vessels were recorded from the coronariographic studies&#44; and the left ventricular ejection fraction was registered&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">With regard to the air pollutants and meteorological variables&#44; each patient was associated to the mean daily exposure values &#40;24<span class="elsevierStyleHsp" style=""></span>h&#41; recorded from the day before &#40;lag 1&#41; to day 7 &#40;lag 7&#41; prior to admission&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">A time series analysis was made with interaction between contamination and the modifier &#40;STE-ACS and NSTE-ACS&#41;&#46; Continuous variables are reported as the mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41;&#44; and as the median &#40;interquartile range &#91;IQR&#93;&#41; in the case of a non-normal distribution&#46; Qualitative variables in turn are presented as absolute frequencies and percentages&#46; The baseline characteristics in the two patient groups were compared by means of the chi-squared test for categorical variables&#46; In the case of continuous quantitative variables with a normal distribution&#44; we used the Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#44; or the equivalent nonparametric tests&#44; as applicable &#40;Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test or Kruskal&#8211;Wallis test&#41;&#46; A multivariate analysis was performed based on a binary logistic regression model in which the dependent variables were STE-ACS &#40;value 1&#41; and NSTE-ACS &#40;value 0&#41;&#44; and the independent variables were those parameters yielding a <span class="elsevierStyleItalic">p</span>-value &#60;0&#46;05 in the univariate analysis&#46; The results are expressed with the odds ratio &#40;OR&#41;&#44; with the 95&#37; confidence interval &#40;95&#37;CI&#41;&#46; Statistical significance was considered for <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in all cases&#46; The SPSS version 20&#46;0 statistical package &#40;Chicago&#44; IL&#44; USA&#41; was used throughout&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">Of the 307 patients participating in the study&#44; 138 &#40;45&#37;&#41; belonged to the STE-ACS group and 169 &#40;55&#37;&#41; to the NSTE-ACS group&#46; In the STE-ACS group&#44; 51 patients suffered acute thrombotic occlusion of the anterior descending artery&#44; 55 of the right coronary artery&#44; and 32 of the circumflex artery&#46; The mean age was 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 years&#44; and 76&#46;2&#37; of the subjects were males &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The characteristics of both groups are summarized in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; Significant differences were observed between the two groups in terms of age and the number of diseased coronary vessels&#8211;the patients in the NSTE-ACS group being older&#44; with a larger proportion of two and three diseased vessels&#44; and lower troponin I levels&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The meteorological data&#44; gaseous pollutants and atmospheric particles are reported in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; The meteorological variables showed the patients in the STE-ACS group to be exposed to higher atmospheric pressure than those in the NSTE-ACS group&#46; On comparing the concentrations of the gaseous pollutants with exposure in both groups&#44; the patients with STE-ACS were seen to be less exposed to sulfur dioxide&#46; With regard to exposure to the different atmospheric particles&#44; no statistically significant differences were observed between the two groups&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">In a multivariate model &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#44; atmospheric pressure &#40;OR&#58; 1&#46;14&#59; 95&#37;CI&#58; 1&#46;04&#8211;1&#46;24&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; was found to be an independent predictor of the presentation of STE-ACS&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">To our knowledge&#44; this is the first study in Spain to analyze the relationship between meteorological conditions and hospital admission due to STE-ACS and NSTE-ACS&#46; The results of our study&#44; which serve to generate hypotheses&#44; indicate that patients with STE-ACS have been exposed to higher atmospheric pressure values during the previous days&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The impact of atmospheric pressure upon cardiovascular disease has been studied in different European countries&#44; with contradictory results&#46; In effect&#44; while some studies have found no association between atmospheric pressure and the incidence of acute myocardial infarction&#44;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;11&#8211;13</span></a> other studies have indeed reported a correlation&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">A prospective study<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> involving a 10-year follow-up of 257&#44;000 males between 25 and 64 years of age detected a V-form relationship between atmospheric pressure and the rate of coronary episodes &#8211; the incidence being lowest when the atmospheric pressure was 1016<span class="elsevierStyleHsp" style=""></span>mbar&#44; i&#46;e&#46;&#44; approximately the separating point between high and low pressures&#46; This study<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> was carried out in the city of Lille &#40;France&#41;&#44; where in the course of its 10-year duration the highest recorded atmospheric pressure was 1044<span class="elsevierStyleHsp" style=""></span>mbar&#44; the minimum pressure 991<span class="elsevierStyleHsp" style=""></span>mbar&#44; and the mean pressure 1017&#46; According to the results of the study&#44; an increase of 10<span class="elsevierStyleHsp" style=""></span>mbar above a pressure of 1016<span class="elsevierStyleHsp" style=""></span>mbar was associated to an 11&#37; increase in total coronary episodes&#44; an 18&#37; increase in coronary