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la asociaci&#243;n de factores de riesgo con la EVAC determin&#243; una asociaci&#243;n entre la EVAC y la hipertensi&#243;n arterial &#40;HTA&#41;&#44; la diabetes mellitus&#44; la hipercolesterolemia y los niveles bajos de colesterol-HDL<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">4</span></a>&#46; En los estudios epidemiol&#243;gicos publicados los resultados sobre los factores de riesgo cardiovascular &#40;FRCV&#41; asociados con la EVAC o la EA no son homog&#233;neos&#46; Adem&#225;s&#44; diversos FRCV se asocian con la tasa de progresi&#243;n de la EA y tambi&#233;n con otras comorbilidades relacionadas con la EVAC o la EA<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">4&#8211;12</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Se han realizado pocos estudios epidemiol&#243;gicos que investiguen la asociaci&#243;n de los diferentes FRCV y comorbilidades con la EA en un &#225;mbito poblacional determinado&#44; y solo uno de ellos ha sido realizado en Espa&#241;a<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">4&#44;6&#8211;10&#44;13&#44;14</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La EA es habitualmente una enfermedad de inicio lento y silente&#44; que se puede acompa&#241;ar de un retraso diagn&#243;stico y una dilaci&#243;n en la indicaci&#243;n de intervenci&#243;n terap&#233;utica que puede empeorar su pron&#243;stico&#46; Identificar factores de riesgo de EA grave podr&#237;a facilitar la identificaci&#243;n de la poblaci&#243;n con mayor riesgo y reducir el retraso diagn&#243;stico&#44; y sobre todo el de intervenci&#243;n terap&#233;utica quir&#250;rgica o intervencionista<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El objetivo del presente estudio fue evaluar la asociaci&#243;n de diferentes FRCV y comorbilidades con la EA grave sintom&#225;tica en pacientes mayores de 65 a&#241;os&#44; en el &#225;mbito poblacional y geogr&#225;fico de las comarcas de una provincia de Espa&#241;a&#44; comparando los casos de EA grave sintom&#225;tica con controles del mismo centro de atenci&#243;n primaria&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio epidemiol&#243;gico observacional de casos y controles entre febrero de 2014 y abril de 2018&#46; Se consider&#243; &#171;caso&#187; todo individuo<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os de las comarcas de una provincia de Espa&#241;a con criterios cl&#237;nicos y ecocardiogr&#225;ficos de EA grave sintom&#225;tica que durante el per&#237;odo del estudio fuera candidato a cirug&#237;a card&#237;aca de sustituci&#243;n valvular&#44; seg&#250;n los criterios recomendados por las gu&#237;as cl&#237;nicas<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">16&#44;17</span></a>&#46; Los casos se seleccionaron entre todos los pacientes que se hab&#237;an remitido a la comisi&#243;n interdisciplinar de cardiolog&#237;a y cirug&#237;a cardiovascular para valorar el tipo de tratamiento de su EA grave sintom&#225;tica&#46; Todos los pacientes cumpl&#237;an los criterios establecidos por la gu&#237;a de la Sociedad Europea de Cardiolog&#237;a vigente en el per&#237;odo de estudio y que consist&#237;an en presencia de cl&#237;nica &#40;angor&#44; disnea o s&#237;ncope&#41; y de gravedad ecocardiogr&#225;fica &#40;un gradiente medio superior a 40<span class="elsevierStyleHsp" style=""></span>mmHg&#44; una velocidad de flujo transvalvular a&#243;rtico superior a 4<span class="elsevierStyleHsp" style=""></span>m&#47;s&#44; una &#225;rea valvular a&#243;rtica inferior a 1<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">2</span> o un &#225;rea valvular indexada inferior a 0&#44;6<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">2</span>&#47;m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">16</span></a>&#46; Se defini&#243; como &#171;control&#187; al individuo<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os de las comarcas de una provincia de Espa&#241;a&#44; sin EA conocida y procedente del mismo centro de atenci&#243;n primaria &#40;CAP&#41; que el caso apareado por edad &#40;&#177;<span class="elsevierStyleHsp" style=""></span>5 a&#241;os&#41; y sexo&#46; Los controles fueron seleccionados por el propio m&#233;dico de atenci&#243;n primaria entre los pacientes &#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os que hab&#237;a consultado y no presentaban cl&#237;nica de EA&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">La recogida de informaci&#243;n se realiz&#243; de forma prospectiva a trav&#233;s de entrevistas con los pacientes&#44; exploraci&#243;n f&#237;sica y consulta de las historias cl&#237;nicas electr&#243;nicas del &#225;mbito hospitalario y de atenci&#243;n primaria&#46; La recogida de datos&#44; almacenamiento y an&#225;lisis se realiz&#243; de conformidad con la normativa vigente&#46; Los pacientes otorgaron el consentimiento informado por escrito y el estudio fue aprobado por el comit&#233; de &#233;tica de investigaci&#243;n cl&#237;nica de nuestro centro y por el comit&#233; de &#233;tica de investigaci&#243;n del centro de atenci&#243;n primaria de la provincia donde se realiz&#243; el estudio&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La variable dependiente del estudio fue ser &#171;caso&#187; o &#171;control&#187;&#44; y las variables independientes las caracter&#237;sticas demogr&#225;ficas &#40;edad y sexo&#41; y cl&#237;nicas de los pacientes&#46; En relaci&#243;n con el tama&#241;o muestral se calcul&#243; el n&#250;mero de casos y controles para detectar una <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; de 2&#44;5&#44; con un riesgo &#945;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05 y un &#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#44; a partir de&#58; P<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#40;P<span class="elsevierStyleInf">1</span><span class="elsevierStyleHsp" style=""></span>&#42;<span class="elsevierStyleHsp" style=""></span>OR&#41;&#47;&#40;1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>P<span class="elsevierStyleInf">1</span><span class="elsevierStyleHsp" style=""></span>&#42;<span class="elsevierStyleHsp" style=""></span> &#91;OR-1&#93;&#41;&#46; Para una P<span class="elsevierStyleInf">1</span> esperada de 0&#44;50 se estim&#243; que ser&#237;an necesarios 87 casos y 261 controles&#46; As&#237;&#44; para cada caso que entraba en el estudio se pretend&#237;a seleccionar 3 controles apareados por edad &#40;&#177;5 a&#241;os&#41; y sexo procedentes del mismo CAP o &#225;rea b&#225;sica de salud &#40;ABS&#41; del caso&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis en 2 etapas&#58; primero se realiz&#243; un an&#225;lisis bivariado de las variables cl&#237;nicas del estudio y en segundo lugar se construy&#243; un modelo de regresi&#243;n log&#237;stica m&#250;ltiple para estudiar los FRCV y comorbilidades asociadas al riesgo de EA grave sintom&#225;tica&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se estudi&#243; la asociaci&#243;n estad&#237;stica de la variable dependiente &#40;caso&#47;control&#41; con las variables cualitativas independientes con la prueba de Chi cuadrado o el test exacto de Fisher&#46; Para las variables cuantitativas independientes se utiliz&#243; la &#171;t&#187; de Student o la prueba no param&#233;trica de Mann-Whitney en caso de no cumplir la hip&#243;tesis de normalidad&#46; En los 2 casos se acept&#243; un nivel de significaci&#243;n estad&#237;stica p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; La fuerza de la asociaci&#243;n de los FRCV y las comorbilidades con la variable dependiente se estudi&#243; con la <span class="elsevierStyleItalic">odds ratio</span> cruda &#40;ORc&#41; con su intervalo de confianza &#40;IC&#41; del 95&#37;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">La implicaci&#243;n independiente de cada factor al riesgo de ser &#171;caso&#187; se estim&#243; mediante la <span class="elsevierStyleItalic">odds ratio</span> ajustada &#40;ORa&#41; a trav&#233;s de modelos de regresi&#243;n log&#237;stica en los cuales la variable dependiente fue caso&#47;control&#44; y las independientes los diferentes FRCV y las comorbilidades&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se construyeron 2 tipos de modelo de regresi&#243;n log&#237;stica m&#250;ltiple&#58; 1&#41; FRCV&#59; y 2&#41; comorbilidades&#46; Se consideraron candidatas las variables con un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;2 y su entrada se realiz&#243; a partir de los algoritmos de selecci&#243;n de variables hacia adelante y hacia atr&#225;s&#46; A continuaci&#243;n se ajust&#243; nuevamente el modelo probando aquellos factores que quedaron en la zona l&#237;mite del valor p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;1&#46; Se estudiaron las caracter&#237;sticas de calibrado a partir del contraste de Hosmer y Lemeshow y el poder de discriminaci&#243;n &#40;estad&#237;stico c del AUC&#41;&#46; Se probaron los efectos cuadr&#225;ticos de las variables num&#233;ricas y las posibles interacciones&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Todos los c&#225;lculos se realizaron con el paquete estad&#237;stico SPSS 15&#46;0 y R&#44; fijando la significaci&#243;n en 0&#44;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">Se estudiaron un total de 102 casos y 221 controles&#46; Para cada caso se incluyeron entre uno y 3 controles procedentes del mismo CAP&#44; apareados por sexo y edad con una media de 2&#44;17 controles para cada caso&#46; La edad media de los casos fue de 77&#44;6 a&#241;os y de los controles de 75&#44;5 a&#241;os&#44; con una diferencia de 2&#44;1 a&#241;os entre ambos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Esta diferencia se debe a que el apareamiento de casos y controles fue de &#177;5<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; No se encontraron diferencias significativas respecto al sexo ni otras variables antropom&#233;tricas&#44; aunque se observ&#243; un grado elevado de sobrepeso y obesidad&#46; El per&#237;metro abdominal y la presencia de obesidad central fueron significativamente superiores en los casos&#44; pero no se encontraron diferencias respecto al valor absoluto del &#237;ndice tobillo-brazo &#40;ITB&#41; ni en la presencia de un ITB patol&#243;gico &#40;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#41;&#46; Finalmente&#44; tanto la hemoglobina como el hematocrito fueron significativamente menores en los casos&#44; de manera que la prevalencia de anemia fue significativamente mayor en los casos frente a los controles &#40;37&#44;3&#37; y 13&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Con relaci&#243;n a los