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Shuka N, Cabeli A, Simoni L, Gina M, Kondi L, Dado E. Impact of Temperature and Atmospheric Pressure on Hospitalizations of Patients Presenting With Acute Coronary Syndrome. Cureus 2024; 16:e54833. [PMID: 38533174 PMCID: PMC10964120 DOI: 10.7759/cureus.54833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2024] [Indexed: 03/28/2024] Open
Abstract
AIM This study aims to investigate the impact of temperature and atmospheric pressure on hospitalizations of patients with acute coronary syndrome (ACS). MATERIALS AND METHODS This is a retrospective, observational, analytical study conducted in a single center, University Hospital Center "Mother Teresa," Tirana, Albania, in the period January-December 2018. This study included 1,165 patients with ACS, who performed urgent coronary angiography, from January 2018 to December 2018. Patients were diagnosed with ACS based on clinical and examination findings. The data were collected retrospectively using patient files. Baseline demographic, clinical, and procedural characteristics were collected. Data on atmospheric parameters, measured at the weather monitoring station, were obtained from the National Meteorological Service database. Measurements from the meteorological service provided values for each parameter: average daily temperature and atmospheric pressure in each country district. Atmospheric data measurements were taken for the day under review. The number of inhabitants for the respective districts is taken from the National Institute of Statistics (INSTAT). RESULTS The study involved 1,165 patients, with a mean age of 63.1 years, ranging from 27 years to 89 years old. The majority of patients (78.6%) were male, while 21.4% were female. A statistically significant relationship was observed between seasonal changes in temperature and atmospheric pressure concerning the number of cases with ACS; the autumn season prevails with 27.9% of the total cases, followed by the spring season with 25.6%, the summer season with 24.2%, and winter season with 22.3% (p = 0.04). Additionally, significant changes in the average monthly values of temperature and atmospheric pressure were accompanied by a statistically significant increase in the number of cases as occurred in March-April and October-November (p ≤ 0.05). Most cases in the cold period (November-March) occurred on days with a change in temperature or atmospheric pressure with a statistically significant value of p < 0.05. CONCLUSION An important relationship between seasonal, monthly, and daily changes in temperature and atmospheric pressure concerning the frequency of cases with ACS was observed.
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Affiliation(s)
- Naltin Shuka
- Cardiovascular Medicine, University Hospital Center "Mother Teresa", Tirana, ALB
| | - Andri Cabeli
- Physiology, University of Medicine, Tirana, Tirana, ALB
| | - Leonard Simoni
- Cardiovascular Disease, University Hospital Center "Mother Teresa", Tirana, ALB
| | - Mirald Gina
- Cardiovascular Disease, University Hospital Center "Mother Teresa", Tirana, ALB
| | - Ledjana Kondi
- Cardiovascular Disease, University Hospital Center "Mother Teresa", Tirana, ALB
| | - Edvin Dado
- Cardiovascular Disease, University of Medicine, Tirana, Tirana, ALB
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2
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Rus AA, Mornoş C. The Impact of Meteorological Factors and Air Pollutants on Acute Coronary Syndrome. Curr Cardiol Rep 2022; 24:1337-1349. [PMID: 35932446 PMCID: PMC9361940 DOI: 10.1007/s11886-022-01759-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/04/2022]
Abstract
Purpose of Review Several studies have found that air pollution and climate change can have an impact on acute coronary syndromes (ACS), the leading cause of death worldwide. We synthesized the latest information about the impact of air pollution and climate change on ACS, the latest data about the pathophysiological mechanisms of meteorological factors and atmospheric pollutants on atherosclerotic disease, and an overall image of air pollution and coronary heart disease in the context of the COVID-19 pandemic. Recent Findings The variation of meteorological factors in different seasons increased the risk of ACS. Both the increase and the decrease in apparent temperature were found to be risk factors for ACS admissions. It was also demonstrated that exposure to high concentrations of air pollutants, especially particulate matter, increased cardiovascular morbidity and mortality. Summary Climate change as well as increased emissions of air pollutants have a major impact on ACS. The industrialization era and the growing population cause a constant increase in air pollution worldwide. Thus, the number of ACS favored by air pollution and the variations in meteorological factors is expected to increase dramatically in the next few years.
