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Meteorological triggering of ST-elevation Myocardial Infarction
Session:
Painel 6 - Doença Coronária 10
Speaker:
Marta Fontes Oliveira
Congress:
CPC 2020
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Marta Fontes Oliveira; Susete Vieira; Mariana Santos; Rui Magalhães; Ricardo Costa; André Luz; Severo Torres
Abstract
<p><strong>Background</strong>: Some studies have linked meteorological factors to the pathophysiology of ST-elevation Myocardial Infarction (STEMI). Since its impact in Portugal is unknown, we sought to evaluate if certain weather characteristics influence the STEMI-incidence over the past 7 years.</p> <p><strong>Methods:</strong> Retrospective analysis of a consecutive series of STEMI-patients confirmed by primary percutaneous coronary intervention at single center from January 2010 to December 2017 (2922 days). Meteorological data was obtained from IPMA – Instituto Português do Mar e Atmosfera – a government-lead institute, comprising the coverage of our region (aprox. 250 000 inhabitants). The following atmospheric variables were analyzed: atmospheric temperature (mean, minimum, maximum), relative humidity (RH, %), rainfall and atmospheric pressure. The statistical analysis was performed using Generalized Linear Models (GLM) with a Poisson distribution, and a series of models with multivariate analysis were considered for exposure at different days before the event. The effects (GLM coefficients) are presented as excess relative risk (ERR) for a unit drop in the temperature parameters and for a unit rise in the RH.</p> <p><strong>Results: </strong>1004 STEMI-patients confirmed by PCI had their data completed and were included in the study. We observed 25% more events in winter than in summer (ERR 25.1, 95% CI 4.5 to 49.7, p=0.015). Minimum temperature at 2 days before (ERR 1.9%, 95% CI 0.5 to 3.3, p=0.009) and RH 1 and 3 days before STEMI were associated with STEMI admission rates (ERR -0.6%, 95% CI -0.11 to -0.1, p=0.023 and ERR 0.7%, 95% CI 0.2 to 1.3, p=0.006, respectively). In multivariate analysis after adjustment for season of the year, RH 1 and 3 days before the event were independent predictors for STEMI admission. Other climate parameters such as temperature range, atmospheric pressure and precipitation were not associated with STEMI-incidence.</p> <p><strong>Conclusion: </strong>Lowest minimum temperatures 2 days before, lowest RH in the previous day and highest RH in the previous 3 days are associated with a higher incidence of STEMI. These features are aligned with some European cohorts and may drive the allocation of resources to accommodate expected rises in STEMI-incidence.</p>
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