FRCV&#44; los casos mostraron una diferencia significativa frente a los controles en el consumo de tabaco actual o previo &#40;38&#44;2&#37; y 25&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;020&#41;&#44; HTA &#40;85&#44;3&#37; y 70&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; hipercolesterolemia &#40;71&#44;6&#37; y 51&#44;2&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y niveles bajos de colesterol-HDL &#40;34&#44;3&#37; y 19&#44;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46; En cambio&#44; no se observaron diferencias significativas en la prevalencia de obesidad&#44; diabetes e historia familiar de cardiopat&#237;a isqu&#233;mica documentada&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En relaci&#243;n con los antecedentes patol&#243;gicos o comorbilidades&#44; los casos presentaron un porcentaje significativamente mayor de insuficiencia renal cr&#243;nica &#40;IRC&#41; &#40;28&#44;4&#37; y 8&#44;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; EPOC &#40;18&#44;6&#37; y 11&#44;9&#37;&#44; otras 11&#44;8&#37; y 7&#44;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;049&#41;&#44; AVC &#40;8&#44;8&#37; y 2&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; y estenosis carot&#237;dea &#40;EC&#41; &#40;5&#44;9&#37; y 0&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; Sin embargo&#44; no hubo diferencias estad&#237;sticamente significativas respecto al antecedente de arteriopat&#237;a perif&#233;rica&#44; enfermedad endocrina o digestiva&#46; En el grupo de casos hubo m&#225;s antecedentes de historia cardiol&#243;gica en comparaci&#243;n con los controles&#44; y presentaron una mayor frecuencia de alg&#250;n episodio previo de IAM &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y de intervencionismo cardiol&#243;gico previo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestra el resultado del modelo de regresi&#243;n log&#237;stica m&#250;ltiple de FRCV&#46; Se encontr&#243; una asociaci&#243;n estad&#237;sticamente significativa entre la EA grave sintom&#225;tica y los FRCV siguientes&#58; hipercolesterolemia &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;67&#59; IC 95&#37;&#58; 1&#44;54-4&#44;64&#41;&#44; tabaquismo &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;60&#59; IC 95&#37;&#58; 1&#44;48-4&#44;58&#41;&#44; HTA &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;41&#59; IC 95&#37;&#58; 1&#44;23-4&#44;72&#41;&#44; cifras bajas de colesterol-HDL &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;20&#59; IC 95&#37;&#58; 1&#44;25-3&#44;88&#41; y edad &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;08&#59; IC 95&#37;&#58; 1&#44;03-1&#44;13&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se observa que la curva de eficacia diagn&#243;stica &#40;<span class="elsevierStyleItalic">Receiving Operating Characteristic</span> &#91;ROC&#93;&#41; del modelo de regresi&#243;n log&#237;stica de los FRCV mostr&#243; una buena discriminaci&#243;n &#40;0&#44;74&#59; 0&#44;68-0&#44;80&#41; de la asociaci&#243;n de los diferentes FRCV con la EA&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> muestra los resultados del modelo de regresi&#243;n log&#237;stica m&#250;ltiple de comorbilidades&#44; donde se encontr&#243; una asociaci&#243;n estad&#237;sticamente significativa entre la EA grave sintom&#225;tica y las comorbilidades&#58; arteriopat&#237;a carot&#237;dea &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#44;5&#59; IC 95&#37;&#58; 1&#44;61-129&#41;&#44; AVC &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;14&#59; IC 95&#37;&#58; 1&#44;20-14&#44;2&#41; e IRC &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;78&#59; IC 95&#37;&#58; 1&#44;88-7&#44;59&#41;&#46; Por contra&#44; los niveles de hemoglobina se asociaron de forma inversa con la EA grave &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#59; IC 95&#37;&#58; 0&#44;65-0&#44;90&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a> se muestra que la curva ROC del modelo de regresi&#243;n log&#237;stica de comorbilidades present&#243; un &#225;rea bajo la curva de 0&#44;74 &#40;0&#44;68-0&#44;80&#41;&#44; de forma que este modelo evidenci&#243; una buena discriminaci&#243;n&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">Este estudio ha permitido constatar que FRCV asociados a la cardiopat&#237;a isqu&#233;mica &#40;hipertensi&#243;n&#44; tabaquismo&#44; hipercolesterolemia y cifras bajas de HDL&#41; son tambi&#233;n factores de riesgo para la EA&#46; An&#225;logamente al estudio Framingham&#44; todos ellos presentan OR entre 2 y 3&#44; y podr&#237;an tener un valor predictivo del riesgo en pacientes mayores de 65 a&#241;os&#46; El estudio tambi&#233;n identifica que la EA se asocia a comorbilidades &#40;muy especialmente la estenosis carot&#237;dea&#44; el AVC y la insuficiencia renal&#41; que podr&#237;an ser marcadores de riesgo&#46; Dada la elevada prevalencia de EA en ancianos y el envejecimiento poblacional actual&#44; este estudio presenta importantes aplicaciones pr&#225;cticas<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Existe un estudio epidemiol&#243;gico que explor&#243; la asociaci&#243;n entre FRCV y la gravedad de la EVAC en un grupo de pacientes similar al nuestro&#46; Este estudio observ&#243; que la edad&#44; el tabaquismo&#44; la HTA&#44; el per&#237;metro abdominal y un ITB<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;9 presentaban una asociaci&#243;n estad&#237;sticamente significativa con la EVAC&#46; Por otro lado&#44; el an&#225;lisis multivariante del <span class="elsevierStyleItalic">Helsinki Ageing Study</span> demostr&#243; que solo la edad&#44; la HTA y un IMC bajo se asociaban con la calcificaci&#243;n valvular a&#243;rtica&#44; y que la edad y los niveles de calcio en suero eran los &#250;nicos factores que se asociaron con la EA&#46; Finalmente&#44; los datos epidemiol&#243;gicos del <span class="elsevierStyleItalic">Cardiovascular Health Study</span> evidenciaron que la edad&#44; el sexo masculino y la lipoprote&#237;na A se correlacionaban fuertemente con la prevalencia de EVAC o EA&#44; y que los antecedentes de HTA&#44; el tabaquismo activo&#44; el colesterol-LDL y la altura se asociaban&#44; en una magnitud menor&#44; con la presencia de EVAC o EA&#46; Adem&#225;s&#44; en el an&#225;lisis bivariante observaron una asociaci&#243;n inversa estad&#237;sticamente significativa con los niveles de colesterol-HDL&#44; en l&#237;nea con nuestros resultados<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">6&#44;7&#44;14</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En relaci&#243;n con las comorbilidades asociadas con la EA grave&#44; hay que tener en cuenta que algunas comparten FRCV en su etiopatogenia y que estas comorbilidades podr&#237;an estar relacionadas desde el punto de vista fisiopatol&#243;gico con el desarrollo y progresi&#243;n de la EA&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante Ferreira-Gonz&#225;lez et al&#46;<span class="elsevierStyleSup">6</span> mostraron que la EVAC se asociaba a la insuficiencia renal moderada-grave&#44; pero no a la enfermedad leve-moderada&#46; De hecho&#44; como la insuficiencia renal lleva a un desarrollo r&#225;pido de la aterosclerosis&#44; ellos afirman que esto puede explicar que el fracaso renal se asocie a los estados avanzados de EVAC&#46; En nuestro estudio tambi&#233;n se hall&#243; una asociaci&#243;n entre IRC y EA&#46; Por el contrario&#44; otros estudios no observaron ninguna asociaci&#243;n en el an&#225;lisis multivariante entre una tasa de filtrado glomerular estimado<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> y la EVAC&#44; ni entre los niveles de creatinina y la progresi&#243;n de la EA&#46; En este sentido&#44; el <span class="elsevierStyleItalic">Framingham Offspring Study</span> tampoco hall&#243; una asociaci&#243;n estad&#237;sticamente significativa entre la IRC y la esclerosis valvular a&#243;rtica o la calcificaci&#243;n anular a&#243;rtica&#46; En efecto&#44; la relaci&#243;n entre la IRC y una calcificaci&#243;n valvular importante &#40;mitral y a&#243;rtica&#41; se mostr&#243; marcadamente atenuada despu&#233;s de ser ajustada por los FRCV en el an&#225;lisis multivariante&#46; Los autores sugieren que los factores de riesgo que comparten la enfermedad renal cr&#243;nica y la calcificaci&#243;n valvular podr&#237;an explicar parcialmente la prevalencia de calcificaci&#243;n valvular en la enfermedad renal cr&#243;nica<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">6&#44;9&#44;10&#44;19&#44;20</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">En relaci&#243;n con la aterosclerosis o la estenosis carot&#237;dea no encontramos ning&#250;n estudio que eval&#250;e su asociaci&#243;n con la EVAC o la EA en un modelo de regresi&#243;n log&#237;stica&#46; Existen estudios que eval&#250;an otros tipos de asociaciones&#44; por ejemplo en un an&#225;lisis multivariante se observ&#243; que los predictores de estenosis carot&#237;dea hemodin&#225;micamente significativa en el <span class="elsevierStyleItalic">screening</span> mediante ecograf&#237;a-Doppler carot&#237;dea previo a cirug&#237;a valvular incluyen la edad avanzada &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>75<span class="elsevierStyleHsp" style=""></span>a&#241;os&#41;&#44; la enfermedad valvular a&#243;rtica&#44; la enfermedad renal cr&#243;nica y la vasculopat&#237;a perif&#233;rica<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">21</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En referencia a la asociaci&#243;n del AVC con la EVAC o la EA cabe decir que Ferreira et al&#46; tambi&#233;n observaron una asociaci&#243;n estad&#237;sticamente significativa del AVC con la EVAC que no se mantuvo en el modelo multinomial de regresi&#243;n&#46; Esto puede ser debido en parte a que la EA podr&#237;a ser un factor de riesgo para el AVC &#40;y no a la inversa&#41;&#44; o que el AVC comparte FRCV con la EA y&#44; por tanto&#44; no es un aut&#233;ntico factor de riesgo de EA&#46; Esta misma explicaci&#243;n podr&#237;a ser v&#225;lida para el resto de comorbilidades analizadas en nuestro estudio<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">6&#44;22&#8211;27</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Tanto los niveles de hemoglobina como el hematocrito fueron significativamente menores en los casos respecto a los controles y&#44; consecuentemente&#44; se observ&#243; una mayor prevalencia de anemia en los casos&#46; La posible asociaci&#243;n con la anemia y la insuficiencia renal&#44; y su eventual papel confusor&#44; se ha neutralizado introduciendo las 2 variables en el modelo multivariante final de comorbilidades&#46; En