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Affiliation(s)
- Andreea-Alexandra Rus
- PhD School Department, Research Centre of the Institute for Cardiovascular Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041, Timisoara, Romania.
| | - Cristian Mornoş
- Department VI Cardiology, 2nd Discipline of Cardiology, Research Centre of the Institute for Cardiovascular Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041, Timisoara, Romania
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3
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Koo GPY, Zheng H, Pek PP, Hughes F, Lim SL, Yeo JW, Ong MEH, Ho AFW. Clustering of Environmental Parameters and the Risk of Acute Myocardial Infarction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148476. [PMID: 35886328 PMCID: PMC9318360 DOI: 10.3390/ijerph19148476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 02/04/2023]
Abstract
The association between days with similar environmental parameters and cardiovascular events is unknown. We investigate the association between clusters of environmental parameters and acute myocardial infarction (AMI) risk in Singapore. Using k-means clustering and conditional Poisson models, we grouped calendar days from 2010 to 2015 based on rainfall, temperature, wind speed and the Pollutant Standards Index (PSI) and compared the incidence rate ratios (IRR) of AMI across the clusters using a time-stratified case-crossover design. Three distinct clusters were formed with Cluster 1 having high wind speed, Cluster 2 high rainfall, and Cluster 3 high temperature and PSI. Compared to Cluster 1, Cluster 3 had a higher AMI incidence with IRR 1.04 (95% confidence interval 1.01–1.07), but no significant difference was found between Cluster 1 and Cluster 2. Subgroup analyses showed that increased AMI incidence was significant only among those with age ≥65, male, non-smokers, non-ST elevation AMI (NSTEMI), history of hyperlipidemia and no history of ischemic heart disease, diabetes or hypertension. In conclusion, we found that AMI incidence, especially NSTEMI, is likely to be higher on days with high temperature and PSI. These findings have public health implications for AMI prevention and emergency health services delivery during the seasonal Southeast Asian transboundary haze.
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Affiliation(s)
| | - Huili Zheng
- National Registry of Diseases Office, Health Promotion Board, Singapore 168937, Singapore;
| | - Pin Pin Pek
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
| | - Fintan Hughes
- Department of Anesthesiology, Duke University Hospital, Duke University, Durham, NC 27710, USA;
| | - Shir Lynn Lim
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore;
- Department of Medicine, National University Singapore, Singapore 119228, Singapore
| | - Jun Wei Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Marcus E. H. Ong
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Andrew F. W. Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School Singapore, Singapore 169857, Singapore
- Correspondence:
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4
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Li N, Ma J, Liu F, Zhang Y, Ma P, Jin Y, Zheng ZJ. Associations of apparent temperature with acute cardiac events and subtypes of acute coronary syndromes in Beijing, China. Sci Rep 2021; 11:15229. [PMID: 34315978 PMCID: PMC8316341 DOI: 10.1038/s41598-021-94738-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/07/2021] [Indexed: 11/09/2022] Open
Abstract
Limited evidence is available on apparent temperature (AT) and hospital admissions for acute cardiac events. We examined the associations of AT with admissions for acute cardiac events and acute coronary syndrome (ACS), and explored the effect difference between ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction ACS (NSTE-ACS). Poisson regression with distributed lag non-linear model was applied to examine the temperature-lag-admission associations. Stratified analyses were performed by gender and age-groups for acute cardiac events. A total of 11,657 acute cardiac events admissions were collected from hospital-based chest pain centers in Beijing, during 2017-2019. The single day effect of low AT (- 11 °C, 2.5th percentile) appeared on the 2nd day and persisted until the 11th day, with estimated relative risk (RR) ranging from 1.44 (95% CI: 1.159, 1.790) to 1.084 (95% CI: 1.022, 1.150) for acute cardiac events and from 1.034 (95% CI: 1.010, 1.059) to 1.006 (95% CI: 1.000, 1.011) for ACS. The single day effect of high AT (34 °C, 97.5th percentile) was only observed on the current day. The cold effect on acute cardiac events was more pronounced among female and older patients. The cumulative effect of high AT on STEMI admissions and low AT on NSTE-ACS reached a peak RR peak of 2.545 (95% CI: 1.016, 6.375) and 3.71 (95% CI: 1.315, 10.469) on lag 0-6 days, respectively. Both high and low ATs were associated with increased risk of acute cardiac events and ACS admissions. STEMI admissions may be more sensitive to high AT while NSTE-ACS to low AT.