deaths&#44; a 7&#37; increase in myocardial infarctions&#44; and a 30&#37; increase in relapse rate&#46; In turn&#44; with a 10<span class="elsevierStyleHsp" style=""></span>mbar decrease below 1016<span class="elsevierStyleHsp" style=""></span>mbar&#44; these increments were found to be 12&#37;&#44; 13&#37;&#44; 8&#37; and 30&#37;&#44; respectively&#46; In our study&#44; with each mbar increase in atmospheric pressure during the week before the event&#44; the risk of admission due to STE-ACS versus NSTE-ACS was found to increase 14&#37;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Differences in climate&#44; orography and data analyzing methodology must be taken into account on comparing our results with those of the study conducted in Lille&#46; Firstly&#44; the present study was carried out in Tenerife&#44; corresponding to a subtropical region with practically permanent high pressures due to the Azores anti-cyclonic effect&#46; In contrast&#44; Lille is characterized by greater meteorological variability&#44; with the alternation of winter and summer high pressure periods due to anti-cyclonic situations versus low pressure periods in spring and autumn due to the passing of showers typical of such middle latitudes&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Accordingly&#44; the pressure variation range differs between the two studies&#58; 28<span class="elsevierStyleHsp" style=""></span>mbar in our study versus 53<span class="elsevierStyleHsp" style=""></span>mbar in the study published by Danet et al&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Secondly&#44; in our study the orography is abrupt&#44; with a greater time variability in atmospheric pressure than in flatter regions&#44; as is the case of the city of Lille&#46; Lastly&#44; in our study we used the mean pressures during the 7 days prior to patient admission&#44; while Danet et al&#46; employed data recorded during 10 years&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The physiopathological mechanisms of STE-ACS and NSTE-ACS may be superimposable&#46; Both conditions are characterized by atheroma plaque rupture&#44; fissure or erosion&#44; with the generation of an overlying thrombus&#8211;the latter being occlusive in the case of STE-ACS and non-occlusive or intermittently occlusive in the case of NSTE-ACS&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">The results of our study serve to generate hypotheses&#59; as a result&#44; such small differences in atmospheric pressure may at least in part have clinical consequences based on the concept of extra-arterial dynamic pressure&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> This concept was introduced by Saul<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> as pressure proportional to atmospheric pressure and counter to transmural pressure&#46; An increase in extra-arterial dynamic pressure<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> acts against arterial dilatation&#44; with a decrease in vessel lumen&#44; and therefore facilitates occlusive atherogenic phenomena resulting in STE-ACS&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The originality of our study focuses on three aspects&#58; &#40;a&#41; It is the first study in Spain to prospectively analyze the effect of atmospheric pressure in patients admitted due to acute ischemic coronary disease&#59; &#40;b&#41; In the study published by Danet et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> the analysis was population based&#44; in contrast to our own study&#44; where the analysis focused on hospital admissions due to ACS&#59; and &#40;c&#41; In the patients who suffered ACS&#44; increased atmospheric pressure in the week prior to admission was found to be a predictor of the presentation of STE-ACS&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Recently in Spain&#44; and specifically in the region of Galicia&#44; a retrospective study showed the incidence of acute myocardial infarction to be associated to atmospheric pressure&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> The difference with respect to our study is that we used a retrospective design and for the first time showed the presence of elevated atmospheric pressure values during the week prior to the event to increase the risk that ACS will manifest as STE-ACS &#40;i&#46;e&#46;&#44; acute coronary syndrome with ST-segment elevation&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Determining the influence of the variations in atmospheric pressure upon the physiopathological aspects of ACS could improve our understanding of the underlying cause&#8211;effect relationship and help to identify patients at risk&#44; as well as design individualized preventive strategies&#46; In this regard&#44; the best preventive measure is adequate education of patients referred to the meteorological conditions of the region in which they live&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Accordingly&#44; patients at risk should be made aware that sudden changes in atmospheric pressure are fundamentally caused by changes in altitude&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Meteorological variables are not independent but inter-relate with each other&#59; it therefore seems reasonable to assume that atmospheric pressure&#44; humidity and other factors might contribute to variations in the incidence of ACS and explain the heterogeneity of the results found in the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Limitations</span><p id="par0120" class="elsevierStylePara elsevierViewall">Our study has a number of limitations that should be commented&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;a&#41;</span><p id="par0125" class="elsevierStylePara elsevierViewall">A problem inherent to studies of this kind on the effects of air pollution is error in the measurement of exposure&#44; mainly as a result of the differences between what is measured by the recording stations and the actual exposure of each individual in the population &#40;inter-individual