diversos estudios epidemiol&#243;gicos se ha asociado una elevada prevalencia de anemia con la presencia&#44; gravedad y peor pron&#243;stico de la EA&#46; Asimismo&#44; la elevada prevalencia de anemia puede afectar a la calidad de vida y al estado de salud percibido por el paciente dado que&#44; especialmente en pacientes ancianos&#44; la anemia se asocia con puntuaciones menores en las escalas de valoraci&#243;n de la calidad de vida y con un mayor riesgo de hospitalizaci&#243;n y ca&#237;das<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">28&#8211;30</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">La EA es una enfermedad silente&#44; de instauraci&#243;n lenta y que a menudo se diagnostica cuando aparecen s&#237;ntomas que afectan la calidad de vida del paciente&#46; La identificaci&#243;n de los factores de riesgo y comorbilidades asociados a la EA grave podr&#237;a facilitar modelos predictivos para la identificaci&#243;n y el seguimiento de los pacientes&#44; reducir el retraso diagn&#243;stico &#40;basado en la auscultaci&#243;n&#44; anamnesis y eventual estudio ecogr&#225;fico&#41; y terap&#233;utico&#44; y as&#237; mejorar el pron&#243;stico y la calidad de vida de los pacientes&#46; Del valor predictivo de las comorbilidades&#44; en concreto&#44; se deber&#237;a valorar la posibilidad de presentaci&#243;n de la EA en pacientes con estenosis carotidea e IRC&#46; Finalmente&#44; la prevenci&#243;n de la exposici&#243;n a los factores de riesgo a nivel poblacional podr&#237;a tener un efecto multiplicativo para otras enfermedades cr&#243;nicas que comparten los mismos factores de riesgo y repercutir directamente en la reducci&#243;n de la morbimortalidad&#46; De hecho&#44; en un estudio poblacional realizado en Suecia entre 1989 y 2009 se observ&#243; una disminuci&#243;n en la incidencia de EA y una mejora en el pron&#243;stico de esta enfermedad&#44; que sugieren que se debe al mejor control de los factores de riesgo&#44; junto con el tratamiento adecuado<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">15&#44;31</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Este estudio tiene algunas limitaciones&#59; algunos casos candidatos a formar parte del estudio podr&#237;an haber fallecido y esto podr&#237;a comportar un sesgo&#44; al estar sobrerrepresentados los pacientes con mejor pron&#243;stico&#46; Ello podr&#237;a sesgar los resultados hacia la hip&#243;tesis nula&#44; reforzando el valor de los factores detectados&#46; En el mismo sentido&#44; los controles podr&#237;an ser un potencial caso no diagnosticado&#44; dado que la EA puede no tener traducci&#243;n cl&#237;nica incluso en etapas avanzadas&#46; Este supuesto tambi&#233;n sesgar&#237;a los resultados hacia la hip&#243;tesis nula y&#44; por lo tanto&#44; la detecci&#243;n de cualquier factor de riesgo se afianzar&#237;a a&#250;n m&#225;s en esta situaci&#243;n&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">En relaci&#243;n con el tama&#241;o de la muestra&#44; para algunos casos no se pudieron seleccionar los 3 controles y la muestra final fue algo inferior a la prevista &#40;221 versus 261&#41;&#44; con lo que disminuy&#243; la precisi&#243;n y la potencia estad&#237;stica del estudio&#46; La edad de los controles fue 2&#44;1 a&#241;os inferior a los casos debido a que estaban apareados<span class="elsevierStyleHsp" style=""></span>&#177;5<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; De todos modos&#44; el n&#250;mero absoluto de a&#241;os no se considera muy elevado y esta variable se tuvo en cuenta en todos los modelos de regresi&#243;n log&#237;stica para neutralizar su posible papel de confusi&#243;n&#46; Asimismo&#44; dado que los controles eran pacientes que fueron a consulta en atenci&#243;n primaria&#44; es plausible que puedan presentar una prevalencia de comorbilidades algo mayor que la poblaci&#243;n general no seleccionada&#44; lo que podr&#237;a sesgar tambi&#233;n los resultados hacia la hip&#243;tesis nula&#46; Adem&#225;s&#44; debido a la naturaleza del estudio observacional no se puede inferir relaciones causales entre FRCV y casos de EA grave&#46; El hecho de que el estudio fue limitado a personas mayores de 65 a&#241;os podr&#237;a influir en la magnitud de la asociaci&#243;n de FRCV y EA grave&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Los resultados de la regresi&#243;n se obtuvieron de los pacientes que aportaron todos los datos&#46; En el caso de la regresi&#243;n donde se determina el efecto de la hemoglobina&#44; un 7&#44;7&#37; de los pacientes no registr&#243; el dato&#44; por lo que los resultados de la regresi&#243;n obviaron el perfil de este 7&#44;7&#37; de los pacientes&#46; Dicha limitaci&#243;n podr&#237;a o no introducir un posible sesgo que los autores consideramos improbable&#44; teniendo en cuenta que consideramos que no existen caracter&#237;sticas diferentes entre los pacientes que registraron o no el dato de inter&#233;s&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Finalmente&#44; los resultados podr&#237;an no ser extrapolables a otras &#225;reas geogr&#225;ficas&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Con este estudio hemos podido cuantificar el papel de los factores de riesgo y las comobilidades que acompa&#241;an a la EA grave&#46; La identificaci&#243;n de pacientes con un riesgo mayor de poder desarrollar esta enfermedad permite reducir el tiempo de diagn&#243;stico y de tratamiento&#44; mejorando&#44; a su vez&#44; su calidad de vida&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusiones</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los FRCV tabaquismo&#44; HTA&#44; hipercolesterolemia y niveles bajos de colesterol-HDL se asocian con la EA grave en personas<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">La enfermedad renal cr&#243;nica&#44; el accidente vascular cerebral y la estenosis carot&#237;dea son las comorbilidades que se asocian con la EA grave en personas<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; y tambi&#233;n se asocian de forma inversa los niveles de hemoglobina&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Este estudio&#44; respecto a anteriores trabajos&#44; ha permitido cuantificar el papel de factores de riesgo y comorbilidades que acompa&#241;an a la EA grave y que podr&#237;an facilitar la identificaci&#243;n de pacientes con mayor riesgo de desarrollar la enfermedad&#46; Esto podr&#237;a reducir el retraso diagn&#243;stico y terap&#233;utico&#44; y con ello mejorar la calidad de vida de los pacientes&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Financiaci&#243;n</span><p id="par0175" class="elsevierStylePara elsevierViewall">El presente trabajo ha sido financiado parcialmente por la Unitat d&#8217;Assaigs Cl&#237;nics i Investigaci&#243; del Servei de Cardiologia de l&#8217;Hospital Arnau de Vilanova de Lleida&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicto de intereses</span><p id="par0180" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La estenosis a&#243;rtica &#40;EA&#41; es una de las enfermedades cardiovasculares m&#225;s prevalentes en sujetos<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; Algunos estudios epidemiol&#243;gicos sugieren que ciertos factores de riesgo cardiovascular &#40;FRCV&#41; y comorbilidades pueden estar asociados con la EA&#46; El objetivo del estudio es evaluar la asociaci&#243;n de FRCV y comorbilidades con la EA grave sintom&#225;tica en pacientes<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os en una regi&#243;n sanitaria espa&#241;ola&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio epidemiol&#243;gico de casos y controles procedentes del mismo centro de atenci&#243;n primaria&#46; Se recogi&#243; informaci&#243;n sobre la exposici&#243;n a FRCV y comorbilidades&#44; y se determin&#243; la asociaci&#243;n de ambos con la EA con <span class="elsevierStyleItalic">odds ratio</span> ajustadas &#40;ORa&#41;&#44; mediante modelos de regresi&#243;n log&#237;stica m&#250;ltiple&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron un total de 102 casos &#40;edad media<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>77&#44;6 a&#241;os&#41; y 221 controles &#40;edad media<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>75&#44;5 a&#241;os&#41;&#46; Los FRCV significativamente asociados con la EA grave sintom&#225;tica fueron hipercolesterolemia &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;67&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; tabaquismo &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;60&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; hipertensi&#243;n &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;41&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;010&#41; y cifras bajas de colesterol-HDL &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;20&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; Las comorbilidades significativamente asociadas con la EA grave sintom&#225;tica fueron estenosis carot&#237;dea &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#44;5&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; accidente vascular cerebral &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;14&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;024&#41;&#44; insuficiencia renal cr&#243;nica &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;78&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y bajos niveles de hemoglobina &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La hipercolesterolemia&#44; el tabaquismo&#44; la hipertensi&#243;n arterial y los niveles bajos de colesterol-HDL son los FRCV que comportan mayor riesgo de EA grave&#46; Asimismo&#44; esta enfermedad se asocia con algunas comorbilidades &#40;insuficiencia renal cr&#243;nica&#44; accidente vascular cerebral&#44; estenosis carot&#237;dea y niveles de hemoglobina m&#225;s bajos&#41; que podr&#237;an ser marcadores de EA&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Aortic stricture &#40;AS&#41; is one of the most prevalent cardiovascular diseases in individuals 65 years of age or older&#46; A number of epidemiological studies have suggested that certain cardiovascular risk factors &#40;CRFs&#41; and comorbidities could be associated with AS&#46; The aim of this study was to evaluate the association between CRFs and comorbidities and severe symptomatic AS in individuals 65 years of age or older in a Spanish healthcare region&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We conducted an epidemiological case-control study from a single primary care centre&#46; We collected information on exposure to CRFs and comorbidities and determined their association with AS&#44; employing