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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">El infarto agudo de miocardio con elevaci&#243;n del segmento ST &#40;IAMCEST&#41; es uno de los mayores problemas de salud p&#250;blica en nuestra sociedad<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Tradicionalmente&#44; se ha considerado que las mujeres que presentan un IAMCEST tienen un pron&#243;stico m&#225;s desfavorable que los hombres<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">3</span></a>&#44; probablemente debido a que reciben peor tratamiento &#40;menos hospitalizaciones&#44; menor porcentaje de terapias m&#233;dicas recomendadas por las gu&#237;as de pr&#225;ctica cl&#237;nica y menor porcentaje de angioplastia primaria &#91;AP&#93;&#41;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">4</span></a>&#44; y por un mayor retraso en la aplicaci&#243;n de terapias de reperfusi&#243;n<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">5</span></a>&#46; Sin embargo&#44; estudios m&#225;s recientes han mostrado que tras ajustar por los factores de confusi&#243;n&#44; no existen diferencias relacionadas con el g&#233;nero en cuanto al tratamiento y el pron&#243;stico<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El beneficio de las terapias de reperfusi&#243;n en el IAMCEST depende del tiempo<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">8</span></a>&#46; La AP&#44; realizada dentro de la ventana temporal recomendada&#44; es capaz de reducir el riesgo de muerte y reinfarto en comparaci&#243;n con la fibrin&#243;lisis<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">9</span></a>&#46; Asimismo&#44; el transporte de pacientes con IAMCEST desde hospitales sin capacidad de AP las 24<span class="elsevierStyleHsp" style=""></span>h del d&#237;a&#44; los 7 d&#237;as de la semana &#40;24&#47;7&#41;&#44; hacia hospitales con capacidad de AP 24&#47;7 ha demostrado ser una estrategia factible y segura<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">10</span></a>&#46; Es por ello que la AP se considera el tratamiento de elecci&#243;n en pacientes con IAMCEST siempre y cuando pueda ser realizada por un operador experimentado dentro de los primeros 120<span class="elsevierStyleHsp" style=""></span>min tras el primer contacto m&#233;dico &#40;PCM&#41;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La implantaci&#243;n de las redes de atenci&#243;n al IAMCEST ha contribuido a expandir las terapias de reperfusi&#243;n&#44; principalmente realizadas mediante AP&#44; y generalizar as&#237; el tratamiento m&#225;s beneficioso para cada paciente seg&#250;n la ventana temporal recomendada por las gu&#237;as de pr&#225;ctica cl&#237;nica<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">11</span></a>&#46; Sin embargo&#44; los datos acerca del impacto del g&#233;nero en poblaciones con IAMCEST atendidas por redes espec&#237;ficamente dise&#241;adas a tal efecto no es muy abundante<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">4&#44;12</span></a>&#46; El objetivo de este estudio es analizar el impacto del g&#233;nero en t&#233;rminos de cuidados m&#233;dicos recibidos y en la mortalidad &#40;intrahospitalaria&#44; a 30 d&#237;as y a un a&#241;o&#41; en una poblaci&#243;n atendida por una red regional de atenci&#243;n al IAMCEST&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Poblaci&#243;n del estudio&#44; red de atenci&#243;n al Infarto agudo de miocardio con elevaci&#243;n del segmento ST y Registro Codi Infart</span><p id="par0020" class="elsevierStylePara elsevierViewall">Este estudio observacional y multic&#233;ntrico se basa en una base de datos recogida de forma prospectiva de pacientes consecutivos con IAMCEST atendidos por la red catalana de atenci&#243;n al IAMCEST &#40;Registro Codi Infart&#41; desde enero de 2010 a diciembre de 2011&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La Comunidad Aut&#243;noma de Catalu&#241;a se sit&#250;a en la zona noreste de Espa&#241;a y comprende aproximadamente una poblaci&#243;n de 7&#44;5 millones de habitantes&#46; En junio de 2009 se implant&#243; una red de atenci&#243;n al IAMCEST en dicha comunidad aut&#243;noma<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">13&#44;14</span></a>&#46; La red divid&#237;a Catalu&#241;a en &#225;reas de referencia para los 10 hospitales preexistentes con capacidad de AP&#44; con el objetivo de realizar la terapia de reperfusi&#243;n m&#225;s apropiada para cada paciente&#46; El Codi Infart comprend&#237;a 5 componentes b&#225;sicos&#58; &#40;1&#41; las ambulancias del Servei d&#8217;Emergencies M&#232;diques &#40;SEM&#41;&#44; las cuales estaban equipadas con m&#233;dico&#47;a&#40;s&#41; o enfermero&#47;a&#40;s&#41; capaces de diagnosticar los s&#237;ntomas&#44; interpretar los electrocardiogramas &#40;ECG&#41; y administrar la terapia fibrinol&#237;tica&#59; &#40;2&#41; el centro de coordinaci&#243;n del SEM que decid&#237;a la estrategia de reperfusi&#243;n y coordinaba la log&#237;stica entre las ambulancias&#44; los hospitales comarcales y los hospitales con capacidad de AP&#59; &#40;3&#41; los 10 hospitales con capacidad de AP&#44; 5 de los cuales ten&#237;an disponibilidad 24&#47;7&#59; &#40;4&#41; las unidades de cuidados intensivos o unidades coronarias de todos los hospitales participantes en el proyecto en las que los pacientes deb&#237;an ingresar tras recibir el tratamiento de reperfusi&#243;n&#44; y &#40;5&#41; la inclusi&#243;n de todos los pacientes atendidos por la red en un registro prospectivo obligatorio &#40;Registro Codi Infart&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Brevemente&#44; el protocolo dictaba que cuando un profesional m&#233;dico