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Int J Cardiol. 2015 Mar 15;183:17-23. doi: 10.1016/j.ijcard.2015.01.078. Epub 2015 Jan 28.

Short-term exposure to environmental parameters and onset of ST elevation myocardial infarction. The CARDIO-ARSIF registry.

Author information

1
Institut Mutualiste Montsouris, Paris, France.
2
INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
3
Agence Régionale de Santé d'Ile de France, Paris, France.
4
Observatoire Régional de Santé d'Ile de France, Paris, France.
5
SAMU 78, CH Versailles, France.
6
Hôpital Foch, Suresnes, France; ICPS, Massy, France.
7
ICPS, Quincy, France.
8
Hôpital Bichat, Paris, France.
9
Hôpital Cochin, France.
10
Hôpital Henri Mondor, Créteil, France.
11
Department of Cardiology, CH Versailles, France.
12
INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France. Electronic address: christian.spaulding@egp.aphp.fr.
13
INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.

Abstract

BACKGROUND:

Environmental parameters have been reported to be triggers of acute myocardial infarction (MI). However, the individual role of each parameter is unknown. We quantified the respective association of climate parameters, influenza epidemics and air pollutants with the onset of ST elevation MI (STEMI) in Paris and the surrounding small ring.

METHODS:

Data from the CARDIO-ARSIF registry (Paris and small ring STEMI population), Météo France (Climate), GROG (Influenza epidemic) and AIRPARIF (Air Pollution) were analyzed. The association between short-term exposure (1 day lag time) to environmental parameters and STEMI occurrence was quantified by time series modeling of daily STEMI count data, using Poisson regression with generalized additive models.

RESULTS:

Between 2003 and 2008, 11,987 <24H STEMI confirmed by angiography were adjudicated. There was a 5.0% excess relative risk (ERR) of STEMI per 10°C decrease in maximal temperature (95% CI 2.1% to 7.8%: p=0.001) and an 8.9% ERR (95% CI 3.2% to 14.9%: p=0.002) during an influenza epidemic after adjustment on week-days and holidays. Associations were consistent when short-term exposure varied from 2 to 7 days. Associations between lower temperatures and STEMI were stronger in magnitude when influenza epidemic was present. Short-term exposure to climatic parameters or pollutants was not associated with STEMI.

CONCLUSIONS:

The present population based registry of STEMI suggests that short-term exposure to lower temperature and influenza epidemic is associated with a significant excess relative risk of STEMI. Subjects at risk for MI may benefit from specific protections against cold temperature and influenza infection.

KEYWORDS:

Acute coronary syndrome; Air pollutants; Climate; Influenza; Myocardial infarction

PMID:
25662048
DOI:
10.1016/j.ijcard.2015.01.078
[Indexed for MEDLINE]

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