adjusted odds ratios &#40;OR&#41; and multiple logistic regression models&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study included 102 cases &#40;mean age&#44; 77&#46;6 years&#41; and 221 controls &#40;mean age&#44; 75&#46;5 years&#41;&#46; The CRFs significantly associated with severe symptomatic AS were hypercholesterolaemia &#40;OR&#44; 2&#46;67&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; tobacco use &#40;OR&#44; 2&#46;60&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; hypertension &#40;OR&#44; 2&#46;41&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;010&#41; and low HDL cholesterol readings &#40;OR&#44; 2&#46;20&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;007&#41;&#46; The comorbidities significantly associated with severe symptomatic AS were carotid stenosis &#40;OR&#44; 14&#46;5&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;017&#41;&#44; stroke &#40;OR&#44; 4&#46;14&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;024&#41;&#44; chronic renal failure &#40;OR&#44; 3&#46;78&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and low haemoglobin levels &#40;OR&#44; 0&#46;76&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Hypercholesterolaemia&#44; tobacco use&#44; arterial hypertension and low HDL cholesterol levels are the CRFs with a greater risk of severe AS&#46; Furthermore&#44; this disease is associated with a number of comorbidities &#40;chronic renal failure&#44; stroke&#44; carotid stenosis and low haemoglobin levels&#41;&#44; which could be markers of AS&#46;</p></span>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AIT&#58; accidente isqu&#233;mico transitorio&#59; AVC&#58; accidente vascular cerebral&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; EC&#58; estenosis carot&#237;dea&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; HDL&#58; lipoprote&#237;nas de alta densidad &#40;<span class="elsevierStyleItalic">high density lipoproteins</span>&#41;&#59; IAM&#44; infarto agudo de miocardio&#59; IMC&#44; &#237;ndice de masa corporal&#59; IRC&#58; insuficiencia renal cr&#243;nica&#59; ITB&#58; &#237;ndice tobillo-brazo&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">La obesidad central se ha definido como un per&#237;metro abdominal<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>102<span class="elsevierStyleHsp" style=""></span>cm en varones y<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>88<span class="elsevierStyleHsp" style=""></span>cm en mujeres&#44; y la prevalencia de anemia se ha definido como niveles de hemoglobina<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>13<span class="elsevierStyleHsp" style=""></span>g&#47;dl en varones y &#60;<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>g&#47;dl en mujeres&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Casos&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>221&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Edad en a&#241;os&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo&#44; n &#40;&#37; femenino&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;38&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;41&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;564&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Peso &#40;kg&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;9<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;4<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;9<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;5<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IMC categorizado &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;335&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Normal &#40;&#8804;<span class="elsevierStyleHsp" style=""></span>24&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;18&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;20&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sobrepeso &#40;25-29&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;43&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;46&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Obesidad &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;38&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;32&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Per&#237;metro abdominal &#40;cm&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;6<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;1<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">h</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Obesidad central&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;83&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;67&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">h</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;024<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ITB&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ITB</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#44;9&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;8&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;15&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;267&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hemoglobina &#40;media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;7<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">i</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hematocrito &#40;media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;1<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;3<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">j</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Factores de riesgo cardiovascular</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tabaquismo &#40;actual o previo&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;38&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;25&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;020<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de hipertensi&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;85&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">147 &#40;70&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de hipercolesterolemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;71&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107 &#40;51&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de HDL bajo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;34&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;19&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de diabetes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;33&#44;7&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">f</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;28&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">l</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;383&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de obesidad&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;43&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;34&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Historia familiar de cardiopat&#237;a isqu&#233;mica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;833&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89 &#40;89&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">186 &#40;91&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">m</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dudosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">m</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237; &#40;documentada&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;8&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;8&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">m</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Antecedentes patol&#243;gicos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes nefrol&#243;gicos &#40;IRC&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;28&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;8&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes patol&#243;gicos respiratorios&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;049<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;69&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">169 &#40;80&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;18&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;11&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;11&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;7&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes neurol&#243;gicos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;88&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179 &#40;85&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AIT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;1&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AVC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;8&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;2&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;10&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes arteriopat&#237;a carot&#237;dea &#40;EC&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;5&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes arteriopat&#237;a perif&#233;rica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;562&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IAM&#44; n &#40;&#37;&#41;</span><span class="elsevierStyleHsp" style=""></span>Ninguno<span class="elsevierStyleHsp" style=""></span>Uno<span class="elsevierStyleHsp" style=""></span>Dos o m&#225;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;86&#44;3&#37;&#41;10 &#40;9&#44;8&#37;&#41;4 &#40;3&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">190 &#40;96&#44;4&#37;&#41;7 &#40;3&#44;6&#37;&#41;0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Intervencionismo cardiol&#243;gico previo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;17&#44;65&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#44;95&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes patol&#243;gicos endocrinol&#243;gicos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;6&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;11&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes digestivos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;17&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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Original
Factores de riesgo y comorbilidades asociadas a la estenosis aórtica grave: estudio de casos y controles
Risk factors and comorbidities associated with severe aortic stenosis: a case-control study
J.M. Gracia Baenaa,b,
Autor para correspondencia
drjmccv@hotmail.com

Autor para correspondencia.
