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Abstract: Aim To study the composition and population dynamics of Chironomidae (Diptera) from a high-altitude tropical stream in Ecuador. Methods Samples were taken at Saltana River between April 2009 and November 2010. Physico-chemical parameters, such as flow, dissolved oxygen, conductivity, pH, and temperature, were measured in each sampling campaign. Larvae and pupae sampling was conducted with a Hess sampler in different substrates. During each sampling campaign, adults were sampled using amphibious emergence traps for 24 hours. All materials collected were separated and classified in the laboratory. The biomass was calculated using the individual weight of the larvae of different instars multiplied by the density of each instar at each sample. Results A total of 18 larval taxa were found in 14 different genera in the benthic samples. The subfamily Orthocladiinae showed the highest richness (12 genera), followed by Podonominae, Diamesinae, and Chironominae, with two genera each. The most frequent taxa were Cricotopus sp.3, C. (Oliveiriella) rieradevallae, and Genus 1 sp.a. Total densities fluctuate very much from one month to another following the changes of the most abundant species, and only one species showed a relationship with the substrates. Biomass values are lower from June to August of both years, which matches the high flow season. Conclusions The Saltana River’s cold temperature (6-7 °C) and the flow variability determine the low richness, density and biomass throughout the year. It is unclear if individuals showed very short or long-life cycles due to constant temperature throughout the year. However, there is a clear asynchrony in life cycles due to the presence of emerging adults throughout the year.

Abstract Large predators have disproportionate effects on their underlying food webs. Thus, appropriately assigning trophic positions has important conservation implications both for the predators themselves and for their prey. Large-bodied predators are often referred to as apex predators, implying that they are many trophic levels above primary producers. However, theoretical considerations predict both higher and lower trophic position with increasing body size. Nitrogen stable isotope values (δ 15N) are increasingly replacing stomach contents or behavioral observations to assess trophic position and it is often assumed that ontogenetic dietary shifts result in higher trophic positions. Intraspecific studies based on δ 15N values found a positive relationship between size and inferred trophic position. Here, we use datasets of predatory vertebrate ectotherms (crocodilians, turtles, lizards and fishes) to show that, although there are positive intraspecific relationships between size and δ 15N values, relationships between stomach-content-based trophic level (TPdiet) and size are undetectable or negative. As there is usually no single value for 15N trophic discrimination factor (TDF) applicable to a predator species or its prey, estimates of trophic position based on δ 15N in ectotherm vertebrates with large size ranges, may be inaccurate and biased. We urge a reconsideration of the sole use of δ 15N values to assess trophic position and encourage the combined use of isotopes and stomach contents to assess diet and trophic level.

Abstract Anthropometric characteristics in a subject are a good indication of their body-weight status and diagnosis of overweight and obesity. O and O multifactorial, so today the curiosity arises to investigate new risk factors that predispose to increased body weight, including chronotype. The objective of this study is to evaluate the anthropometric characteristics and caloric intake according to the chronotype in sick Ecuadorian adults. This cross-sectional study consisted of 400 men and women aged between 18 and 63 years, who were hospitalized at the Enrique Garcés General Hospital in the city of Quito. Anthropometric measurements were taken using ISAK techniques. Calorie intake was measured by a 24-hour recall and food frequency, and the Horne and Osttberg questionnaire was applied to measure the chronotype of the subjects. Statistical analyses were performed in R and R studio software. The study subjects were classified into 4 groups depending on their chronotype: moderate morning, extreme morning, intermediate, and moderate evening. It was observed that moderate evening subjects had higher values of body weight, high waist circumference, high triceps skinfold, high percentage of fat mass, visceral fat, and caloric intake than the other groups (p < 0.05). Evening chronotype appears to be related to overweight and obesity and caloric intake.

“House in Guápulo”, a representative project of Guadalupe Ibarra, the first woman architect in Ecuador, is the result of a pragmatic process, without allegations about locality or identity, but which, due to its consistency in execution, allows establishing a discursive and critical structure. The work is observed, as a starting point, from a dialogue between geography, landscape and typology. Once the macro context of its implementation is understood, an approach is made to the spatial and material cultures, an issue that also allows to understand the logic of insertion in the place, and that due to its own location and design mechanisms turns the house into an element of transition between different topographies, landscapes and urban areas. Finally, on a smaller scale, a brief analysis of the actors in the process is addressed: inhabitant, author and other collaborators. As conclusions, what was previously stated is integrated, a reflection on the architectural strategies for the Andean landscape, recognizing Ibarra for the weight of his contributions, without demagoguery or do-goodism, where contextual, spatial, compositional, and constructive issues of the project are analyzed, allowing value it as an object where the parts and the whole establish synergistic relationships.