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Affiliation(s)
- Na Li
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
| | - Fangjing Liu
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
| | - Yan Zhang
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Pengkun Ma
- Institute of Urban Meteorology, Chinese Meteorological Administration, Beijing, China
| | - Yinzi Jin
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China. .,Institute for Global Health and Development, Peking University, Beijing, China.
| | - Zhi-Jie Zheng
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
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5
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Vallabhajosyula S, Patlolla SH, Cheungpasitporn W, Holmes DR, Gersh BJ. Influence of seasons on the management and outcomes acute myocardial infarction: An 18-year US study. Clin Cardiol 2020; 43:1175-1185. [PMID: 32761957 PMCID: PMC7533976 DOI: 10.1002/clc.23428] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022] Open
Abstract
Background There are limited data on the seasonal variation in acute myocardial infarction (AMI) in the contemporary literature. Hypothesis There would be decrease in the seasonal variation in the management and outcomes of AMI. Methods Adult (>18 years) AMI admissions were identified using the National Inpatient Sample (2000‐2017). Seasons were classified as spring, summer, fall, and winter. Outcomes of interest included prevalence, in‐hospital mortality, use of coronary angiography, and percutaneous coronary intervention (PCI). Subgroup analyses for type of AMI and patient characteristics were performed. Results Of the 10 880 856 AMI admissions, 24.3%, 22.9%, 22.2%, and 24.2% were admitted in spring, summer, fall, and winter, respectively. The four cohorts had comparable age, sex, race, and comorbidities distribution. Rates of coronary angiography and PCI were slightly but significantly lower in winter (62.6% and 40.7%) in comparison to the other seasons (64‐65% and 42‐43%, respectively) (P < .001). Compared to spring, winter admissions had higher in‐hospital mortality (adjusted odds ratio [aOR]: 1.07; 95% confidence interval [CI]: 1.06‐1.08), whereas summer (aOR 0.97; 95% CI 0.96‐0.98) and fall (aOR 0.98; 95% CI 0.97‐0.99) had slightly lower in‐hospital mortality (P < .001). ST‐segment elevation (10.0% vs 9.1%; aOR 1.07; 95% CI 1.06‐1.08) and non‐ST‐segment elevation (4.7% vs 4.2%; aOR 1.07; 95% CI 1.06‐1.09) AMI admissions in winter had higher in‐hospital mortality compared to spring (P < .001). The primary results were consistent when stratified by age, sex, race, geographic region, and admission year. Conclusions Compared to other seasons, winter admission was associated with higher in‐hospital mortality in AMI in the United States.