, I. Calaf Vallc, M. Zielonkac, J.R. Marsal Morad, P. Godoyb,e,f, F. Worner Dizc
a Servei de Cirurgia Cardíaca d’Adults, Hospital Universitari Vall d’Hebron, Barcelona, España
b Unitat d’Epidemiologia Aplicada, Departament de Cirurgia, Universitat de Lleida, Lérida, España
c Servei de Cardiologia, Hospital Universitari Arnau de Vilanova, Lérida, España
d Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España
e CIBER de Epidemiología y Salud Pública CIBERESP, Barcelona, España
f Agència de Salut Pública de Catalunya, Barcelona, España
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la asociaci&#243;n de factores de riesgo con la EVAC determin&#243; una asociaci&#243;n entre la EVAC y la hipertensi&#243;n arterial &#40;HTA&#41;&#44; la diabetes mellitus&#44; la hipercolesterolemia y los niveles bajos de colesterol-HDL<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">4</span></a>&#46; En los estudios epidemiol&#243;gicos publicados los resultados sobre los factores de riesgo cardiovascular &#40;FRCV&#41; asociados con la EVAC o la EA no son homog&#233;neos&#46; Adem&#225;s&#44; diversos FRCV se asocian con la tasa de progresi&#243;n de la EA y tambi&#233;n con otras comorbilidades relacionadas con la EVAC o la EA<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">4&#8211;12</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Se han realizado pocos estudios epidemiol&#243;gicos que investiguen la asociaci&#243;n de los diferentes FRCV y comorbilidades con la EA en un &#225;mbito poblacional determinado&#44; y solo uno de ellos ha sido realizado en Espa&#241;a<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">4&#44;6&#8211;10&#44;13&#44;14</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La EA es habitualmente una enfermedad de inicio lento y silente&#44; que se puede acompa&#241;ar de un retraso diagn&#243;stico y una dilaci&#243;n en la indicaci&#243;n de intervenci&#243;n terap&#233;utica que puede empeorar su pron&#243;stico&#46; Identificar factores de riesgo de EA grave podr&#237;a facilitar la identificaci&#243;n de la poblaci&#243;n con mayor riesgo y reducir el retraso diagn&#243;stico&#44; y sobre todo el de intervenci&#243;n terap&#233;utica quir&#250;rgica o intervencionista<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El objetivo del presente estudio fue evaluar la asociaci&#243;n de diferentes FRCV y comorbilidades con la EA grave sintom&#225;tica en pacientes mayores de 65 a&#241;os&#44; en el &#225;mbito poblacional y geogr&#225;fico de las comarcas de una provincia de Espa&#241;a&#44; comparando los casos de EA grave sintom&#225;tica con controles del mismo centro de atenci&#243;n primaria&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio epidemiol&#243;gico observacional de casos y controles entre febrero de 2014 y abril de 2018&#46; Se consider&#243; &#171;caso&#187; todo individuo<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os de las comarcas de una provincia de Espa&#241;a con criterios cl&#237;nicos y ecocardiogr&#225;ficos de EA grave sintom&#225;tica que durante el per&#237;odo del estudio fuera candidato a cirug&#237;a card&#237;aca de sustituci&#243;n valvular&#44; seg&#250;n los criterios recomendados por las gu&#237;as cl&#237;nicas<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">16&#44;17</span></a>&#46; 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La recogida de datos&#44; almacenamiento y an&#225;lisis se realiz&#243; de conformidad con la normativa vigente&#46; Los pacientes otorgaron el consentimiento informado por escrito y el estudio fue aprobado por el comit&#233; de &#233;tica de investigaci&#243;n cl&#237;nica de nuestro centro y por el comit&#233; de &#233;tica de investigaci&#243;n del centro de atenci&#243;n primaria de la provincia donde se realiz&#243; el estudio&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La variable dependiente del estudio fue ser &#171;caso&#187; o &#171;control&#187;&#44; y las variables independientes las caracter&#237;sticas demogr&#225;ficas &#40;edad y sexo&#41; y cl&#237;nicas de los pacientes&#46; En relaci&#243;n con el tama&#241;o muestral se calcul&#243; el n&#250;mero de casos y controles para detectar una <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; de 2&#44;5&#44; con un riesgo &#945;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05 y un &#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#44; a partir de&#58; P<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#40;P<span class="elsevierStyleInf">1</span><span class="elsevierStyleHsp" style=""></span>&#42;<span class="elsevierStyleHsp" style=""></span>OR&#41;&#47;&#40;1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>P<span class="elsevierStyleInf">1</span><span class="elsevierStyleHsp" style=""></span>&#42;<span class="elsevierStyleHsp" style=""></span> &#91;OR-1&#93;&#41;&#46; Para una P<span class="elsevierStyleInf">1</span> esperada de 0&#44;50 se estim&#243; que ser&#237;an necesarios 87 casos y 261 controles&#46; As&#237;&#44; para cada caso que entraba en el estudio se pretend&#237;a seleccionar 3 controles apareados por edad &#40;&#177;5 a&#241;os&#41; y sexo procedentes del mismo CAP o &#225;rea b&#225;sica de salud &#40;ABS&#41; del caso&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis en 2 etapas&#58; primero se realiz&#243; un an&#225;lisis bivariado de las variables cl&#237;nicas del estudio y en segundo lugar se construy&#243; un modelo de regresi&#243;n log&#237;stica m&#250;ltiple para estudiar los FRCV y comorbilidades asociadas al riesgo de EA grave sintom&#225;tica&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se estudi&#243; la asociaci&#243;n estad&#237;stica de la variable dependiente &#40;caso&#47;control&#41; con las variables cualitativas independientes con la prueba de Chi cuadrado o el test exacto de Fisher&#46; Para las variables cuantitativas independientes se utiliz&#243; la &#171;t&#187; de Student o la prueba no param&#233;trica de Mann-Whitney en caso de no cumplir la hip&#243;tesis de normalidad&#46; En los 2 casos se acept&#243; un nivel de significaci&#243;n estad&#237;stica p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; La fuerza de la asociaci&#243;n de los FRCV y las comorbilidades con la variable dependiente se estudi&#243; con la <span class="elsevierStyleItalic">odds ratio</span> cruda &#40;ORc&#41; con su intervalo de confianza &#40;IC&#41; del 95&#37;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">La implicaci&#243;n independiente de cada factor al riesgo de ser &#171;caso&#187; se estim&#243; mediante la <span class="elsevierStyleItalic">odds ratio</span> ajustada &#40;ORa&#41; a trav&#233;s de modelos de regresi&#243;n log&#237;stica en los cuales la variable dependiente fue caso&#47;control&#44; y las independientes los diferentes FRCV y las comorbilidades&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se construyeron 2 tipos de modelo de regresi&#243;n log&#237;stica m&#250;ltiple&#58; 1&#41; FRCV&#59; y 2&#41; comorbilidades&#46; Se consideraron candidatas las variables con un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;2 y su entrada se realiz&#243; a partir de los algoritmos de selecci&#243;n de variables hacia adelante y hacia atr&#225;s&#46; A continuaci&#243;n se ajust&#243; nuevamente el modelo probando aquellos factores que quedaron en la zona l&#237;mite del valor p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;1&#46; Se estudiaron las caracter&#237;sticas de calibrado a partir del contraste de Hosmer y Lemeshow y el poder de discriminaci&#243;n &#40;estad&#237;stico c del AUC&#41;&#46; Se probaron los efectos cuadr&#225;ticos de las variables num&#233;ricas y las posibles interacciones&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Todos los c&#225;lculos se realizaron con el paquete estad&#237;stico SPSS 15&#46;0 y R&#44; fijando la significaci&#243;n en 0&#44;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">Se estudiaron un total de 102 casos y 221 controles&#46; Para cada caso se incluyeron entre uno y 3 controles procedentes del mismo CAP&#44; apareados por sexo y edad con una media de 2&#44;17 controles para cada caso&#46; La edad media de los casos fue de 77&#44;6 a&#241;os y de los controles de 75&#44;5 a&#241;os&#44; con una diferencia de 2&#44;1 a&#241;os entre ambos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Esta diferencia se debe a que el apareamiento de casos y controles fue de &#177;5<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; No se encontraron diferencias significativas respecto al sexo ni otras variables antropom&#233;tricas&#44; aunque se observ&#243; un grado elevado de sobrepeso y obesidad&#46; El per&#237;metro abdominal y la presencia de obesidad central fueron significativamente superiores en los casos&#44; pero no se encontraron diferencias respecto al valor absoluto del &#237;ndice tobillo-brazo &#40;ITB&#41; ni en la presencia de un ITB patol&#243;gico &#40;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;9&#41;&#46; Finalmente&#44; tanto la hemoglobina como el hematocrito fueron significativamente menores en los casos&#44; de manera que la prevalencia de anemia fue significativamente mayor en los casos frente a los controles &#40;37&#44;3&#37; y 13&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Con relaci&#243;n a los FRCV&#44; los casos mostraron una diferencia significativa frente a los controles en el consumo de tabaco actual o previo &#40;38&#44;2&#37; y 25&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;020&#41;&#44; HTA &#40;85&#44;3&#37; y 70&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; hipercolesterolemia &#40;71&#44;6&#37; y 51&#44;2&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y niveles bajos de colesterol-HDL &#40;34&#44;3&#37; y 19&#44;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46; En cambio&#44; no se observaron diferencias significativas en la prevalencia de obesidad&#44; diabetes e historia familiar de cardiopat&#237;a isqu&#233;mica documentada&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En relaci&#243;n con los antecedentes patol&#243;gicos o comorbilidades&#44; los casos presentaron un porcentaje significativamente mayor de insuficiencia renal cr&#243;nica &#40;IRC&#41; &#40;28&#44;4&#37; y 8&#44;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; EPOC &#40;18&#44;6&#37; y 11&#44;9&#37;&#44; otras 11&#44;8&#37; y 7&#44;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;049&#41;&#44; AVC &#40;8&#44;8&#37; y 