Environmental triggers of acute myocardial infarction: results of a nationwide multiple-factorial population study

Claeys, Marc J.; Coenen, Sarah; Colpaert, Charlotte; Bilcke, Joke; Beutels, Philippe; Wouters, Kristien; Legrand, Victor; Damme, Pierre Van; Vrints, Christiaan

doi:10.1080/ac.70.6.3120182

Cited by 30 publications

(25 citation statements)

References 28 publications

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“…Whereas a few studies have previously reported similar findings with regard to air temperature, most of these studies have been geographically limited, with a relatively small sample size and/or use of administrative data with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, ambulance records, and death certificates as surrogate for MI. 10,11,[13][14][15][17][18][19][20][21][22]24 To our knowledge, this study not only constitutes the largest of its kind but also the only one investigating a wider spectrum of weather variables to clinical data with electrocardiographic and biomarkerpositive MI from a well-known nationwide register. We performed a number of subgroup, regional, seasonal, and sensitivity analyses to complement our primary analysis.…”

Section: Discussionmentioning

confidence: 99%

“…In the last decades, evidence linking the incidence of MI to colder temperatures and snow has been published. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] However, most studies have used surrogate variables, such as International Statistical Classification of Diseases, Tenth Revision codes, as indicators of MI, and many studies have only looked at air temperature and snow; other meteorological parameters have not been as widely investigated.…”

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confidence: 99%

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Association of Weather With Day-to-Day Incidence of Myocardial Infarction

et al. 2018

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IMPORTANCE Whether certain weather conditions modulate the onset of myocardial infarction (MI) is of great interest to clinicians because it could be used to prevent MIs as well as guide allocation of health care resources. OBJECTIVE To determine if weather is associated with day-today incidence of MI. DESIGN, SETTING, AND PARTICIPANTS In this prospective, population-based and nationwide setting, daily weather data from the Swedish Meteorological and Hydrological Institute were extracted for all MIs reported to the Swedish nationwide coronary care unit registry, Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART), during 1998 to 2013 and then merged with each MI on date of symptom onset and coronary care unit. All patients admitted to any coronary care unit in Sweden owing to MI were included. A total of 280 873 patients were included, of whom 92 044 were diagnosed as having ST-elevation MI. Weather data were available for 274 029 patients (97.6%), which composed the final study population. Data were analyzed between February 2017 and April 2018. EXPOSURES The nationwide daily mean air temperature, minimum air temperature, maximum air temperature, wind velocity, sunshine duration, atmospheric air pressure, air humidity, snow precipitation, rain precipitation, and change in air temperature. MAIN OUTCOMES AND MEASURES The nationwide daily counts of MI as outcome. RESULTS In 274 029 patients, mean (SD) age was 71.7 (12) years. Incidence of MI increased with lower air temperature, lower atmospheric air pressure, higher wind velocity, and shorter sunshine duration. The most pronounced association was observed for air temperature, where a 1-SD increase in air temperature (7.4°C) was associated with a 2.8% reduction in risk of MI (unadjusted incidence ratio, 0.972; 95% CI, 0.967-0.977; P <.001). Results were consistent for non-ST-elevation MI as well as ST-elevation MI and across a large range of subgroups and health care regions. CONCLUSIONS AND RELEVANCE In this large, nationwide study, low air temperature, low atmospheric air pressure, high wind velocity, and shorter sunshine duration were associated with risk of MI with the most evident association observed for air temperature.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Association of Weather With Day-to-Day Incidence of Myocardial Infarction

et al. 2018

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“…Some studies adjusted for daily pollutant levels and climate parameters2526, and some considered only temperature as a linear effect. Still others considered the possibility of lag effects of temperature in various hazard periods before AMI2728. Furthermore, few studies were conducted in countries located in sub-tropical or tropical climates such as countries in East Asia.…”

Section: Discussionmentioning

confidence: 99%

The Interaction Effects of Meteorological Factors and Air Pollution on the Development of Acute Coronary Syndrome