Abstract Circadian rhythms, which are governed by a circadian clock, regulate important biological processes associated with obesity. SNPs in circadian clock genes have been linked to energy and lipid homeostasis. The aim of our study was to evaluate the associations of CLOCK and REV-ERBα SNPs with BMI and plasma lipid levels in pre-pubertal boys and girls. The study sample population comprised 1268 children aged 6–8 years. Information regarding anthropometric parameters and plasma lipid concentrations was available. Genotyping of CLOCK SNPs rs1801260, rs4580704, rs3749474, rs3736544 and rs4864548 and REV-ERBα SNPs rs2017427, rs20711570 and rs2314339 was performed by RT-PCR. The CLOCK SNPs rs3749474 and rs4864548 were significantly associated with BMI in girls but no in boys. Female carriers of the minor alleles for these SNPs presented lower BMI compared to non-carriers. A significant association of the REV-ERBα SNP rs2071570 with plasma total cholesterol, LDL-cholesterol and Apo B in males was also observed. Male AA carriers showed lower plasma levels of total cholesterol, LDL-cholesterol and Apo B levels as compared with carriers of the C allele. No significant associations between any of the studied REV-ERBα SNPs and plasma lipid levels were observed in females. In summary, CLOCK and REV-ERBα SNPs were associated with BMI and plasma lipid levels respectively in a sex-dependent manner. Our findings suggest that sex-related factors may interact with Clock genes SNPs conditioning the effects of these polymorphisms on circadian alterations.

Abstract Background In 1990, David Barker proposed that prenatal nutrition is directly linked to adult cardiovascular disease. Since then, the relationship between adult cardiovascular risk, metabolic syndrome and birth weight has been widely documented. Here, we used the TruSeq Methyl Capture EPIC platform to compare the methylation patterns in cord blood from large for gestational age (LGA) vs adequate for gestational age (AGA) newborns from the LARGAN cohort. Results We found 1672 differentially methylated CpGs (DMCs) with a nominal p

Foundation: the connection projects with society carried out by Ecuadorian universities are an opportunity for service and an alternative to bring their students closer to the community.Objective: to describe the grant value by teachers on the link between university and community in the dental students training process.Methods: observational, descriptive and cross-sectional study of dentistry teachers at the Los Andes Regional Autonomous University from January to June 2022. The population of 15 teachers at the Santo Domingo campus.Results: 100% of the teachers considered that the university-community connection allows the application of the acquired knowledge. The short duration of the periods (100%) and the lack of empowerment of teachers (100%) were indicated as weaknesses; and as positive elements the promotion of microenterprises among students (100%) and comprehensive development in the professional future (100%). Feedback between the university and the community (100%) and changes in training paradigms (100%) were identified as needs.Conclusions: teachers identify the university-community link as an opportunity of great value in the dental students training, preparing them based on the social problems solution typical of professional practice. The lack of empowerment and the conception of short-term projects are recognized as weaknesses, which demands transformations in current teaching dynamics, based on feedback between academia and society.

Foundation: liver cirrhosis is a chronic liver disease characterized by the formation of scar tissue and a decrease in normal liver function. The quality of life of patients with liver cirrhosis may be affected due to the chronic nature of the disease and the possible associated complications. Objective: to analyze the quality of life perceived by patients with cirrhosis, as well as to examine the factors that generally influence their quality of life. Method: a descriptive, analytical and correlational, cross-sectional study was carried out with a sample consisting of 40 patients with liver cirrhosis. The main tool for data collection was the survey. Comparative analyzes were performed to evaluate perceptions of quality of life, health, and other vital domains based on demographic variables. Statistical tests such as Spearman correlation, Mann-Whitney U test and Kruskal-Wallis test were used, as appropriate for each variable. The results were shown in graphs and tables expressed in values and percentages. Results: in the study carried out, statistical significance was found between the level of education and the physical, psychological and environmental domains, likewise, statistical significance was observed between the sex of the subjects and the psychological and social domains, in addition, it was found statistical significance between comorbidities and the psychological, social and environmental domain. Conclusions: patients differed in the evaluative criteria of their quality of life. Factors such as: sex, education and coexisting diseases showed influence on the quality of life of patients with cirrhosis.