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Affiliation(s)
- Saraschandra Vallabhajosyula
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Center for Clinical and Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota, USA.,Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sri Harsha Patlolla
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Wisit Cheungpasitporn
- Division of Nephrology, Department of Medicine, University of Mississippi School of Medicine, Jackson, Mississippi, USA
| | - David R Holmes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Bernard J Gersh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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6
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Kurihara O, Takano M, Yamamoto E, Yonetsu T, Kakuta T, Soeda T, Yan BP, Crea F, Higuma T, Kimura S, Minami Y, Adriaenssens T, Boeder NF, Nef HM, Kim CJ, Thondapu V, Kim HO, Russo M, Sugiyama T, Fracassi F, Lee H, Mizuno K, Jang IK. Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes. J Am Heart Assoc 2020; 9:e015579. [PMID: 32611221 PMCID: PMC7670515 DOI: 10.1161/jaha.119.015579] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Seasonal variations in acute coronary syndromes (ACS) have been reported, with incidence and mortality peaking in the winter. However, the underlying pathophysiology for these variations remain speculative. Methods and Results Patients with ACS who underwent optical coherence tomography were recruited from 6 countries. The prevalence of the 3 most common pathologies (plaque rupture, plaque erosion, and calcified plaque) were compared between the 4 seasons. In 1113 patients with ACS (885 male; mean age, 65.8±11.6 years), the rates of plaque rupture, plaque erosion, and calcified plaque were 50%, 39%, and 11% in spring; 44%, 43%, and 13% in summer; 49%, 39%, and 12% in autumn; and 57%, 30%, and 13% in winter (P=0.039). After adjusting for age, sex, and other coronary risk factors, winter was significantly associated with increased risk of plaque rupture (odds ratio [OR], 1.652; 95% CI, 1.157-2.359; P=0.006) and decreased risk of plaque erosion (OR, 0.623; 95% CI, 0.429-0.905; P=0.013), compared with summer as a reference. Among patients with rupture, the prevalence of hypertension was significantly higher in winter (P=0.010), whereas no significant difference was observed in the other 2 groups. Conclusions Seasonal variations in the incidence of ACS reflect differences in the underlying pathobiology. The proportion of plaque rupture is highest in winter, whereas that of plaque erosion is highest in summer. A different approach may be needed for the prevention and treatment of ACS depending on the season of its occurrence. Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT03479723.
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Affiliation(s)
- Osamu Kurihara
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA
| | - Masamichi Takano
- Cardiovascular Center Nippon Medical School Chiba Hokusoh Hospital Inzai, Chiba Japan
| | - Erika Yamamoto
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA
| | - Taishi Yonetsu
- Department of Interventional Cardiology Tokyo Medical and Dental University Tokyo Japan
| | - Tsunekazu Kakuta
- Division of Cardiovascular Medicine Tsuchiura Kyodo General Hospital Ibaraki Japan
| | - Tsunenari Soeda
- Department of Cardiovascular Medicine Nara Medical University Nara Japan
| | - Bryan P Yan
- Division of Cardiology Department of Medicine and Therapeutics Prince of Wales Hospital Chinese University of Hong Kong Hong Kong SAR China
| | - Filippo Crea
- Fondazione Policlinico Universitario A Gemelli IRCCS Roma Italy
| | - Takumi Higuma
- Division of Cardiology Department of Internal Medicine St. Marianna University School of Medicine Kawasaki Kanagawa Japan
| | - Shigeki Kimura
- Division of Cardiology Kameda Medical Center Chiba Japan
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Japan
| | - Tom Adriaenssens
- Department of Cardiovascular Medicine University Hospitals Leuven Leuven Belgium
| | | | - Holger M Nef
- Department of Cardiology University of Giessen Germany
| | - Chong Jin Kim
- Department of Cardiology Kyung Hee University Hospital Seoul Korea
| | - Vikas Thondapu
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA
| | - Hyung Oh Kim
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA
| | - Michele Russo
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA
| | - Tomoyo Sugiyama
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA
| | - Francesco Fracassi
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA
| | - Hang Lee
- Biostatistics Center Massachusetts General Hospital Harvard Medical School Boston MA
| | | | - Ik-Kyung Jang
- Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA.,Department of Cardiology Kyung Hee University Hospital Seoul Korea
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Chongprasertpon N, Coughlan JJ, Cahill C, Kiernan TJ. Circadian and seasonal variations in patients with acute STEMI: A retrospective, single PPCI center study. Chronobiol Int 2018; 35:1663-1669. [PMID: 30067392 DOI: 10.1080/07420528.2018.1500478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This was a retrospective observational analysis of all (n = 876) ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI) at University Hospital Limerick (UHL) from 2012 to 2016 to determine whether chronological patterns existed in incidence and mortality at our center. Data were obtained from the electronic Cardiology STEMI database in UHL. Statistical analysis was performed using the Independent Samples t Test, ANOVA and Pearson's Chi-Squared test. The rate of STEMI from 0800 and 2259 hours (46.9/hr) was greater than 2300 to 0759 hours (19.1/hr) (p < 0.001). No association was found between 30-day mortality and weekend/weekdays presentation (p = 0.81) or off/in hour presentation (p = 0.86). No seasonal variation was found in STEMI incidence at our center using international (p = 0.29) or Celtic (p = 0.82) seasonal calendars. 30-Day mortality is equivalent whether STEMI patients treated with PPCI present during "normal working hours" or during the "out of hours"/weekend period at our center. The majority of STEMIs occur during the hours 0800 to 2259, but no further chronological relationship was observed in incidence.