2&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; y estenosis carot&#237;dea &#40;EC&#41; &#40;5&#44;9&#37; y 0&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; Sin embargo&#44; no hubo diferencias estad&#237;sticamente significativas respecto al antecedente de arteriopat&#237;a perif&#233;rica&#44; enfermedad endocrina o digestiva&#46; En el grupo de casos hubo m&#225;s antecedentes de historia cardiol&#243;gica en comparaci&#243;n con los controles&#44; y presentaron una mayor frecuencia de alg&#250;n episodio previo de IAM &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y de intervencionismo cardiol&#243;gico previo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestra el resultado del modelo de regresi&#243;n log&#237;stica m&#250;ltiple de FRCV&#46; Se encontr&#243; una asociaci&#243;n estad&#237;sticamente significativa entre la EA grave sintom&#225;tica y los FRCV siguientes&#58; hipercolesterolemia &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;67&#59; IC 95&#37;&#58; 1&#44;54-4&#44;64&#41;&#44; tabaquismo &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;60&#59; IC 95&#37;&#58; 1&#44;48-4&#44;58&#41;&#44; HTA &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;41&#59; IC 95&#37;&#58; 1&#44;23-4&#44;72&#41;&#44; cifras bajas de colesterol-HDL &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;20&#59; IC 95&#37;&#58; 1&#44;25-3&#44;88&#41; y edad &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;08&#59; IC 95&#37;&#58; 1&#44;03-1&#44;13&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se observa que la curva de eficacia diagn&#243;stica &#40;<span class="elsevierStyleItalic">Receiving Operating Characteristic</span> &#91;ROC&#93;&#41; del modelo de regresi&#243;n log&#237;stica de los FRCV mostr&#243; una buena discriminaci&#243;n &#40;0&#44;74&#59; 0&#44;68-0&#44;80&#41; de la asociaci&#243;n de los diferentes FRCV con la EA&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> muestra los resultados del modelo de regresi&#243;n log&#237;stica m&#250;ltiple de comorbilidades&#44; donde se encontr&#243; una asociaci&#243;n estad&#237;sticamente significativa entre la EA grave sintom&#225;tica y las comorbilidades&#58; arteriopat&#237;a carot&#237;dea &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#44;5&#59; IC 95&#37;&#58; 1&#44;61-129&#41;&#44; AVC &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;14&#59; IC 95&#37;&#58; 1&#44;20-14&#44;2&#41; e IRC &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;78&#59; IC 95&#37;&#58; 1&#44;88-7&#44;59&#41;&#46; Por contra&#44; los niveles de hemoglobina se asociaron de forma inversa con la EA grave &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#59; IC 95&#37;&#58; 0&#44;65-0&#44;90&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a> se muestra que la curva ROC del modelo de regresi&#243;n log&#237;stica de comorbilidades present&#243; un &#225;rea bajo la curva de 0&#44;74 &#40;0&#44;68-0&#44;80&#41;&#44; de forma que este modelo evidenci&#243; una buena discriminaci&#243;n&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">Este estudio ha permitido constatar que FRCV asociados a la cardiopat&#237;a isqu&#233;mica &#40;hipertensi&#243;n&#44; tabaquismo&#44; hipercolesterolemia y cifras bajas de HDL&#41; son tambi&#233;n factores de riesgo para la EA&#46; An&#225;logamente al estudio Framingham&#44; todos ellos presentan OR entre 2 y 3&#44; y podr&#237;an tener un valor predictivo del riesgo en pacientes mayores de 65 a&#241;os&#46; El estudio tambi&#233;n identifica que la EA se asocia a comorbilidades &#40;muy especialmente la estenosis carot&#237;dea&#44; el AVC y la insuficiencia renal&#41; que podr&#237;an ser marcadores de riesgo&#46; Dada la elevada prevalencia de EA en ancianos y el envejecimiento poblacional actual&#44; este estudio presenta importantes aplicaciones pr&#225;cticas<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Existe un estudio epidemiol&#243;gico que explor&#243; la asociaci&#243;n entre FRCV y la gravedad de la EVAC en un grupo de pacientes similar al nuestro&#46; Este estudio observ&#243; que la edad&#44; el tabaquismo&#44; la HTA&#44; el per&#237;metro abdominal y un ITB<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;9 presentaban una asociaci&#243;n estad&#237;sticamente significativa con la EVAC&#46; Por otro lado&#44; el an&#225;lisis multivariante del <span class="elsevierStyleItalic">Helsinki Ageing Study</span> demostr&#243; que solo la edad&#44; la HTA y un IMC bajo se asociaban con la calcificaci&#243;n valvular a&#243;rtica&#44; y que la edad y los niveles de calcio en suero eran los &#250;nicos factores que se asociaron con la EA&#46; Finalmente&#44; los datos epidemiol&#243;gicos del <span class="elsevierStyleItalic">Cardiovascular Health Study</span> evidenciaron que la edad&#44; el sexo masculino y la lipoprote&#237;na A se correlacionaban fuertemente con la prevalencia de EVAC o EA&#44; y que los antecedentes de HTA&#44; el tabaquismo activo&#44; el colesterol-LDL y la altura se asociaban&#44; en una magnitud menor&#44; con la presencia de EVAC o EA&#46; Adem&#225;s&#44; en el an&#225;lisis bivariante observaron una asociaci&#243;n inversa estad&#237;sticamente significativa con los niveles de colesterol-HDL&#44; en l&#237;nea con nuestros resultados<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">6&#44;7&#44;14</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En relaci&#243;n con las comorbilidades asociadas con la EA grave&#44; hay que tener en cuenta que algunas comparten FRCV en su etiopatogenia y que estas comorbilidades podr&#237;an estar relacionadas desde el punto de vista fisiopatol&#243;gico con el desarrollo y progresi&#243;n de la EA&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante Ferreira-Gonz&#225;lez et al&#46;<span class="elsevierStyleSup">6</span> mostraron que la EVAC se asociaba a la insuficiencia renal moderada-grave&#44; pero no a la enfermedad leve-moderada&#46; De hecho&#44; como la insuficiencia renal lleva a un desarrollo r&#225;pido de la aterosclerosis&#44; ellos afirman que esto puede explicar que el fracaso renal se asocie a los estados avanzados de EVAC&#46; En nuestro estudio tambi&#233;n se hall&#243; una asociaci&#243;n entre IRC y EA&#46; Por el contrario&#44; otros estudios no observaron ninguna asociaci&#243;n en el an&#225;lisis multivariante entre una tasa de filtrado glomerular estimado<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> y la EVAC&#44; ni entre los niveles de creatinina y la progresi&#243;n de la EA&#46; En este sentido&#44; el <span class="elsevierStyleItalic">Framingham Offspring Study</span> tampoco hall&#243; una asociaci&#243;n estad&#237;sticamente significativa entre la IRC y la esclerosis valvular a&#243;rtica o la calcificaci&#243;n anular a&#243;rtica&#46; En efecto&#44; la relaci&#243;n entre la IRC y una calcificaci&#243;n valvular importante &#40;mitral y a&#243;rtica&#41; se mostr&#243; marcadamente atenuada despu&#233;s de ser ajustada por los FRCV en el an&#225;lisis multivariante&#46; Los autores sugieren que los factores de riesgo que comparten la enfermedad renal cr&#243;nica y la calcificaci&#243;n valvular podr&#237;an explicar parcialmente la prevalencia de calcificaci&#243;n valvular en la enfermedad renal cr&#243;nica<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">6&#44;9&#44;10&#44;19&#44;20</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">En relaci&#243;n con la aterosclerosis o la estenosis carot&#237;dea no encontramos ning&#250;n estudio que eval&#250;e su asociaci&#243;n con la EVAC o la EA en un modelo de regresi&#243;n log&#237;stica&#46; Existen estudios que eval&#250;an otros tipos de asociaciones&#44; por ejemplo en un an&#225;lisis multivariante se observ&#243; que los predictores de estenosis carot&#237;dea hemodin&#225;micamente significativa en el <span class="elsevierStyleItalic">screening</span> mediante ecograf&#237;a-Doppler carot&#237;dea previo a cirug&#237;a valvular incluyen la edad avanzada &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>75<span class="elsevierStyleHsp" style=""></span>a&#241;os&#41;&#44; la enfermedad valvular a&#243;rtica&#44; la enfermedad renal cr&#243;nica y la vasculopat&#237;a perif&#233;rica<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">21</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En referencia a la asociaci&#243;n del AVC con la EVAC o la EA cabe decir que Ferreira et al&#46; tambi&#233;n observaron una asociaci&#243;n estad&#237;sticamente significativa del AVC con la EVAC que no se mantuvo en el modelo multinomial de regresi&#243;n&#46; Esto puede ser debido en parte a que la EA podr&#237;a ser un factor de riesgo para el AVC &#40;y no a la inversa&#41;&#44; o que el AVC comparte FRCV con la EA y&#44; por tanto&#44; no es un aut&#233;ntico factor de riesgo de EA&#46; Esta misma explicaci&#243;n podr&#237;a ser v&#225;lida para el resto de comorbilidades analizadas en nuestro estudio<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">6&#44;22&#8211;27</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Tanto los niveles de hemoglobina como el hematocrito fueron significativamente menores en los casos respecto a los controles y&#44; consecuentemente&#44; se observ&#243; una mayor prevalencia de anemia en los casos&#46; La posible asociaci&#243;n con la anemia y la insuficiencia renal&#44; y su eventual papel confusor&#44; se ha neutralizado introduciendo las 2 variables en el modelo multivariante final de comorbilidades&#46; En diversos estudios epidemiol&#243;gicos se ha asociado una elevada prevalencia de anemia con la presencia&#44; gravedad y peor pron&#243;stico de la EA&#46; Asimismo&#44; la elevada prevalencia de anemia puede afectar a la calidad de vida y al estado de salud percibido por el paciente dado que&#44; especialmente en pacientes ancianos&#44; la anemia se asocia con puntuaciones menores en las escalas de valoraci&#243;n de la calidad de vida y con un mayor riesgo de hospitalizaci&#243;n y ca&#237;das<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">28&#8211;30</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">La EA es una enfermedad silente&#44; de instauraci&#243;n lenta y que a menudo se diagnostica cuando aparecen s&#237;ntomas que afectan la calidad de vida del paciente&#46; La identificaci&#243;n de los factores de riesgo y comorbilidades asociados a la EA grave podr&#237;a facilitar modelos predictivos para la identificaci&#243;n y el seguimiento de los pacientes&#44; reducir el retraso