If Derrida once praised English for the richness of the expression “to enforce the law,” in this article I return the favor and embrace the ambiguity of the French word endroit. While it means nothing more than place, I suggest one could draw from Benjamin’s work on dwelling to ponder on the meaning of being within the spaces of 19th century (counter) revolutionary internationalism. In this vein, I read Benjamin’s unfinished Arcades Project—and, in particular, its analysis of the rise of iron & glass architecture that accompanied the conquering bourgeois and the persistent aristocracy—to analyze the new built environments of the fin de siècle North Atlantic diplomacy. Despite the growing interest in the history of global governance, for historians and critical legal scholars alike, the spatial dimension of “the international” have been a largely unexplored affair. Conversely, I suggest Benjamin’s insistence on the materiality of architecture reminds us that international law’s castles were not built solely in the air. In this vein, I suggest one can trace a material history of the spaces in which revolutionary and counterrevolutionary internationalisms struggled to fashion a shell for themselves during Europe’s turbulent 19th century.

Abstract We report on the thermal neutron flux measurements carried out at the Laboratorio Subterráneo de Canfranc (LSC) with two commercial $$2^{\prime \prime } \times 2^{\prime \prime }$$ 2 ″ × 2 ″ CLYC detectors. The measurements were performed as part of an experimental campaign at LSC with $$^{3}$$ 3 He detectors, for establishing the sensitivity limits and use of CLYCs in low background conditions. A careful characterization of the intrinsic $$\alpha $$ α and $$\gamma $$ γ -ray background in the detectors was required and done with dedicated measurements. It was found that the $$\alpha $$ α activities in the two CLYC crystals differ by a factor of three, and the use of Monte Carlo simulations and a Bayesian unfolding method allowed us to determine the specific $$\alpha $$ α activities from the $$^{238}$$ 238 U and $$^{232}$$ 232 Th decay chains. The simulations and unfolding also revealed that the $$\gamma $$ γ -ray background registered in the detectors is dominated by the intrinsic activity of the components of the detector such as the aluminum housing and photo-multiplier and that the activity within the crystal is low in comparison. The data from the neutron flux measurements with the two detectors were analyzed with different methodologies: one based on an innovative $$\alpha $$ α /neutron pulse shape discrimination method and one based on the subtraction of the intrinsic $$\alpha $$ α background that masks the neutron signals in the region of interest. The neutron sensitivity of the CLYCs was calculated by Monte Carlo simulations with MCNP6 and GEANT4. The resulting thermal neutron fluxes are in good agreement with complementary flux measurement performed with $$^{3}$$ 3 He detectors, but close to the detection limit imposed by the intrinsic $$\alpha $$ α activity.

En el plan urbanístico de Quito de 2011 se incorporó la zonificación “zonas de riesgo por deslizamiento”, prohibiendo nuevas edificaciones. Esta política, con débil sustento técnico, tuvo imprecisiones con impactos en la seguridad de las familias, afectando sus economías. Tras diez años de aplicación y reformas aún no solventa el problema. Ante tal situación, este análisis propone aprendizajes para futuros contextos similares. Este estudio de caso revisó planes, regulación urbanística y estudios municipales sobre riesgo de deslizamiento, desde 1990. Se trianguló con entrevistas a funcionarios, y el análisis de datos de gestión territorial. Para contrastar, se sobrepusieron espacialmente las capas de zonas de riesgos, eventos del período 2005-2017 y áreas altamente susceptibles a deslizamientos. Durante diez años, 81% (644 hectáreas) de áreas con alta amenaza de deslizamientos no fueron protegidas como zona de riesgo, liberando la generación de riesgo. Contrariamente, 25% (218 hectáreas) del área zona de riesgo no presentaba alta susceptibilidad a deslizamientos, afectando a propietarios de terrenos con restricción de uso. Recientemente el plan urbanístico del 2021 actualizó como capa de afectación a 260 mil hectáreas de las áreas con alta amenaza de deslizamientos en Quito metropolitano, donde sólo 27% de los eventos 2005-2017 coincidieron con esta alta amenaza de deslizamientos. Este último plan abre la posibilidad de precisar la planificación preventiva con instrumentos de planificación de escalas menores de territorios y se espera un plan maestro de gestión de riesgos. La zonificación 2011 para la prevención de riesgo de deslizamiento, aunque tenía un objetivo de reducción del riesgo, tuvo imprecisiones que desprotegieron territorios con alta amenaza de deslizamientos y afectó a propietarios de terrenos sin riesgo. Aunque hubo mejores estudios en el mediano plazo, la política no se actualizó sino hasta 2021. Sin embargo, la nueva capa apenas cubre el 27% de los sitios siniestrados y se ha programado que planes futuros -de escalas menores de ciudad- precisen la zonificación, pues mientras más eventos sigan ocurriendo, las variabilidades climáticas extremas serán cada vez más frecuentes.