diagnosticaba un IAMCEST con base en criterios cl&#237;nicos y en el ECG&#44; durante el PCM se activaba la red y se seleccionaba la estrategia de acuerdo con las gu&#237;as de pr&#225;ctica cl&#237;nica<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a>&#46; Todos los pacientes con IAMCEST directamente admitidos en un centro con capacidad de AP eran tratados mediante esta&#44; mientras que los pacientes inicialmente atendidos en un hospital sin capacidad de realizar AP&#44; en centros de atenci&#243;n primaria o directamente por el SEM eran transferidos de acuerdo con su perfil de riesgo y si la expectativa de tiempo hasta la realizaci&#243;n de la AP era inferior a 120<span class="elsevierStyleHsp" style=""></span>min&#46; Si el retraso esperado para la realizaci&#243;n de la AP era superior a 120<span class="elsevierStyleHsp" style=""></span>min y el estado cl&#237;nico lo permit&#237;a&#44; los pacientes recib&#237;an terapia fibrinol&#237;tica&#44; y solo en caso de fibrin&#243;lisis fallida eran transferidos para angioplastia de rescate&#46; La prevenci&#243;n secundaria se prescrib&#237;a seg&#250;n la pr&#225;ctica m&#233;dica habitual de cada centro<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#44;2&#44;14</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">El registro Codi Infart se realiz&#243; de acuerdo con los principios de la Declaraci&#243;n de Helsinki y satisfaciendo todos los requerimientos legales&#46; Todos los centros eran conminados a cumplimentar el registro y todos los pacientes atendidos por la red deb&#237;an ser incluidos en el registro&#46; Se registraron datos demogr&#225;ficos&#44; cl&#237;nicos&#44; del procedimiento&#44; as&#237; como los intervalos de tiempo y las complicaciones intrahospitalarias&#44; y se realiz&#243; un seguimiento telef&#243;nico a 30 d&#237;as&#46; La mortalidad por todas las causas a un a&#241;o se obtuvo cruzando los datos de cada paciente con la base de datos del Instituto Nacional de Estad&#237;stica &#40;certificados de muerte&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Variables de valoraci&#243;n</span><p id="par0040" class="elsevierStylePara elsevierViewall">Para el prop&#243;sito del estudio&#44; todas las variables de valoraci&#243;n fueron analizadas de acuerdo con el g&#233;nero&#46; La variable de valoraci&#243;n primaria fue la mortalidad por todas las causas a un a&#241;o&#46; Las variables de valoraci&#243;n cl&#237;nicas secundarias incluyeron&#58; mortalidad por todas las causas intrahospitalaria y a 30 d&#237;as&#44; complicaciones intrahospitalarias definidas como la combinaci&#243;n de fibrilaci&#243;n ventricular&#44; taquicardia ventricular&#44; asistolia&#44; bloqueo auriculoventricular completo&#44; fibrilaci&#243;n auricular&#44; shock cardiog&#233;nico o necesidad de ventilaci&#243;n mec&#225;nica&#44; as&#237; como cada uno de sus componentes individuales por separado&#46; El shock cardiog&#233;nico fue definido como la necesidad de f&#225;rmacos inotr&#243;picos intravenosos y&#47;o bal&#243;n de contrapulsaci&#243;n intraa&#243;rtico para mantener una presi&#243;n arterial sist&#243;lica<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>90<span class="elsevierStyleHsp" style=""></span>mmHg<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a>&#46; Adem&#225;s&#44; fueron evaluadas otras variables de valoraci&#243;n secundarias relacionadas con el tratamiento m&#233;dico&#44; como el tipo de terapia de reperfusi&#243;n administrada y los siguientes intervalos de atenci&#243;n m&#233;dica&#58; inicio de s&#237;ntomas-PCM&#44; PCM-ECG diagn&#243;stico&#44; ECG diagn&#243;stico-bal&#243;n&#44; PCM-bal&#243;n e inicio de s&#237;ntomas-bal&#243;n &#40;tiempo total de isquemia&#41;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a>&#46; El PCM fue definido como el primer contacto con el sistema sanitario donde el paciente era atendido por un m&#233;dico&#47;a o un enfermero&#47;a&#44; ya fuese a nivel hospitalario como prehospitalario&#44; con capacidad de iniciar la activaci&#243;n de la red de atenci&#243;n del IAMCEST<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Todos los eventos fueron adjudicados por el Servei Catal&#224; de la Salut&#58; CatSalut &#40;Departament de Salut&#44; Generalitat de Catalunya&#41;&#46; Todas las variables de valoraci&#243;n fueron analizadas seg&#250;n el g&#233;nero&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">La normalidad de las variables continuas fue explorada mediante el test Kolmogorov-Smirnov&#46; Las variables distribuidas normalmente fueron expresadas como media &#40;desviaci&#243;n est&#225;ndar&#41;&#44; y las que no se distribu&#237;an normalmente lo fueron como media &#40;rango intercuart&#237;lico&#41; y se compararon mediante los test t-Student o U de Mann-Whitney&#44; seg&#250;n correspondiese&#46; Las variables categ&#243;ricas fueron expresadas como n&#250;mero &#40;porcentaje&#41; y se compararon usando el test Chi-cuadrado&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para evaluar la asociaci&#243;n entre el g&#233;nero &#40;variable de exposici&#243;n&#41; y la mortalidad global a 30 d&#237;as y a un a&#241;o se desarrollaron modelos de regresi&#243;n de riesgos proporcionales de Cox&#46; Se realiz&#243; un an&#225;lisis exploratorio univariado y las covariables con justificaci&#243;n cl&#237;nica o un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;10 fueron introducidas en los modelos de Cox&#46; Las siguientes variables fueron incluidas en el modelo&#58; g&#233;nero&#44; edad&#44; diabetes mellitus&#44; infarto de miocardio previo&#44; angioplastia previa&#44; intervenci&#243;n de derivaci&#243;n arterial coronaria previa&#44; ECG