diagn&#243;stico &#40;basado en la auscultaci&#243;n&#44; anamnesis y eventual estudio ecogr&#225;fico&#41; y terap&#233;utico&#44; y as&#237; mejorar el pron&#243;stico y la calidad de vida de los pacientes&#46; Del valor predictivo de las comorbilidades&#44; en concreto&#44; se deber&#237;a valorar la posibilidad de presentaci&#243;n de la EA en pacientes con estenosis carotidea e IRC&#46; Finalmente&#44; la prevenci&#243;n de la exposici&#243;n a los factores de riesgo a nivel poblacional podr&#237;a tener un efecto multiplicativo para otras enfermedades cr&#243;nicas que comparten los mismos factores de riesgo y repercutir directamente en la reducci&#243;n de la morbimortalidad&#46; De hecho&#44; en un estudio poblacional realizado en Suecia entre 1989 y 2009 se observ&#243; una disminuci&#243;n en la incidencia de EA y una mejora en el pron&#243;stico de esta enfermedad&#44; que sugieren que se debe al mejor control de los factores de riesgo&#44; junto con el tratamiento adecuado<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">15&#44;31</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Este estudio tiene algunas limitaciones&#59; algunos casos candidatos a formar parte del estudio podr&#237;an haber fallecido y esto podr&#237;a comportar un sesgo&#44; al estar sobrerrepresentados los pacientes con mejor pron&#243;stico&#46; Ello podr&#237;a sesgar los resultados hacia la hip&#243;tesis nula&#44; reforzando el valor de los factores detectados&#46; En el mismo sentido&#44; los controles podr&#237;an ser un potencial caso no diagnosticado&#44; dado que la EA puede no tener traducci&#243;n cl&#237;nica incluso en etapas avanzadas&#46; Este supuesto tambi&#233;n sesgar&#237;a los resultados hacia la hip&#243;tesis nula y&#44; por lo tanto&#44; la detecci&#243;n de cualquier factor de riesgo se afianzar&#237;a a&#250;n m&#225;s en esta situaci&#243;n&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">En relaci&#243;n con el tama&#241;o de la muestra&#44; para algunos casos no se pudieron seleccionar los 3 controles y la muestra final fue algo inferior a la prevista &#40;221 versus 261&#41;&#44; con lo que disminuy&#243; la precisi&#243;n y la potencia estad&#237;stica del estudio&#46; La edad de los controles fue 2&#44;1 a&#241;os inferior a los casos debido a que estaban apareados<span class="elsevierStyleHsp" style=""></span>&#177;5<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; De todos modos&#44; el n&#250;mero absoluto de a&#241;os no se considera muy elevado y esta variable se tuvo en cuenta en todos los modelos de regresi&#243;n log&#237;stica para neutralizar su posible papel de confusi&#243;n&#46; Asimismo&#44; dado que los controles eran pacientes que fueron a consulta en atenci&#243;n primaria&#44; es plausible que puedan presentar una prevalencia de comorbilidades algo mayor que la poblaci&#243;n general no seleccionada&#44; lo que podr&#237;a sesgar tambi&#233;n los resultados hacia la hip&#243;tesis nula&#46; Adem&#225;s&#44; debido a la naturaleza del estudio observacional no se puede inferir relaciones causales entre FRCV y casos de EA grave&#46; El hecho de que el estudio fue limitado a personas mayores de 65 a&#241;os podr&#237;a influir en la magnitud de la asociaci&#243;n de FRCV y EA grave&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Los resultados de la regresi&#243;n se obtuvieron de los pacientes que aportaron todos los datos&#46; En el caso de la regresi&#243;n donde se determina el efecto de la hemoglobina&#44; un 7&#44;7&#37; de los pacientes no registr&#243; el dato&#44; por lo que los resultados de la regresi&#243;n obviaron el perfil de este 7&#44;7&#37; de los pacientes&#46; Dicha limitaci&#243;n podr&#237;a o no introducir un posible sesgo que los autores consideramos improbable&#44; teniendo en cuenta que consideramos que no existen caracter&#237;sticas diferentes entre los pacientes que registraron o no el dato de inter&#233;s&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Finalmente&#44; los resultados podr&#237;an no ser extrapolables a otras &#225;reas geogr&#225;ficas&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Con este estudio hemos podido cuantificar el papel de los factores de riesgo y las comobilidades que acompa&#241;an a la EA grave&#46; La identificaci&#243;n de pacientes con un riesgo mayor de poder desarrollar esta enfermedad permite reducir el tiempo de diagn&#243;stico y de tratamiento&#44; mejorando&#44; a su vez&#44; su calidad de vida&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusiones</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los FRCV tabaquismo&#44; HTA&#44; hipercolesterolemia y niveles bajos de colesterol-HDL se asocian con la EA grave en personas<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">La enfermedad renal cr&#243;nica&#44; el accidente vascular cerebral y la estenosis carot&#237;dea son las comorbilidades que se asocian con la EA grave en personas<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; y tambi&#233;n se asocian de forma inversa los niveles de hemoglobina&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Este estudio&#44; respecto a anteriores trabajos&#44; ha permitido cuantificar el papel de factores de riesgo y comorbilidades que acompa&#241;an a la EA grave y que podr&#237;an facilitar la identificaci&#243;n de pacientes con mayor riesgo de desarrollar la enfermedad&#46; Esto podr&#237;a reducir el retraso diagn&#243;stico y terap&#233;utico&#44; y con ello mejorar la calidad de vida de los pacientes&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Financiaci&#243;n</span><p id="par0175" class="elsevierStylePara elsevierViewall">El presente trabajo ha sido financiado parcialmente por la Unitat d&#8217;Assaigs Cl&#237;nics i Investigaci&#243; del Servei de Cardiologia de l&#8217;Hospital Arnau de Vilanova de Lleida&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicto de intereses</span><p id="par0180" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La estenosis a&#243;rtica &#40;EA&#41; es una de las enfermedades cardiovasculares m&#225;s prevalentes en sujetos<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; Algunos estudios epidemiol&#243;gicos sugieren que ciertos factores de riesgo cardiovascular &#40;FRCV&#41; y comorbilidades pueden estar asociados con la EA&#46; El objetivo del estudio es evaluar la asociaci&#243;n de FRCV y comorbilidades con la EA grave sintom&#225;tica en pacientes<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65<span class="elsevierStyleHsp" style=""></span>a&#241;os en una regi&#243;n sanitaria espa&#241;ola&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio epidemiol&#243;gico de casos y controles procedentes del mismo centro de atenci&#243;n primaria&#46; Se recogi&#243; informaci&#243;n sobre la exposici&#243;n a FRCV y comorbilidades&#44; y se determin&#243; la asociaci&#243;n de ambos con la EA con <span class="elsevierStyleItalic">odds ratio</span> ajustadas &#40;ORa&#41;&#44; mediante modelos de regresi&#243;n log&#237;stica m&#250;ltiple&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron un total de 102 casos &#40;edad media<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>77&#44;6 a&#241;os&#41; y 221 controles &#40;edad media<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>75&#44;5 a&#241;os&#41;&#46; Los FRCV significativamente asociados con la EA grave sintom&#225;tica fueron hipercolesterolemia &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;67&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; tabaquismo &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;60&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; hipertensi&#243;n &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;41&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;010&#41; y cifras bajas de colesterol-HDL &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;20&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; Las comorbilidades significativamente asociadas con la EA grave sintom&#225;tica fueron estenosis carot&#237;dea &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#44;5&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; accidente vascular cerebral &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;14&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;024&#41;&#44; insuficiencia renal cr&#243;nica &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;78&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y bajos niveles de hemoglobina &#40;ORa<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La hipercolesterolemia&#44; el tabaquismo&#44; la hipertensi&#243;n arterial y los niveles bajos de colesterol-HDL son los FRCV que comportan mayor riesgo de EA grave&#46; Asimismo&#44; esta enfermedad se asocia con algunas comorbilidades &#40;insuficiencia renal cr&#243;nica&#44; accidente vascular cerebral&#44; estenosis carot&#237;dea y niveles de hemoglobina m&#225;s bajos&#41; que podr&#237;an ser marcadores de EA&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Aortic stricture &#40;AS&#41; is one of the most prevalent cardiovascular diseases in individuals 65 years of age or older&#46; A number of epidemiological studies have suggested that certain cardiovascular risk factors &#40;CRFs&#41; and comorbidities could be associated with AS&#46; The aim of this study was to evaluate the association between CRFs and comorbidities and severe symptomatic AS in individuals 65 years of age or older in a Spanish healthcare region&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We conducted an epidemiological case-control study from a single primary care centre&#46; We collected information on exposure to CRFs and comorbidities and determined their association with AS&#44; employing adjusted odds ratios &#40;OR&#41; and multiple logistic regression models&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study included 102 cases &#40;mean age&#44; 77&#46;6 years&#41; and 221 controls &#40;mean age&#44; 75&#46;5 years&#41;&#46; The CRFs significantly associated with severe symptomatic AS were hypercholesterolaemia &#40;OR&#44; 2&#46;67&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; tobacco use &#40;OR&#44; 2&#46;60&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; hypertension &#40;OR&#44; 2&#46;41&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;010&#41; and low HDL cholesterol readings &#40;OR&#44; 2&#46;20&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;007&#41;&#46; The comorbidities significantly associated with