VIM-type-producing Gram-negative bacteria (GNB) infections are difficult to treat. This is a retrospective single-center study of 34 patients who received cefiderocol for the treatment of VIM-type-producing GNB infections, including 25 Pseudomonas spp., 7 Enterobacterales, and 5 Achromobacter sp. Primary outcomes were clinical failure (defined as death, lack of clinical improvement, or a switch to another drug) at day 14 and 30-day all-cause mortality. The median age was 59 years (IQR 53.7–73.4), and the median Charlson comorbidity index was 3.5 (IQR 2–5). The main infections were respiratory tract infections (n = 9, 27%) and skin and soft tissue infections (n = 9, 27%). Eight patients exhibited bacteremia. In 9/17 patients with a drainable focus, drainage was performed. The median cefiderocol treatment duration was 13 days (IQR 8–24). Five patients (15%) experienced clinical failure on day 14, and the thirty-day mortality rate was 9/34 (27%); two cases occurred because of an uncontrolled infection source, and one was due to a new infection caused by the same bacteria. The other six deaths were unrelated to the index infection. Five patients experienced microbiological recurrence within three months. Susceptibility testing revealed the development of cefiderocol resistance in 1/7 cases with persistent or recurrent positive cultures. Cefiderocol, even in monotherapy, could be considered for the treatment of VIM-type-producing GNB infections.

Fluoropyrimidines (FPs) are commonly prescribed in many cancer streams. The EMA and FDA-approved drug labels for FPs recommend genotyping the DPYD*2A (rs3918290), *13 (rs55886062), *HapB3 (rs56038477), alleles, and DPYD rs67376798 before treatment starts. We implemented the DPYD genotyping in our daily clinical routine, but we still found patients showing severe adverse drug events (ADEs) to FPs. We studied among these patients the DPYD rs1801265, rs17376848, rs1801159, rs1801160, rs1801158, and rs2297595 as explanatory candidates of the interindividual differences for FP-related toxicities, examining the association with the response to FPs . We also studied the impact of DPYD testing for FP dose tailoring in our clinical practice and characterized the DPYD gene in our population. We found a total acceptance among physicians of therapeutic recommendations translated from the DPYD test, and this dose tailoring does not affect the treatment efficacy. We also found that the DPYD*4 (defined by rs1801158) allele is associated with a higher risk of ADEs (severity grade ≥ 3) in both the univariate (O.R. = 5.66; 95% C.I. = 1.35–23.67; p = 0.014) and multivariate analyses (O.R. = 5.73; 95% C.I. = 1.41–28.77; p = 0.019) among FP-treated patients based on the DPYD genotype. This makes it a candidate variant for implementation in clinical practice.

Una de las maneras para superar las necesidades económicas y productivas de las diferentes zonas rurales, es a través del emprendimiento. Por este motivo estudiar desde epistemologías como la fenomenología, el constructivismo, y el empirismo, logra abarracar las diferentes preguntas y brechas que se presentan en las incidencias para el desarrollo formación de los jóvenes en actividades de emprendimiento agrícola. Sin embargo, el emprendimiento da soluciones a las problemáticas sociales en cada una de las regiones. De esta manera también logra estimular en los jóvenes de los colegios agrícolas nociones de emprendimiento, y genera aportes en la transformación de los entornos, aumentando las dinámicas económicas adaptadas en las regiones, que finalmente aportan al desarrollo de los jóvenes, y la obtención de capacidades en emprendimiento. Se realiza una revisión sistemática de artículos publicados en revistas indexadas en inglés y español de aportes investigativos en temas de formación en emprendimiento agrícola, las experiencias que se dan de acuerdo con las condiciones y características de cada uno de los diferentes estudios realizados, y su adaptabilidad en los entornos rurales a partir de los paradigmas que enmarcan estas condiciones en cada una de las regiones a nivel global.