diagn&#243;stico&#44; localizaci&#243;n del infarto de miocardio&#44; clase de Killip al ingreso&#44; lugar del PCM&#44; intervalos de tiempo y tratamiento recibido&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">El resultado fue reportado como hazard ratio con un intervalo de confianza al 95&#37;&#46; Todos los valores de p fueron a 2 colas&#44; consider&#225;ndose estad&#237;sticamente significativos aquellos valores de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Los an&#225;lisis estad&#237;sticos se realizaci&#243;n utilizando el paquete estad&#237;stico SPSS<span class="elsevierStyleSup">&#174;</span> Statistics 20&#46;0 &#40;SPSS Inc&#46;&#44; Chicago&#44; Illinois&#44; Estados Unidos de Am&#233;rica&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">Entre enero de 2010 y diciembre de 2011 un total de 5&#46;831 pacientes con sospecha de IAMCEST fueron activados dentro de la Red Codi Infart&#46; Se incluyeron en el an&#225;lisis final 4&#46;380 pacientes &#40;75&#44;1&#37;&#41;&#46; El diagrama de flujo se representa en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Caracter&#237;sticas cl&#237;nicas y estrategias de reperfusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Entre los 4&#46;380 pacientes analizados&#44; 961 &#40;21&#44;9&#37;&#41; eran mujeres y 3&#46;419 &#40;78&#44;1&#37;&#41; eran hombres&#46; Las caracter&#237;sticas basales de ambos grupos se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; Las mujeres eran mayores &#40;69&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;4 vs&#46; 60&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;8 a&#241;os&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; con mayor prevalencia de diabetes mellitus &#40;27&#44;1 vs&#46; 18&#46;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y de Killip<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>I al ingreso &#40;24&#44;9 vs&#46; 17&#44;3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Adem&#225;s&#44; las mujeres ten&#237;an menor prevalencia de infarto de miocardio previo &#40;6&#44;9 vs&#46; 9&#44;7&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#44; angioplastia previa &#40;3&#44;9 vs&#46; 6&#46;9&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e intervenci&#243;n de derivaci&#243;n arterial coronaria previa &#40;0&#44;3 vs&#46; 1&#44;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;022&#41; en comparaci&#243;n con los hombres&#46; Asimismo&#44; el lugar del PCM tambi&#233;n vari&#243; de forma significativa entre los grupos&#46; Tambi&#233;n es de rese&#241;ar que la poblaci&#243;n femenina present&#243; un mayor porcentaje de pacientes no reperfundidos que la poblaci&#243;n masculina &#40;8&#44;8 vs&#46; 5&#44;2&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Retrasos en la atenci&#243;n m&#233;dica</span><p id="par0075" class="elsevierStylePara elsevierViewall">En comparaci&#243;n con la poblaci&#243;n masculina&#44; la poblaci&#243;n femenina que recibi&#243; AP present&#243; mayores retrasos en los siguientes intervalos de tiempo de atenci&#243;n m&#233;dica&#58; inicio de s&#237;ntomas-PCM &#40;90 vs&#46; 74<span class="elsevierStyleHsp" style=""></span>min&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; PCM-ECG diagn&#243;stico &#40;26 vs&#46; 22<span class="elsevierStyleHsp" style=""></span>min&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; ECG diagn&#243;stico-bal&#243;n &#40;83 vs&#46; 80<span class="elsevierStyleHsp" style=""></span>min&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;020&#41;&#44; PCM-bal&#243;n &#40;132 vs&#46; 122<span class="elsevierStyleHsp" style=""></span>min&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e inicio de s&#237;ntomas-bal&#243;n &#40;tiempo total de isquemia&#41; &#40;236 vs&#46; 210<span class="elsevierStyleHsp" style=""></span>min&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Los datos que comparan los intervalos de tiempo en la atenci&#243;n m&#233;dica entre los grupos se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Eventos cl&#237;nicos</span><p id="par0085" class="elsevierStylePara elsevierViewall">Los datos que comparan los eventos cl&#237;nicos entre los grupos se exponen en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#46; En conjunto&#44; las mujeres presentaron mayor porcentaje de complicaciones intrahospitalarias &#40;22&#44;2 vs&#46; 19&#44;0&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;031&#41;&#46; En particular&#44; las mujeres tuvieron m&#225;s bloqueo auriculoventricular &#40;6&#44;1 vs&#46; 3&#46;7&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; fibrilaci&#243;n auricular &#40;3&#44;4 vs&#46; 2&#44;2&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;032&#41; y shock cardiog&#233;nico &#40;9&#44;7 vs&#46; 7&#44;9&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; que los hombres&#46; Adem&#225;s&#44; la poblaci&#243;n femenina present&#243; un mayor porcentaje de mortalidad global intrahospitalaria &#40;4&#44;8 vs&#46; 2&#44;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; mortalidad global a 30 d&#237;as &#40;9&#44;1 vs&#46; 4&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y mortalidad global a un a&#241;o &#40;14&#44;0 vs&#46; 8&#44;3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">No obstante&#44; tras el ajuste multivariado no se observaron diferencias en la mortalidad global a 30 d&#237;as &#40;hazard ratio ajustada a 30 d&#237;as &#91;intervalo de confianza al 95&#37;&#93;&#58; 1&#44;25 &#91;0&#44;94-1&#44;65&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;123&#59; hazard ratio ajustada a un a&#241;o &#91;intervalo de confianza al 95&#37;&#93;&#58; 0&#44;88 &#91;0&#44;69-1&#44;07&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;128&#41;&#46; La curva de regresi&#243;n de Cox para la mortalidad por todas las causas a un a&#241;o se presenta en la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Discusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">Las principales conclusiones de este estudio fueron&#58; 1&#41; las mujeres con IAMCEST tuvieron peor perfil de riesgo y mayor proporci&#243;n de complicaciones intrahospitalarias y mortalidad global bruta&#59; 2&#41; las mujeres recibieron menos terapia de reperfusi&#243;n y presentaron mayores retrasos en la atenci&#243;n m&#233;dica en comparaci&#243;n con los hombres&#44; y 3&#41; tras ajustar por los factores de confusi&#243;n&#44; las mujeres y los hombres presentaron similar mortalidad por todas las causas a 30 d&#237;as y a un a&#241;o de seguimiento&#46;</p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Red de atenci&#243;n al IAMCEST y &#171;brecha de g&#233;nero en la atenci&#243;n m&#233;dica&#187;</span><p id="par0100" class="elsevierStylePara elsevierViewall">La implementaci&#243;n de estrategias que faciliten a la poblaci&#243;n con IAMCEST el acceso el sistema de atenci&#243;n m&#233;dica ha demostrado disminuir los retrasos en la realizaci&#243;n de intervenciones coronarias percut&#225;neas<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">16&#44;17</span></a>&#44; la mortalidad<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a> y los costes hospitalarios totales<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A pesar de la mejor&#237;a en el cuidado m&#233;dico que ha supuesto la implementaci&#243;n de las redes de atenci&#243;n al IAMCEST&#44; la &#171;brecha de g&#233;nero&#187; todav&#237;a persiste en la atenci&#243;n m&#233;dica&#46; De hecho&#44; en nuestro trabajo las mujeres mostraron mayores retrasos y menor proporci&#243;n de revascularizaciones que los hombres&#46; Estudios previos hab&#237;an demostrado que la poblaci&#243;n femenina presentaba mayores retrasos en la atenci&#243;n m&#233;dica&#44; lo que se traduc&#237;a en un mayor tiempo puerta-bal&#243;n y mayor tiempo total de isquemia<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#8211;23</span></a>&#46; Las redes de atenci&#243;n al IAMCEST&#44; al permitir la realizaci&#243;n de ECG domiciliarios&#44; la activaci&#243;n extrahospitalaria de los equipos de hemodin&#225;mica y el traslado directo a los laboratorios de hemodin&#225;mica por el SEM&#44; se han relacionado con menores retrasos en la atenci&#243;n m&#233;dica y menor mortalidad<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">24&#44;25</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Tras la implantaci&#243;n de la red Codi Infart&#44; la poblaci&#243;n femenina presentaba todav&#237;a intervalos de atenci&#243;n m&#233;dica m&#225;s prolongados y menores tasas de reperfusi&#243;n que la poblaci&#243;n masculina&#46; Esta &#171;brecha de g&#233;nero&#187; en los intervalos de tiempo y la terapia de reperfusi&#243;n se podr&#237;a explicar por diferencias en la presentaci&#243;n cl&#237;nica y en la fisiopatolog&#237;a del IAMCEST entre g&#233;neros&#44; lo cual debe ser tenido en cuenta a la hora de evaluar y tratar a pacientes mujeres con sospecha o diagn&#243;stico establecido de IAMCEST&#44; dado que se trata de un grupo de alta complejidad diagn&#243;stica y terap&#233;utica<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La mayor edad y la mayor prevalencia de diabetes mellitus entre las mujeres observada en nuestro trabajo se relaciona con una mayor presencia de s&#237;ntomas at&#237;picos en estas&#44; lo que pudo conllevar retrasos por parte de las pacientes en la consulta con el sistema de atenci&#243;n m&#233;dica &#40;retraso del paciente&#41;&#44; as&#237; como a errores en la valoraci&#243;n cl&#237;nica del IAMCEST que retrasasen los tiempos una vez las pacientes entraban dentro del sistema &#40;retraso del sistema&#41;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#44;20&#8211;23</span></a>&#46; Estas diferencias se visualizaron en que las mujeres presentaban mayores retrasos en todos los intervalos de tiempo evaluados en comparaci&#243;n con los hombres&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Tambi&#233;n cabe se&#241;alar que a pesar de que la AP es actualmente la terapia de reperfusi&#243;n preferida en el IAMCEST&#44; especialmente entre las mujeres debido a que en ellas se reducen las complicaciones hemorr&#225;gicas en mayor medida que entre los hombres<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9&#44;27&#8211;29</span></a>&#44; la diferencia en las terapias de reperfusi&#243;n todav&#237;a persiste en nuestra red&#44; como demuestra el mayor porcentaje de mujeres que no recibieron terapia en comparaci&#243;n con sus hom&#243;logos masculinos &#40;8&#44;8 vs&#46; 5&#44;2&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los datos recogidos en nuestra investigaci&#243;n no permiten explicar en profundidad esta diferencia&#44; aunque podr&#237;a estar mediada en parte por variaciones fisiopatol&#243;gicas entre ambos g&#233;neros en el IAMCEST&#44; como ser&#237;an la mayor incidencia de disecci&#243;n coronaria espont&#225;nea y espasmo coronario entre la poblaci&#243;n femenina<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1&#44;26&#44;27</span></a>&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Red de atenci&#243;n al IAMCEST y pron&#243;stico de las mujeres</span><p id="par0125" class="elsevierStylePara elsevierViewall">Los estudios realizados en la era de la trombolisis&#44; como el estudio GUSTO IIB<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a>&#44; demostraron que las mujeres ten&#237;an una mayor proporci&#243;n