severe symptomatic AS were carotid stenosis &#40;OR&#44; 14&#46;5&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;017&#41;&#44; stroke &#40;OR&#44; 4&#46;14&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;024&#41;&#44; chronic renal failure &#40;OR&#44; 3&#46;78&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and low haemoglobin levels &#40;OR&#44; 0&#46;76&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Hypercholesterolaemia&#44; tobacco use&#44; arterial hypertension and low HDL cholesterol levels are the CRFs with a greater risk of severe AS&#46; Furthermore&#44; this disease is associated with a number of comorbidities &#40;chronic renal failure&#44; stroke&#44; carotid stenosis and low haemoglobin levels&#41;&#44; which could be markers of AS&#46;</p></span>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AIT&#58; accidente isqu&#233;mico transitorio&#59; AVC&#58; accidente vascular cerebral&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; EC&#58; estenosis carot&#237;dea&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; HDL&#58; lipoprote&#237;nas de alta densidad &#40;<span class="elsevierStyleItalic">high density lipoproteins</span>&#41;&#59; IAM&#44; infarto agudo de miocardio&#59; IMC&#44; &#237;ndice de masa corporal&#59; IRC&#58; insuficiencia renal cr&#243;nica&#59; ITB&#58; &#237;ndice tobillo-brazo&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">La obesidad central se ha definido como un per&#237;metro abdominal<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>102<span class="elsevierStyleHsp" style=""></span>cm en varones y<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>88<span class="elsevierStyleHsp" style=""></span>cm en mujeres&#44; y la prevalencia de anemia se ha definido como niveles de hemoglobina<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>13<span class="elsevierStyleHsp" style=""></span>g&#47;dl en varones y &#60;<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>g&#47;dl en mujeres&#46;</p>"
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Casos&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>102&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>221&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Edad en a&#241;os&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo&#44; n &#40;&#37; femenino&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;38&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;41&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;564&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Peso &#40;kg&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;9<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;4<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;9<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;5<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IMC categorizado &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;335&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Normal &#40;&#8804;<span class="elsevierStyleHsp" style=""></span>24&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;18&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;20&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sobrepeso &#40;25-29&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;43&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;46&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Obesidad &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;38&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;32&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">g</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Per&#237;metro abdominal &#40;cm&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;6<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;1<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">h</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Obesidad central&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;83&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;67&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">h</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;024<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ITB&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ITB</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#44;9&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;8&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;15&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;267&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hemoglobina &#40;media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;8<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;7<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">i</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hematocrito &#40;media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;1<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;3<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">j</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Factores de riesgo cardiovascular</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tabaquismo &#40;actual o previo&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;38&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;25&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;020<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de hipertensi&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;85&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">147 &#40;70&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de hipercolesterolemia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;71&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107 &#40;51&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de HDL bajo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;34&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;19&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de diabetes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;33&#44;7&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">f</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;28&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">l</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;383&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes de obesidad&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;43&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;34&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">k</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Historia familiar de cardiopat&#237;a isqu&#233;mica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;833&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89 &#40;89&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">186 &#40;91&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">m</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dudosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">m</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237; &#40;documentada&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;8&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;8&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0070"><span class="elsevierStyleSup">m</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Antecedentes patol&#243;gicos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes nefrol&#243;gicos &#40;IRC&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;28&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;8&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes patol&#243;gicos respiratorios&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;049<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;69&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">169 &#40;80&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;18&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;11&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;11&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;7&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes neurol&#243;gicos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;88&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179 &#40;85&#44;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AIT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;1&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AVC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;8&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;2&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;10&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes arteriopat&#237;a carot&#237;dea &#40;EC&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;5&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes arteriopat&#237;a perif&#233;rica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;562&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IAM&#44; n &#40;&#37;&#41;</span><span class="elsevierStyleHsp" style=""></span>Ninguno<span class="elsevierStyleHsp" style=""></span>Uno<span class="elsevierStyleHsp" style=""></span>Dos o m&#225;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;86&#44;3&#37;&#41;10 &#40;9&#44;8&#37;&#41;4 &#40;3&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">190 &#40;96&#44;4&#37;&#41;7 &#40;3&#44;6&#37;&#41;0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Intervencionismo cardiol&#243;gico previo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;17&#44;65&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#44;95&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes patol&#243;gicos endocrinol&#243;gicos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;6&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;11&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Antecedentes digestivos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;17&#44;6&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;12&#44;9&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0075"><span class="elsevierStyleSup">n</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;259&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Anemia&#44; frecuencia &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;37&#44;3&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;010<a class="elsevierStyleCrossRef" href="#tblfn0080">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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Información del artículo
ISSN: 00142565
Idioma original: Español
DOI:10.1016/j.rce.2020.01.010
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