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Affiliation(s)
| | - John Joseph Coughlan
- a Department of Cardiology , University Hospital Limerick , Co. Limerick , Ireland
| | - Ciara Cahill
- a Department of Cardiology , University Hospital Limerick , Co. Limerick , Ireland
| | - Thomas John Kiernan
- a Department of Cardiology , University Hospital Limerick , Co. Limerick , Ireland
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Ravljen M, Hovelja T, Vavpotič D. Immediate, lag and time window effects of meteorological factors on ST-elevation myocardial infarction incidence. Chronobiol Int 2017; 35:63-71. [DOI: 10.1080/07420528.2017.1381847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Mirjam Ravljen
- Nursing Department, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Tomaž Hovelja
- Information Systems Laboratory, Faculty of Computer and Information, University of Ljubljana, Ljubljana, Slovenia
| | - Damjan Vavpotič
- Information Systems Laboratory, Faculty of Computer and Information, University of Ljubljana, Ljubljana, Slovenia
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9
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Seasonal and circadian variations of acute myocardial infarction: Findings from the Get With The Guidelines-Coronary Artery Disease (GWTG-CAD) program. Am Heart J 2017. [PMID: 28625385 DOI: 10.1016/j.ahj.2017.04.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Seasonal variation with winter preponderance of myocardial infarction incidence has been described decades ago, but only a few small studies have classified myocardial infarction based on ST-segment elevation. It is unclear whether seasonal and circadian variations are equally present in warmer and colder regions. We investigated whether seasonal and circadian variations in acute myocardial infarction (AMI) are more prominent in colder northern states compared with warmer southern states. We also investigated the peak time of admission to better understand the circadian rhythm. METHODS Data from the GWTG-CAD database were used. We analyzed 82,971 consecutive acute myocardial infarction (AMI) patients treated at 276 US centers from 2003 to 2008. The country was geographically divided into warmer southern and colder northern states using latitude 35 degrees for this purpose. RESULTS Overall, acute myocardial infarction (AMI) admissions varied across seasons (P < .01), and were higher in winter (winter vs. spring n = 21,483 vs. 20,291, respectively). When stratified based on type of AMI, non-ST-segment elevation myocardial infarction (NSTEMI) admissions varied across seasons (P < .01) and were highest in winter and lowest in spring. Seasonal variation was not significant in STEMI admissions (P = .30). Seasonal variation with winter predominance was noted in AMI patients in warmer southern states (P < .01), but not in colder states. The distributions of length of stay for AMI patients and door to balloon times for STEMI patients were minimally different across all four seasons (P < .01) with longest occurring in winter. Most patients with AMI presented during daytime with a peak close to 11 am and a nadir at approximately 4 am. CONCLUSIONS Seasonal variation with winter predominance exists in AMI admissions and was significant in NSTEMI admissions but not in STEMI admissions. Seasonal variation was only significant in warmer southern states.