de complicaciones intrahospitalarias y mortalidad a 30 d&#237;as que los hombres&#46; Asimismo&#44; dicho estudio demostr&#243; que exist&#237;a una interacci&#243;n entre la mortalidad y el sexo femenino tras el ajuste multivariado<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a>&#46; Estos datos fueron posteriormente confirmados en otros registros realizados en la d&#233;cada de los 90 y a principios de la d&#233;cada del 2000 en nuestro pa&#237;s<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">29&#44;30</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Los estudios realizados tras la generalizaci&#243;n de la AP en la pr&#225;ctica cl&#237;nica habitual<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">6&#44;7&#44;27&#44;31</span></a> tambi&#233;n demostraron que las mujeres presentaban mayor mortalidad intrahospitalaria que los varones&#46; Este hecho podr&#237;a ser explicado por las diferencias en las tasas de reperfusi&#243;n y el peor perfil de riesgo que presentaban las mujeres con IAMCEST en dichos estudios&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">En su trabajo&#44; Lawesson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a> demostraron que la mortalidad a un a&#241;o era un 8&#37; inferior en las mujeres en comparaci&#243;n con los hombres tras el an&#225;lisis multivariado&#46; Este estudio ha sido el primero en mostrar que en el contexto del IAMCEST las mujeres presentan mayor mortalidad intrahospitalaria pero menor mortalidad a largo plazo que los hombres&#46; Nuestro estudio no objetiv&#243; diferencias en la mortalidad global a 30 d&#237;as y a un a&#241;o entre ambos grupos de g&#233;nero tras ajustar por los factores de confusi&#243;n&#46; Los hallazgos de nuestro estudio evidencian que la implantaci&#243;n de redes de atenci&#243;n al IAMCEST ha contribuido a igualar el pron&#243;stico a medio y largo plazo entre hombres y mujeres y nos hace hipotetizar que&#44; en caso de que las terapias de reperfusi&#243;n y los intervalos de atenci&#243;n m&#233;dica pudieran ser prove&#237;dos en ambos g&#233;neros de igual forma&#44; el pron&#243;stico a largo plazo podr&#237;a ser incluso mejor entre las mujeres que entre los hombres&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Limitaciones del estudio</span><p id="par0140" class="elsevierStylePara elsevierViewall">Primera&#44; este estudio es un an&#225;lisis retrospectivo de subgrupos de una base de datos recogida prospectivamente por el Servei Catal&#224; de la Salut &#40;CatSalut&#41;&#46; Sin embargo&#44; es el mayor estudio espa&#241;ol que analiza el rol del g&#233;nero en poblaciones atendidas por una red espec&#237;fica de atenci&#243;n al IAMCEST&#46; Segunda&#44; el pron&#243;stico a un a&#241;o fue evaluado &#250;nicamente mediante la mortalidad por todas las causas y otras variables de valoraci&#243;n pron&#243;stica&#44; como la mortalidad cardiaca&#44; el infarto de miocardio o la necesidad de nuevas revascularizaciones&#46; Tercera&#44; un porcentaje no despreciable de pacientes no recibi&#243; terapia de reperfusi&#243;n&#44; y como se&#241;alamos anteriormente&#44; no disponemos de datos concretos acerca de las causas de ello&#44; ya que no se contempl&#243; la recogida de dichos datos al dise&#241;ar el registro&#46; Cuarta&#44; nuestros datos se refieren a la poblaci&#243;n de Catalu&#241;a&#44; que representa un &#225;rea mediterr&#225;nea y&#44; por lo tanto&#44; no pueden ser completamente extrapolables a otras &#225;reas geogr&#225;ficas&#46; Quinta&#44; no disponemos&#44; asimismo&#44; de datos sobre la extensi&#243;n de la enfermedad arterial coronaria &#40;por ejemplo&#44; n&#250;mero de vasos coronarios enfermos&#41; o acerca del tratamiento farmacol&#243;gico o de cardiolog&#237;a intervencionista realizado durante el seguimiento&#44; lo cual tambi&#233;n puede influir en la extrapolaci&#243;n de nuestros resultados&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conclusiones</span><p id="par0145" class="elsevierStylePara elsevierViewall">La poblaci&#243;n femenina&#44; atendida por nuestra red regional de atenci&#243;n al IAMCEST&#44; present&#243; peor perfil de riesgo y recibi&#243; menos terapias de reperfusi&#243;n con mayores retrasos en la atenci&#243;n m&#233;dica en comparaci&#243;n con la poblaci&#243;n masculina&#46; Sin embargo&#44; tras ajuste multivariado&#44; la poblaci&#243;n femenina present&#243; similares resultados cl&#237;nicos&#44; a 30 d&#237;as y a un a&#241;o&#44; que sus hom&#243;logos masculinos&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Financiaci&#243;n</span><p id="par0150" class="elsevierStylePara elsevierViewall">Ninguna que declarar&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Conflicto de intereses</span><p id="par0155" class="elsevierStylePara elsevierViewall">Ninguno que declarar&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar el impacto del g&#233;nero sobre el pron&#243;stico y el manejo en una red regional de atenci&#243;n al infarto agudo de miocardio con elevaci&#243;n del segmento ST&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Dise&#241;o</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional sobre una base de pacientes consecutivos recogida prospectivamente&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">&#193;mbito</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Red catalana de atenci&#243;n al infarto agudo de miocardio con elevaci&#243;n del segmento ST&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Pacientes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Pacientes atendidos entre enero de 2010 y diciembre de 2011&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Intervenciones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Angioplastia