La toxoplasmosis es una enfermedad causada por un protozoario llamado, Toxoplasma gondii, se manifiesta con gran morbilidad y mortalidad en fetos, recién nacidos y pacientes inmunocomprometidos, sin embargo, la toxoplasmosis también puede manifestarse en pacientes inmunocompetentes que padecen: coriorretinitis, linfadenopatías, neumonías, absceso cerebral, miositis, miocarditis y hepatitis. El objetivo de esta investigación fue identificar las manifestaciones clínicas de la toxoplasmosis en la carne de cerdo y los posibles riesgos para la salud humana. Se realizó una revisión bibliográfica en las bases de datos Scopus, Cochrane, Web of Science, PubMed, Library y Embase hasta octubre de 2022. Se realizaron también búsquedas manuales en las listas de referencias de todos los artículos importantes encontrados electrónicamente, lo que permitió obtener 85 registros, de los cuales fueron seleccionados 19. La toxoplasmosis es una enfermedad infecciosa común en los países en desarrollo, tropicales y subtropicales de todo el mundo. La incidencia ha aumentado en las zonas rurales y en los grupos socioeconómicos más bajos.

El cambio climático contribuye de manera significativa a la inseguridad alimentaria, principalmente por el impacto en los rendimientos agrícolas y la disponibilidad de recursos esenciales, como el agua de riego. Esta exploración implicó la evaluación de factores meteorológicos y su contraste con los escenarios descritos en las Trayectorias de Concentración Representativas (RCP) 4.5 y 8.5, desde un enfoque pluralista en la provincia andina de Tungurahua. Se aplicó un cuestionario semiestructurado a 244 practicantes agrícolas para obtener datos primarios. El análisis incluyó el modelo de Rasch para la evaluación psicométrica, métodos estadísticos descriptivos y el análisis cualitativo de contenido. Se abarcó varias dimensiones, desde determinantes socioeconómicos y métricas de producción agronómica hasta indicadores de seguridad alimentaria y actitudes de los agricultores hacia la variabilidad climática en diferentes altitudes. Los hallazgos clave indican un impacto notable de la variabilidad climática en la producción agrícola, atribuido a factores como heladas, sequías, precipitaciones excesivas y plagas. El análisis de Rasch reveló un riesgo relativamente bajo de inseguridad alimentaria, con una puntuación de 0,74 que indica una capacidad adecuada para el autoabastecimiento. Además, las percepciones y condiciones informadas por los agricultores mostraron una alineación significativa con las proyecciones del escenario RCP 4.5. En conclusión, las percepciones de los agricultores ofrecen valiosos conocimientos para su integración en los análisis del cambio climático. Sin embargo, el estudio también reconoce ciertas limitaciones frente a la precisión de los recuerdos de los agricultores sobre eventos climáticos pasados. Por tanto, los datos consignados en la investigación deben considerarse como subjetivos.

INTRODUCCIÓN: El síndrome de infusión de Propofol (SIP), es producido por la infusión parenteral de este medicamento a altas dosis (≥ 4 mg/kg/h) durante más de 48 horas, en la sedo analgesia de pacientes críticos; que puede provocar falla multiorgánica y alto riesgo de mortalidad. CASOS CLÍNICOS: Se analizaron seis casos clínicos en la UCI del Hospital de Especialidades Carlos Andrade Marín (HECAM) que cumplieron criterios diagnósticos, el seguimiento de los pacientes permitió identificar falla multiorgánica. RESULTADOS: En los seis casos el denominador común fue la hipotensión, acidosis metabólica, alteraciones electrolíticas, el incremento del lactato y la creatina fosfolipasa; el resultado final mostró que un paciente a quien se había retirado el uso de Propofol mejoró su condición clínica de manera temporal, mientras que el resto falleció al mantener su infusión. DISCUSIÓN: Como se muestra en el estudio la alta suspicacia diagnóstica, pueden hacer la diferencia en la disminución de la falla multiorgánica y la muerte de pacientes. La pandemia puso de manifiesto la fragilidad de las cadenas de fabricación, logística y adquisición de fármacos poniendo en riesgo su disponibilidad, además es fundamental señalar que la farmacovigilancia permanente e institucionalizada puede evitar los desenlaces fatales de las reacciones adversas medicamentosas. CONCLUSIÓN: El SIP es un evento infrecuente pero mortal que puede ocurrir tras el uso prolongado y las altas dosis del fármaco, incluso en ocasiones a dosis habituales. El diagnóstico oportuno permite su retiro inmediato y mejorar el pronóstico de los pacientes, la farmacovigilancia es un instrumento fundamental para mejorar la seguridad del paciente.