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Pintaric S, Jelavic MM, Nesek V, Babic Z, Vrsalovic M, Knezovic M, Bielen J, Zeljkovic I, Pintaric H. The influence of air pollutants on appearance of acute myocardial infarction in the region with humid continental climate. Am J Emerg Med 2016; 34:1679-82. [DOI: 10.1016/j.ajem.2016.04.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 04/29/2016] [Accepted: 04/30/2016] [Indexed: 01/06/2023] Open
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11
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Non-ST Elevation Myocardial Infarction with Occluded Artery and its Clinical Implications. Heart Lung Circ 2014; 23:1132-40. [DOI: 10.1016/j.hlc.2014.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 05/19/2014] [Accepted: 05/21/2014] [Indexed: 11/18/2022]
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12
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Ravljen M, Bilban M, Kajfež-Bogataj L, Hovelja T, Vavpotič D. Influence of daily individual meteorological parameters on the incidence of acute coronary syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11616-26. [PMID: 25396770 PMCID: PMC4245633 DOI: 10.3390/ijerph111111616] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/03/2014] [Accepted: 11/04/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND A nationwide study was conducted to explore the short term association between daily individual meteorological parameters and the incidence of acute coronary syndrome (ACS) treated with coronary emergency catheter interventions in the Republic of Slovenia, a south-central European country. METHOD We linked meteorological data with daily ACS incidence for the entire population of Slovenia, for the population over 65 years of age and for the population under 65 years of age. Data were collected daily for a period of 4 years from 1 January 2008 to 31 December 2011. In line with existing studies, we used a main effect generalized linear model with a log-link-function and a Poisson distribution of ACS. RESULTS AND CONCLUSIONS Three of the studied meteorological factors (daily average temperature, atmospheric pressure and relative humidity) all have relevant and significant influences on ACS incidences for the entire population. However, the ACS incidence for the population over 65 is only affected by daily average temperature, while the ACS incidence for the population under 65 is affected by daily average pressure and humidity. In terms of ambient temperature, the overall findings of our study are in line with the findings of the majority of contemporary European studies, which also note a negative correlation. The results regarding atmospheric pressure and humidity are less in line, due to considerable variations in results. Additionally, the number of available European studies on atmospheric pressure and humidity is relatively low. The fourth studied variable-season-does not influence ACS incidence in a statistically significant way.
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Affiliation(s)
- Mirjam Ravljen
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena Pot 5, SI-1000 Ljubljana, Slovenia.
| | - Marjan Bilban
- Institute of Occupational Safety, Chengdujska Cesta 25, SI-1260 Ljubljana-Polje, Slovenia.
| | - Lučka Kajfež-Bogataj
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia.
| | - Tomaž Hovelja
- Information Systems Laboratory, Faculty of Computer and Information Science, University of Ljubljana, Tržaška 25, SI-1000 Ljubljana, Slovenia.
| | - Damjan Vavpotič
- Information Systems Laboratory, Faculty of Computer and Information Science, University of Ljubljana, Tržaška 25, SI-1000 Ljubljana, Slovenia.
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13
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Rott D, Nowatzky J, Teddy Weiss A, Chajek-Shaul T, Leibowitz D. ST deviation pattern and infarct related artery in acute myocardial infarction. Clin Cardiol 2010; 32:E29-32. [PMID: 19816991 DOI: 10.1002/clc.20484] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myocardial infarction (MI) may be classified as ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI). There is little data regarding the relationship between the infarct related artery (IRA), clinical characteristics of the patients, and the ST deviation pattern (ie, STEMI or NSTEMI). HYPOTHESIS There is a predilection of any coronary artery to a particular ST deviation pattern of acute MI. METHODS We reviewed our institutional database and selected patients who presented with an acute MI and underwent coronary angiography within 7 days of admission. The analysis included 830 patients of whom 563 had STEMI and 267 had NSTEMI. The culprit lesion was defined by reviewing each patient's angiographic report, electrocardiogram, and echocardiogram. TIMI flow rate was determined. RESULTS The IRA in STEMI was most frequently the left anterior descending coronary artery (LAD) followed by the right coronary artery (RCA) and then the left circumflex coronary artery (LCX), a statistically significant difference. In patients with NSTEMI there were no significant differences in IRA. Patients with STEMI and LCX as the IRA were significantly younger and had a higher percentage of TIMI grade 3 flow then patients with STEMI and LAD or RCA as IRAs. These differences were not noted in patients with NSTEMI regardless of IRA. CONCLUSIONS In STEMI there were significant differences in age and TIMI flow depending on the IRA. These findings were not demonstrated in patients with NSTEMI.