primaria&#44; fibrin&#243;lisis o manejo conservador&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Variables de inter&#233;s</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se compararon&#44; seg&#250;n el g&#233;nero&#44; intervalos de tiempo&#44; proporci&#243;n y tipo de reperfusi&#243;n&#44; mortalidad global y complicaciones intrahospitalarias y mortalidad global a 30 d&#237;as y un a&#241;o&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">De 5&#46;831 pacientes atendidos&#44; 4&#46;380 ten&#237;an diagn&#243;stico de infarto agudo de miocardio con elevaci&#243;n del segmento ST&#44; siendo 961 &#40;21&#44;9&#37;&#41; de ellos mujeres&#46; Estas ten&#237;an mayor edad &#40;69&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;4 frente a 60&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;8 a&#241;os&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; mayor prevalencia de diabetes &#40;27&#44;1 frente a 18&#44;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; Killip<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>I &#40;24&#44;9 frente a 17&#44;3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ausencia de reperfusi&#243;n &#40;8&#44;8 frente a 5&#44;2&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; que los hombres&#46; Adem&#225;s&#44; las mujeres presentaban mayores retrasos en la atenci&#243;n &#40;primer contacto m&#233;dico-bal&#243;n&#58; 132 frente a 122<span class="elsevierStyleHsp" style=""></span>min&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; inicio de s&#237;ntomas-bal&#243;n&#58; 236 frente a 210<span class="elsevierStyleHsp" style=""></span>min&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; m&#225;s complicaciones intrahospitalarias &#40;20&#44;6 frente a 17&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;031&#41; y mortalidad intrahospitalaria&#44; a 30 d&#237;as y un a&#241;o &#40;4&#44;8 frente a 2&#44;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; 9&#44;1 frente a 4&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; 14&#44;0 frente a 8&#44;3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Sin embargo&#44; tras el an&#225;lisis multivariado no hubo diferencias en mortalidad a 30 d&#237;as y un a&#241;o&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A pesar del peor perfil de riesgo y el peor tratamiento recibido&#44; las mujeres presentaron similares resultados a 30 d&#237;as y un a&#241;o que sus hom&#243;logos masculinos atendidos por una red de atenci&#243;n al infarto&#46;</p></span>"
        "secciones" => array:8 [
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            "titulo" => "Dise&#241;o"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "&#193;mbito"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Pacientes"
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          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Intervenciones"
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          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Variables de inter&#233;s"
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            "identificador" => "abst0035"
            "titulo" => "Resultados"
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            "identificador" => "abst0040"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objective</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">To assess the impact of gender upon the prognosis and medical care in a regional acute ST-elevation myocardial infarction management network&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Design</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">An observational study was made of consecutive patients entered in a prospective database&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Scope</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The Catalan acute ST-elevation myocardial infarction management network&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Patients treated between January 2010 and December 2011&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Interventions</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Primary angioplasty&#44; thrombolysis or conservative management&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables of interest</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Time intervals&#44; proportion and type of reperfusion&#44; overall mortality&#44; and in-hospital complication and overall mortality at 30 days and one year were compared in relation to gender&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Of the 5&#44;831 patients attended by the myocardial infarction network&#44; 4&#44;380 had a diagnosis of acute ST-elevation myocardial infarction&#44; and 961 &#40;21&#46;9&#37;&#41; were women&#46; Women were older &#40;69&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;4 vs&#46; 60&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;8 years&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; had a higher prevalence of diabetes &#40;27&#46;1 vs&#46; 18&#46;1&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; Killip class<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>I &#40;24&#46;9 vs&#46; 17&#46;3&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and no reperfusion &#40;8&#46;8 vs&#46; 5&#46;2&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; versus men&#46; In addition&#44; women had greater delays in medical care &#40;first medical contact-to-balloon&#58; 132 vs&#46; 122<span class="elsevierStyleHsp" style=""></span>min&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; and symptoms onset-to-balloon&#58; 236 