variability&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;b&#41;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Different population-based studies<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;12&#8211;17</span></a> have analyzed the influence of meteorological parameters upon the incidence of ACS&#46; In all these studies the analysis has been made at population level&#44; al contrast to our study&#44; where analysis focuses on the hospital admissions due to ACS&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;c&#41;</span><p id="par0135" class="elsevierStylePara elsevierViewall">The climate of a given region depends on a series of geographical factors&#58; latitude&#44; orography and the geographical setting&#46; Our region is located between 28 and 29&#176;<span class="elsevierStyleHsp" style=""></span>N of the equator&#44; and is therefore close to the tropic of cancer&#44; which as a result of the prevailing winds is characterized by a uniform environmental temperature&#46; Consequently&#44; the results of our study should be confirmed by establishing comparisons with the data obtained in other geographical areas presenting climatic conditions different from our own&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;d&#41;</span><p id="par0140" class="elsevierStylePara elsevierViewall">The present study has conducted a post hoc analysis of atmospheric pressure in relation to the type of ACS&#44; with the inherent possibility of findings attributable to chance&#46;</p></li></ul></p><p id="par0145" class="elsevierStylePara elsevierViewall">In conclusion&#44; the present study shows that in patients with ACS&#44; the presence of increased atmospheric pressure during the week prior to the event increases the risk that such ACS will manifest as STE-ACS &#40;i&#46;e&#46;&#44; acute coronary syndrome with ST-segment elevation&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Financial support</span><p id="par0150" class="elsevierStylePara elsevierViewall">This project was financed by the <span class="elsevierStyleGrantSponsor" id="gs1">Fondo de Investigaci&#243;n Sanitaria&#44; Instituto de Salud Carlos III</span> and <span class="elsevierStyleGrantSponsor" id="gs2">FEDER</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs2">PI12&#47;00092</span>&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conflicts of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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            4 => array:2 [
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              "titulo" => "Intervenciones"
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              "titulo" => "Variables de inter&#233;s principales"
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              "titulo" => "Resultados"
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              "identificador" => "abst0080"
              "titulo" => "Conclusiones"
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          "titulo" => "Palabras clave"
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        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
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        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Patients and methods"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Study population"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Methodology of the air pollution data"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Study variables"
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            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Statistical analysis"
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        6 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Results"
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        7 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Discussion"
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          "identificador" => "sec0045"
          "titulo" => "Limitations"
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          "identificador" => "sec0050"
          "titulo" => "Financial support"
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        10 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conflicts of interest"
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        11 => array:2 [
          "identificador" => "xack275977"
          "titulo" => "Acknowledgement"
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        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-03-07"
    "fechaAceptado" => "2015-04-17"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec819271"
          "palabras" => array:4 [
            0 => "Meteorological variables"
            1 => "Air pollution"
            2 => "Population exposure"
            3 => "Acute myocardial infarction"
          ]
        ]
      ]
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec819270"
          "palabras" => array:4 [
            0 => "Variables meteorol&#243;gicas"
            1 => "Contaminaci&#243;n atmosf&#233;rica"
            2 => "Exposici&#243;n poblacional"
            3 => "Infarto agudo de miocardio"
          ]
        ]
      ]
