BackgroundAcute myocardial infarction (AMI) is one of the most preventable non-communicable diseases in human. Identifying triggers of myocardial infarction (MI) and prevention ways of exposure-induced complications can reduce morbidity and mortality in people at risk.AimThe aim of this study was to identify the emotional, environmental, physical and chemical dimensions of acute triggers in patients with AMI.MethodsThis case-crossover study was conducted on 269 patients with AMI, hospitalized at two remedial centers in Rasht in 2015. The study samples were selected by convenient sampling method. Data were collected using researcher-made questionnaire through interviews. Hazard and control periods for each trigger and its effects on the development of MI were studied. The collected data were analyzed using descriptive and analytical statistical methods, Cochran test, and generalized estimating equation (GEE) model with logistics function default in SPSS version 21, and p < 0.05 was considered statistically significant.ResultsThe results showed that quarrel (P = 0.008, OR = 2.01) and hearing the sudden news (P = 0.001, OR = 2.19) were the most common emotional triggers. Respiratory infections (P = 0.0001, OR = 6.78) and exposure to hot or cold weather (P = 0.005, OR = 2.19) were the most frequent environmental triggers. Doing heavy activities (P = 0.005, OR = 1.66) and sexual activities (P = 0.003, OR = 2.36) were among the most common physical triggers. High-fat foods consumption and overeating (P = 0.0001, OR = 3.79) were the most frequent chemical triggers of AMI.ConclusionIt seems that given the importance of the triggers in the incidence of AMI, planning is necessary to train vulnerable individuals to reduce exposure to triggers.

Introduction: SARS-Covid 2 is a new type of coronavirus which is a serious threat to all countries. Identifying the risk factors and investigating cases between deaths and discharge can increase public awareness to deal with this virus more easily. Methods: We conducted a case-control study on 274 patients with COVID-19 between March 1, 2020, and April 30, 2020. The cases were 137 COVID-19 patients discharged from the hospital, and the controls were patients who died due to COVID-19. Patient's information was obtained with demographic, clinical risk factors questionnaire, and their medical records. Result: The results showed that the age over 70, overweight, and high body mass index were significant predictors of death due to COVID-19. Opium use was associated with the death of COVID-19; however, it was not a significant predictor as an independent variable. Histories of chronic disease, as well as clinical signs of dyspnea, were significantly associated with death due to COVID-19. Fever and myalgia were introduced as the supportive clinical signs, so fever and myalgia were significantly more common in discharged individuals. Conclusion: Given that in this study, age over 70, overweight, obesity, opium use, and having clinical symptoms such as chronic diseases and dyspnea have been introduced as the risk factors for death due to COVID-19, so it is recommended due to lack of access to the appropriate vaccine to prevent COVID-19, during the outbreak of the virus. To prevent infection and spread of the virus, further training is required in the use of face masks, reducing traffic in public places, and proper handwashing.

Objective: Acute triggers are external stimuli that produce acute pathophysiologic changes directly leading to the onset of myocardial infarction (MI). Acute myocardial infarction (AMI) is one of the main causes of mortality. Recent studies have confirmed the impact of acute triggers on the occurrence of AMI, but have not evaluated their differences in terms of demographic characteristics. This study was conducted to investigate the impact of acute triggers on AMI in various demographic groups. Methods: This is an analytical cross-sectional study on 269 patients affected by AMI in two hospitals in 2015 and 2016 in Iran. To attain the goals of the study, acute triggers were divided into four groups of emotional, environmental, physical, and chemical. A researcher-developed questionnaire and interview were used to collect data. The risk and control periods were also evaluated for each trigger. The data were analyzed by descriptive statistics and inferential statistics such as statistical logistic regression and McNemar's test using SPSS 21. The P-value was set at 0.05. Results:The results showed that sudden exposure to hot/cold weather in men (P=0.03, OR=3.4), underlying diseases (P=0.03, OR=1.8), heavy activities (P=0.03, OR=1.6) and consuming tea/coffee in men (P=0.01, OR=1.8) increased the chance of AMI. It was also discovered that triggers such as pulmonary infections, overeating and/or eating high-fat foods that are not dependent on demographic variables promoted the chance of AMI (P<0.05). Conclusion: All people -regardless of age, sex, and the presence/lack of underlying illness -are at risk of developing MI in the face of respiratory infections, overeating, and intake of high-fat foods. Also, sudden exposure to hot and / or cold weather, heavy activity and high consumption of coffee and/or tea, can increase the risk of MI in men. Bulgular: Sonuçlar, erkeklerde sıcak/soğuk havaya ani maruziyetin (P = 0.03, OR = 3.4), altta yatan hastalıkların (P = 0.03, OR = 1.8), ağır aktivitelerin (P = 0.03, OR = 1.6) ve erkeklerde tüketilen çay/kahve (P = 0.01, OR = 1.8) akut kalp krizi riskini artırığını gösterdi. Pulmoner enfeksiyonlar, aşırı yeme ve/veya aşırı yağlı gıdalarla yeme gibi demografik değişkenlere bağımlı olmayan tetikleyicilerin akut kalp krizi riskini arttırdığı da keşfedildi (P <0.05). Sonuç: Yaş, cinsiyet ve altta yatan hastalığın varlığı/eksikliği ne olursa olsun tüm insanlar solunum yolu enfeksiyonları, aşırı yorulma ve yüksek yağlı gıdalar alımı karşısında kalp krizi gelişme riski altındadır. Ayrıca, ani sıcak ve/veya soğuk havaya maruz kalma, yoğun aktivite ve yüksek kahve ve/veya çay tüketimi erkeklerde lap krizi riskini artırabilir.

Introduction: Cardiovascular diseases are the leading causes of death around the world. Identification of triggers that lead to acute coronary events in ischemic heart diseases and their prevention can reduce the complications of myocardial infarction. Objective:The purpose of this study is to determine emotional triggers in patients with acute Myocardial Infarction (MI).Materials and Methods: This is a cross-sectional study conducted on 269 patients with acute MI hospitalized in two medical centers in Rasht, Iran in 2015. The relevant data were collected by a researcher-designed questionnaire completed by interview. The obtained data were analyzed using descriptive and inferential statistical methods, Cochran test and Generalized estimating equations of logistic regression. P values less than 0.05 were considered statistically significant. Results:The Mean±SD time of patients' exposure to studied emotional triggers were reported as 4.99±5.50 h for anger; 13.1±2.4 h for insomnia; 4.71±4.85 h for quarrels; 5.78±5.01 h for unexpected news; 1.9±2.9) h for partner bereavement; and 5.17±4.80 h for watching sport games before acute MI onset. Regression analysis results indicates that the risk of having acute MI is associated with exposure to quarrels (95%CI1.19-3.38, OR=2.01, P=0.008), unexpected news (95% CI 1.35-3.53, OR=2.19, P=0.001), and partner bereavement (95% CI 0.08-0.84, OR=0.27, P=0.024) prior to acute MI onset. Conclusion:The most important emotional triggers of acute MI were quarrels, unexpected news, and partner bereavement during hazard period. Therefore, it is necessary to take these factors into account in order to raise awareness among at-risk people, and to use appropriate emotional control mechanisms to reduce stress after these events.