vs&#46; 210<span class="elsevierStyleHsp" style=""></span>min&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Women presented higher percentages of overall in-hospital complications &#40;20&#46;6 vs&#46; 17&#46;4&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;031&#41;&#44; in-hospital mortality &#40;4&#46;8 vs&#46; 2&#46;6&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; 30-day mortality &#40;9&#46;1 vs&#46; 4&#46;5&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and one-year mortality &#40;14&#46;0 vs&#46; 8&#46;3&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; versus men&#46; Nevertheless&#44; after multivariate adjustment&#44; no gender differences in 30-day and one-year mortality were observed&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Despite a higher risk profile and poorer medical management&#44; women present similar 30-day and one-year outcomes as their male counterparts in the context of the myocardial infarction management network&#46;</p></span>"
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            "titulo" => "Design"
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            "identificador" => "abst0055"
            "titulo" => "Scope"
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            "identificador" => "abst0060"
            "titulo" => "Patients"
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          4 => array:2 [
            "identificador" => "abst0065"
            "titulo" => "Interventions"
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            "identificador" => "abst0070"
            "titulo" => "Variables of interest"
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            "identificador" => "abst0075"
            "titulo" => "Results"
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            "identificador" => "abst0080"
            "titulo" => "Conclusions"
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          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo del estudio&#46;</p> <p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">IAMCEST&#58; infarto agudo de miocardio con elevaci&#243;n del segmento ST&#46;</p>"
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          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Curva de regresi&#243;n de Cox para la mortalidad por todas las causas a un a&#241;o&#46;</p>"
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">AP&#58; angioplastia primaria&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; ECG&#58; electrocardiograma&#59; IDAC&#58; intervenci&#243;n de derivaci&#243;n arterial coronaria&#59; IM&#58; infarto de miocardio&#59; PCM&#58; primer contacto m&#233;dico&#46;</p><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Los datos resaltados en negrita son estad&#237;sticamente significativos&#46;</p>"
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                  <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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&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">Grupo Mujeres<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>961&#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">Grupo Hombres<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;419&#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">p&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">Poblaci&#243;n&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">961 &#40;21&#44;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">3&#46;419 &#40;78&#44;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"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&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">Edad &#40;a&#241;os&#41;&#44; media &#40;DE&#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">69&#44;8 &#40;13&#44;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">60&#44;6 &#40;12&#44;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"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes mellitus&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">260 &#40;27&#44;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">620 &#40;18&#44;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"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&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">IM previo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66 &#40;6&#44;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">331 &#40;9&#44;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"><span class="elsevierStyleBold">0&#44;007</span>&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">Angioplastia previa&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;3&#44;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">236 &#40;6&#44;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"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&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">IDAC previa&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;0&#44;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">39 &#40;1&#44;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"><span class="elsevierStyleBold">0&#44;022</span>&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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">ECG diagn&#243;stico&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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><td class="td" title="table-entry  " align="char" valign="top">0&#46;578&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>Elevaci&#243;n de ST&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">883 &#40;99&#44;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">3&#46;179 &#40;99&#44;3&#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>Bloqueo de rama izquierda&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;0&#44;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">24 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Localizaci&#243;n&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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><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>Anterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">435 &#40;45&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;487 &#40;43&#44;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&#44;339&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>Inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">460 &#40;47&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;738 &#40;50&#44;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&#44;108&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>Lateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;10&#44;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">360 &#40;10&#44;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&#44;809&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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Killip al ingreso&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&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>I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">722 &#40;75&#44;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">2&#46;826 &#40;82&#44;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>II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100 &#40;10&#44;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">261 &#40;7&#44;6&#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>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46 &#40;4&#44;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">63 &#40;1&#44;8&#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>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93 &#40;9&#44;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">269 &#40;7&#44;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" 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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Killip</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#62;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">I al ingreso&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">239 &#40;24&#44;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">593 &#40;17&#44;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"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&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">Lugar del PCM&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&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><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;042</span>&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>Hospital sin capacidad de AP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">383 &#40;39&#44;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">1&#46;266 &#40;37&#44;0&#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>Hospital con capacidad de AP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">156 &#40;16&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">483 &#40;14&#44;1&#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>Centro de atenci&#243;n primaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">160 &#40;16&#44;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">666 &#40;19&#44;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>SEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">262 &#40;27&#44;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">1&#46;004 &#40;29&#44;4&#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" 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="char" valign="top"><span class="elsevierStyleItalic">Tratamiento&#44; n &#40;&#37;&#41;</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>Terapia fibrinol&#237;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;7&#44;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">285 &#40;8&#44;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&#44;227&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>AP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">808 &#40;84&#44;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">2&#46;956 &#40;86&#44;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&#44;066&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>No recibieron terapia de reperfusi&#243;n&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;8&#44;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">178 &#40;5&#44;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"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">808 &#40;21&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;956 &#40;78&#44;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"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#91;60-110&#93;&nbsp;\t\t\t\t\t\t\n
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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">Poblaci&#243;n&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                            4 => "C&#46; Bl&#246;mstrom-Lundqvist"
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                      "doi" => "10.1093/eurheartj/ehs215"
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                            0 => "M&#46; Heras"
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                            2 => "F&#46; Ar&#243;s"
                            3 => "X&#46; Bosch"
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