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluate whether the meterological parameters affecting revenues in patients with ST-segment and non-ST-segment elevation ACS&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective cohort study was carried out&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Coronary Care Unit of Hospital Universitario de Canarias&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We study a total of 307 consecutive patients with a diagnosis of ST-segment and non-ST-segment elevation ACS&#46; We analyze the average concentrations of particulate smaller than 10 and 2&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;m diameter&#44; particulate black carbon&#44; the concentrations of gaseous pollutants and meteorological parameters &#40;wind speed&#44; temperature&#44; relative humidity and atmospheric pressure&#41; that were exposed patients from one day up to 7 days prior to admission&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">None&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Variables of interest</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Demographic&#44; clinical&#44; atmospheric particles&#44; concentrations of gaseous pollutants and meterological parameters&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 138 &#40;45&#37;&#41; patients were classified as ST-segment and 169 &#40;55&#37;&#41; as non-ST-segment elevation ACS&#46; No statistically significant differences in exposure to atmospheric particles in both groups&#46; Regarding meteorological data&#44; we did not find statistically significant differences&#44; except for higher atmospheric pressure in ST-segment elevation ACS &#40;999&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6 vs&#46; 998&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;5<span class="elsevierStyleHsp" style=""></span>mbar&#44; <span class="elsevierStyleItalic">p</span>&#61;&#46;008&#41;&#46; Multivariate analysis showed that atmospheric pressure was significant predictor of ST-segment elevation ACS presentation &#40;OR&#58; 1&#46;14&#44; 95&#37; CI&#58; 1&#46;04&#8211;1&#46;24&#44; <span class="elsevierStyleItalic">p</span>&#61;&#46;004&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In the patients who suffer ACS&#44; the presence of higher number of atmospheric pressure during the week before the event increase the risk that the ST-segment elevation ACS&#46;</p></span>"
        "secciones" => array:8 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Design"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Setting"
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            "identificador" => "abst0020"
            "titulo" => "Patients"
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            "titulo" => "Interventions"
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            "identificador" => "abst0030"
            "titulo" => "Variables of interest"
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            "titulo" => "Results"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluar si los par&#225;metros meteorol&#243;gicos influyen en los ingresos de pacientes con s&#237;ndrome coronario agudo &#40;SCA&#41; con y sin elevaci&#243;n del ST&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Cohorte prospectiva&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Unidad Coronaria del Hospital Universitario de Canarias&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se estudi&#243; un total de 307 pacientes consecutivos con el diagn&#243;stico de SCA con y sin elevaci&#243;n del ST&#46; Analizamos las concentraciones medias de part&#237;culas con tama&#241;o inferior a 10 y 2&#44;5 &#956;m de di&#225;metro&#44; part&#237;culas de carbono negro&#44; concentraciones de gases contaminantes y los par&#225;metros meteorol&#243;gicos a los que estuvieron expuestos los pacientes desde el d&#237;a anterior hasta 7 d&#237;as previos al ingreso&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Ninguna&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables de inter&#233;s principales</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Demogr&#225;ficas&#44; cl&#237;nicas&#44; part&#237;culas atmosf&#233;ricas&#44; contaminantes en fase gas y par&#225;metros meteorol&#243;gicos&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Del total&#44; 138 &#40;45&#37;&#41; pacientes fueron clasificados como SCA con elevaci&#243;n del ST y 169 &#40;55&#37;&#41; sin elevaci&#243;n del ST&#46; No encontramos diferencias estad&#237;sticamente significativas en la exposici&#243;n a part&#237;culas atmosf&#233;ricas entre ambos grupos&#46; Respecto a los datos meteorol&#243;gicos&#44; no encontramos diferencias estad&#237;sticamente significativas&#44; a excepci&#243;n de una mayor presi&#243;n atmosf&#233;rica en el SCA con elevaci&#243;n del ST &#40;999&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;6 vs&#46; 998&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5<span class="elsevierStyleHsp" style=""></span>mbar&#44; p&#61;0&#44;008&#41;&#46; El an&#225;lisis multivariante mostr&#243; que la presi&#243;n atmosf&#233;rica fue predictor significativo de presentaci&#243;n del SCA con elevaci&#243;n del ST &#40;OR&#58; 1&#44;14 IC 95&#37;&#58; 1&#44;04 a 1&#44;24&#59; p&#61;0&#44;004&#41;&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">En los pacientes que sufren un SCA&#44; la presencia de cifras m&#225;s elevadas de presi&#243;n atmosf&#233;rica durante la semana previa al evento incrementa el riesgo de que dicho SCA sea con elevaci&#243;n del ST&#46;</p></span>"
        "secciones" => array:8 [
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            "titulo" => "Dise&#241;o"
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            "identificador" => "abst0055"
            "titulo" => "&#193;mbito"
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            "identificador" => "abst0060"
            "titulo" => "Pacientes"
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            "identificador" => "abst0065"
            "titulo" => "Intervenciones"
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          5 => array:2 [
            "identificador" => "abst0070"
            "titulo" => "Variables de inter&#233;s principales"
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            "titulo" => "Resultados"
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            "titulo" => "Conclusiones"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Dominguez-Rodriguez A&#44; Juarez-Prera RA&#44; Rodr&#237;guez S&#44; Abreu-Gonzalez P&#44; Avanzas P&#46; Influencia de las condiciones meteorol&#243;gicas en el ingreso hospitalario en pacientes con s&#237;ndrome coronario agudo con y sin elevaci&#243;n del segmento ST&#58; resultados del estudio AIRACOS&#46; Med Intensiva&#46; 2016&#46; <span class="elsevierStyleInterRef" id="intr0005" href="doi:10.1016/j.medin.2015.04.007">http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1016&#47;j&#46;medin&#46;2015&#46;04&#46;007</span></p>"