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Affiliation(s)
- David Rott
- Department of Medicine, Hadassah-Hebrew University Medical Center, Mt. Scopus, P.O.B 24035, Jerusalem 91240, Israel.
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Portaluppi F, Cortelli P, Buonaura GC, Smolensky MH, Fabbian F. Do restless legs syndrome (RLS) and periodic limb movements of sleep (PLMS) play a role in nocturnal hypertension and increased cardiovascular risk of renally impaired patients? Chronobiol Int 2009; 26:1206-21. [PMID: 19731113 DOI: 10.3109/07420520903245276] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hypertension can cause or promote renal failure and is related to cardiovascular mortality, the major cause of death in patients with renal impairment. Changes in the circadian BP pattern, particularly the blunting or reversal of the nocturnal decline in BP, are common in chronic renal failure. These changes in turn are among the major determinants of left ventricular hypertrophy. Using a chronobiological approach, it is possible to obtain better insight into the reciprocal relationship between hypertension, renal disease, and increased cardiovascular risk of renal patients. Disruption of the normal circadian rhythm of rest/activity may be hypothesized to underlie the high cardiovascular morbidity and mortality of such patients. Epidemiological studies reveal that hemodialysis patients experience poor subjective sleep quality and insomnia and, in comparison to healthy persons, are more likely to show shorter sleep duration and lower sleep efficiency. Sleep apnea may be present and is usually investigated in these patients; however, the prevalence of restless legs syndrome (RLS), which is high in dialysis patients and which has been associated with increased risk for cardiovascular disease in the general population, could also play a role in the pathogenesis of sleep-time hypertension in renal patients. Careful assessment of sleep quality, in particular, diagnostic screening for RLS and periodic limb movements (PLM) in renal patients, is highly recommended. In renal failure, attention to sleep quality and related perturbations of the sleep/wake cycle may help prevent the occurrence and progression of cardiovascular disease.
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Affiliation(s)
- Francesco Portaluppi
- Hypertension Center and Clinica Medica, University Hospital S. Anna of Ferrara, Ferrara, Italy.
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Lemmer B. Discoveries of rhythms in human biological functions: a historical review. Chronobiol Int 2009; 26:1019-68. [PMID: 19731105 DOI: 10.3109/07420520903237984] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Though there are very early and ancient observations on the daily variation in physiological and pathophysiological functions (e.g., bronchial asthma), more detailed and scientific reports were not published until the beginning of the 17th century. The aim of this review is to bring those reports to the attention of researchers of chronobiology and chronopharmacology. The ancient books and their contents, which constitute the basis for this review, are part of the personal library collection of the author; numerous observations and reports on biologic rhythms in man are presented here for the first time. The intent of this review is to demonstrate that the fields of chronobiology and chronopharmacology are not only a new and modern branch of science, but that it stands on the shoulders of wonderful and insightful observations and explanations made by our scientific forefathers. It is the hope that the reader will enjoy the richness of the ancient reports that contribute to our present knowledge achieved through astute early biologic rhythm research.
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Affiliation(s)
- Björn Lemmer
- Institute of Experimental and Clinical Pharmacology and Toxicology, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany.
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Lee H, Hu C, Chen C, Lin H. Seasonal Variation in Ischemic Stroke Incidence and Association with Climate: A Six‐Year Population‐Based Study. Chronobiol Int 2009; 25:938-49. [DOI: 10.1080/07420520802551469] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cheng TO. Seasonal variation in acute myocardial infarction. Int J Cardiol 2009; 135:277-9. [DOI: 10.1016/j.ijcard.2008.12.075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 12/17/2008] [Indexed: 11/16/2022]
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