Las innovaciones en el campo de la ingeniería computacional y la inteligencia artificial brindan nuevas oportunidades metodológicas para la investigación científica, permitiendo el estudio de fenómenos sociales emergentes que nacen y habitan en los espacios virtuales. El propósito de este trabajo es familiarizar al científico social con los procesos ampliamente establecidos en el análisis masivo de texto mediante técnicas de aprendizaje automático que dan lugar a lo que hoy conocemos como procesamiento de lenguaje natural (PLN). En primer lugar, se lleva a cabo un breve recorrido por la historia del PLN y su relación con el análisis de texto en las ciencias sociales. Luego, en cada sección del texto, se valoran los pasos a seguir cuando se aplica PLN a investigaciones de carácter social, proporcionando información sobre programas informáticos, herramientas, fuentes de datos y enlaces útiles, con el propósito de ofrecer una guía introductoria y simplificada que sirva como acercamiento inicial a esta disciplina. Por último, se examinan y evalúan los principales desafíos que las ciencias sociales enfrentan al implementar técnicas de PLN.

Ecuador es un país productor de materias primas, entre las cuales se encuentran los productos agrarios. Como resultado de su procesamiento se generan residuos que no se han cuantificado, mismos que afectan al medio ambiente. El objetivo del presente trabajo fue investigar sobre el aprovechamiento de las propiedades nutricionales y tecnológicas de fibra dietética proveniente de residuos agroindustriales generados por la industria alimentaria en el Ecuador, con la finalidad de disminuir su impacto ambiental e impulsar el desarrollo de alimentos saludables. A través de la recopilación y organización de información digital disponible en catálogos de bibliotecas, repositorios académicos y bases de datos, como Scopus, Science Direct y Google Académico se estimó que se produjeron 508 miles de TM de subproductos frutales en el país durante el 2021, los cuales poseen altas cantidades de fibra dietética y compuestos bioactivos. Se evidenció que los polvos ricos en fibra modifican la textura, coloración, capacidad antioxidante y emulsionante en productos cárnicos y de panadería, los métodos de modificación de concentrados son efectivos, el consumo de fibra dietética trae beneficios en el organismo y las propiedades tecnológicas como la capacidad de retención de agua, aceite e hinchamiento convierten a la fibra dietética en un ingrediente prometedor para la industria alimentaria. El estudio determinó que la fibra dietética obtenida a partir de cáscaras de frutas tiene potencial para ser utilizada como emulsionante, espesante, antioxidante, etc., en la elaboración de productos de pastelería, panadería y cárnicos.

Abstract Background Cardiovascular diseases and especially Acute Coronary Syndrome (ACS) constitute a major health issue impacting millions of patients worldwide. Being a leading cause of death and hospital admissions in many European countries including Spain, it accounts for enormous amounts of healthcare expenditures for its management. Clopidogrel is one of the oldest antiplatelet medications used as standard of care in ACS. Methods In this study, we performed an economic evaluation study to estimate whether a genome-guided clopidogrel treatment is cost-effective compared to conventional one in a large cohort of 243 individuals of Spanish origin suffering from ACS and treated with clopidogrel. Data were derived from the U-PGx PREPARE clinical trial. Effectiveness was measured as survival of individuals while study data on safety and efficacy, as well as on resource utilization associated with each adverse drug reaction were used to measure costs to treat these adverse drug reactions. A generalized linear regression model was used to estimate cost differences for both study groups. Results Based on our findings, PGx-guided treatment group is cost-effective. PGx-guided treatment demonstrated to have 50% less hospital admissions, reduced emergency visits and almost 13% less ADRs compared to the non-PGx approach with mean QALY 1.07 (95% CI, 1.04–1.10) versus 1.06 (95% CI, 1.03–1.09) for the control group, while life years for both groups were 1.24 (95% CI, 1.20–1.26) and 1.23 (95% CI, 1.19–1.26), respectively. The mean total cost of PGx-guided treatment was 50% less expensive than conventional therapy with clopidogrel [€883 (95% UI, €316–€1582), compared to €1,755 (95% UI, €765–€2949)]. Conclusion These findings suggest that PGx-guided clopidogrel treatment represents a cost-effective option for patients suffering from ACS in the Spanish healthcare setting.