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">ARA-II&#44; angiotensin-II receptor antagonists&#59; LVEF&#44; left ventricular ejection fraction&#59; ACEIs&#44; angiotensin-converting enzyme inhibitors&#59; STE-ACS&#44; acute coronary syndrome with ST-segment elevation&#59; NSTE-ACS&#44; acute coronary syndrome without ST-segment elevation&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Values expressed as n &#40;&#37;&#41;&#44; mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or median &#91;interquartile range&#93;&#46;</p>"
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Body mass index &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous cerebrovascular event</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Clinical condition</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>STE-ACS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NSTE-ACS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">169 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Cardiovascular risk factors</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arterial hypertension&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">129 &#40;56&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypercholesterolemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">187 &#40;60&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Clopidogrel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">283 &#40;92&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Beta-blockers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">273 &#40;88&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACEIs&#47;ARA-II drugs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">307 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antidiabetic medication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98 &#40;31&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Coronary angiography</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Normal coronary arteries&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Single-vessel lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150 &#40;48&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Two-vessel lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88 &#40;28&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Three-vessel lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;27&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LVEF &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Blood test parameters upon admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hemoglobin &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hematocrit &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leukocytes &#40;10<span class="elsevierStyleSup">9</span>&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neutrophils &#40;10<span class="elsevierStyleSup">9</span>&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Creatinine &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Troponin I &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total cholesterol &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">175 &#40;147&#8211;201&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Triglycerides &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">135 &#40;107&#8211;174&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>C-reactive protein &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;3 &#40;5&#8211;17&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Malondialdehyde &#40;nmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;2 &#40;1&#46;7&#8211;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">ARA-II&#44; angiotensin-II receptor antagonists&#59; LVEF&#44; left ventricular ejection fraction&#59; ACEIs&#44; angiotensin-converting enzyme inhibitors&#46;</p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Values expressed as n &#40;&#37;&#41;&#44; mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or median &#91;interquartile range&#93;&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">STE-ACS &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>138&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NSTE-ACS &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>169&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gender &#40;males&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106 &#40;45&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">128 &#40;54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Body mass index &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous cerebrovascular event</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Cardiovascular risk factors</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arterial hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104 &#40;61&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60 &#40;43&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;40&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypercholesterolemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81 &#40;58&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106 &#40;62&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39 &#40;28&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;34&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Medication at discharge</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Aspirin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">169 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Clopidogrel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">133 &#40;96&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150 &#40;88&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Beta-blockers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">123 &#40;89&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150 &#40;88&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACEIs&#47;ARA-<span class="elsevierStyleSmallCaps">II drugs</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94 &#40;68&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">123 &#40;72&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Statins&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">169 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antidiabetic medication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39 &#40;28&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;34&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Coronary angiography</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Normal coronary arteries&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Single-vessel lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85 &#40;61&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;38&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Two-vessel lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;22&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;33&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Three-vessel lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;18&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LVEF &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Blood test parameters upon admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hemoglobin &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;03<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hematocrit &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leukocytes &#40;10<span class="elsevierStyleSup">9</span>&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neutrophils &#40;10<span class="elsevierStyleSup">9</span>&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Creatinine &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;91<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Troponin I &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;17<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>29&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total cholesterol &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">178 &#40;150&#8211;204&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">171&#46;5 &#40;145&#8211;200&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Triglycerides &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">134&#46;5 &#40;104&#46;7&#8211;158&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">136&#46;5 &#40;111&#8211;200&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>C-reactive protein &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9 &#40;5&#8211;16&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;6 &#40;5&#8211;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Malondialdehyde &#40;nmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;235 &#40;1&#46;742&#8211;2&#46;815&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;230 &#40;1&#46;607&#8211;2&#46;875&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;44&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Temperature &#40;&#176;C&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Relative humidity &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Atmospheric pressure &#40;mbar&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">999&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">998&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Gaseous pollutants</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sulfur dioxide&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nitrogen dioxide&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ozone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Atmospheric particles</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PM-10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;4&nbsp;\t\t\t\t\t\t\n
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Article information

ISSN: 21735727
Original language: English

DOI:10.1016/j.medine.2016.04.001

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Year/Month	Html	Pdf	Total

2024 November	6	14	20
2024 October	52	44	96
2024 September	30	30	60
2024 August	51	45	96
2024 July	45	27	72
2024 June	43	45	88
2024 May	33	29	62
2024 April	47	33	80
2024 March	38	27	65
2024 February	35	39	74
2024 January	31	48	79
2023 December	26	48	74
2023 November	35	23	58
2023 October	34	31	65
2023 September	36	47	83
2023 August	30	17	47
2023 July	34	19	53
2023 June	27	24	51
2023 May	54	31	85
2023 April	29	22	51
2023 March	52	19	71
2023 February	43	32	75
2023 January	26	16	42
2022 December	42	33	75
2022 November	43	26	69
2022 October	49	47	96
2022 September	35	34	69
2022 August	35	23	58
2022 July	26	25	51
2022 June	23	15	38
2022 May	31	36	67
2022 April	23	28	51
2022 March	35	47	82
2022 February	46	24	70
2022 January	46	34	80
2021 December	50	41	91
2021 November	35	32	67
2021 October	57	64	121
2021 September	33	30	63
2021 August	32	37	69
2021 July	30	33	63
2021 June	34	34	68
2021 May	46	72	118
2021 April	102	91	193
2021 March	77	39	116
2021 February	56	28	84
2021 January	47	27	74
2020 December	41	20	61
2020 November	44	10	54
2020 October	36	18	54
2020 September	46	11	57
2020 August	29	17	46
2020 July	23	22	45
2020 June	28	18	46
2020 May	26	13	39
2020 April	23	11	34
2020 March	15	21	36
2020 February	81	61	142
2020 January	46	17	63
2019 December	47	24	71
2019 November	24	23	47
2019 October	24	22	46
2019 September	24	24	48
2019 August	26	16	42
2019 July	26	25	51
2019 June	23	16	39
2019 May	41	20	61
2019 April	12	12	24
2019 March	31	24	55
2019 February	31	31	62
2019 January	23	36	59
2018 December	37	65	102
2018 November	91	51	142
2018 October	74	18	92
2018 September	11	5	16
2018 August	20	7	27
2018 July	14	9	23
2018 June	27	5	32
2018 May	15	3	18
2018 April	25	12	37
2018 March	16	5	21
2018 February	19	5	24
2018 January	19	8	27
2017 December	15	7	22
2017 November	22	7	29
2017 October	30	5	35
2017 September	20	5	25
2017 August	16	12	28
2017 July	18	6	24
2017 June	27	7	34
2017 May	29	10	39
2017 April	19	17	36
2017 March	1	7	8
2017 February	11	5	16
2017 January	13	4	17
2016 December	21	15	36
2016 November	25	35	60
2016 October	36	30	66
2016 September	38	0	38
2016 August	32	0	32

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