Huang

Lin

Tsai

et al. 2017

Sci Rep

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This study investigated the interaction effects of meteorological factors and air pollutants on the onset of acute coronary syndrome (ACS). Data of ACS patients were obtained from the Taiwan ACS Full Spectrum Registry and comprised 3164 patients with a definite onset date during the period October 2008 and January 2010 at 39 hospitals. Meteorological conditions and air pollutant concentrations at the 39 locations during the 488-day period were obtained. Time-lag Poisson and logistic regression were used to explore their association with ACS incidence. One-day lag atmospheric pressure (AP), humidity, particulate matter (PM2.5, and PM10), and carbon monoxide (CO) all had significant interaction effects with temperature on ACS occurrence. Days on which high temperatures (>26 °C) and low AP (<1009 hPa) occurred the previous day were associated with a greater likelihood of increased incidence of developing ACS. Typhoon Morakot was an example of high temperature with extremely low AP associated with higher ACS incidence than the daily average. Combinations of high concentrations of PM or CO with low temperatures (<21 °C) and high humidity levels with low temperatures were also associated with increased incidence of ACS. Atmospheric pollution and weather factors have synergistic effects on the incidence of ACS.

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“…Quantification of the exact triggering factor of AMI cannot be possible for every case in clinical practice [5]. However, various epidemiological and clinical studies have identified several associated triggering factors for AMI, which include, heavy physical exertion, emotional liability, drug abuse, sexual activities, and diet [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, in the past few decades, environmental triggers of AMI have gained mounting evidence from various geographies of the world [5,[7][8][9][10][11][12][13][14]. Low temperature or cold weather was found to be a convincing risk factor for the incidence of AMI [5,7]. However, due to geographic variations in seasonal temperature and other metrological parameters, it is difficult to generalize the findings in one population to another population with different climatic conditions.…”

Section: Introductionmentioning

confidence: 99%

Impact of Temperature Variation on Acute Myocardial Infarction in Karachi, Pakistan

Khowaja

Karim

Zahid

et al. 2019

Cureus

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IntroductionEnvironmental triggers of acute myocardial infarction (AMI) have gained mounting evidence from various geographies of the world. However, due to geographic variations in seasonal temperature and other metrological parameters, it is difficult to generalize the findings in one population to another population with different climatic conditions. Therefore, the aim of this study was to assess the relationship between meteorological parameters and the number of primary percutaneous coronary intervention (PCI) procedures for AMI at a tertiary care cardiac hospital in Karachi, Pakistan.MethodsFor this cross-sectional study, data was obtained on the number of primary PCI procedures conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi, Pakistan during 1st June 2016 to 31st May 2018. Daily meteorological data of the Karachi region for the same period was obtained from the Pakistan Meteorological Department. It consists of temperature, atmospheric pressure, and relative humidity. Based on the weather conditions of Karachi, the data was divided into two seasons; summer (April to October) and winter (November to March). Multiple linear regression analysis was performed taken the number of primary PCI performed as regressand and time trend, average temperature, temperature variation, and relative humidity as regressors.ResultsA total of 115,494 hospital admissions were recorded during the study period out of which rate of primary PCI was 10.5% (12,107). A negative relationship between average temperature and number of primary PCI was observed with standardized regression coefficients of -0.13 (p < 0.001) on the overall regression model. A similar significant negative relationship of average temperature was observed on the regression model for the cold season with standardized regression coefficients of -0.17 (p < 0.001). While no such relationship was observed for the warm season.ConclusionThe average daily temperature was found to be negatively related to the number of primary PCI. Subgroup analysis revealed that the average daily temperature had a significant negative relationship with the number of primary PCI in the cold season; however, no such impact was observed in the warm season.

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Environmental triggers of acute myocardial infarction: results of a nationwide multiple-factorial population study

Cited by 30 publications

References 28 publications

Association of Weather With Day-to-Day Incidence of Myocardial Infarction

Association of Weather With Day-to-Day Incidence of Myocardial Infarction

The Interaction Effects of Meteorological Factors and Air Pollution on the Development of Acute Coronary Syndrome

Impact of Temperature Variation on Acute Myocardial Infarction in Karachi, Pakistan

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