Moschos Nikitas, Christoforaki Marietta, Antonatos Panagiotis
General Hospital of Rhodes, Rhodes, Greece
Int J Cardiol. 2004 Jan;93(1):39-44. doi: 10.1016/s0167-5273(03)00124-4.
There is evidence that acute myocardial infraction (aMI) occurs more frequently in certain seasons and months of the year. Recently various infectious agents have been implicated in atherogenesis. In the present study we recorded the seasonal distribution of aMI and evaluated its relation to acute systemic infections (AIs).
The study included 1196 patients with aMI hospitalized during the years 1988-1998 in the General Hospital of the island of Rhodes and 2976 patients with AI during the years 1993-1998. Foreigners or visitors in the island were excluded to avoid their influence in the annual distribution. We corrected the absolute number of the aMI and AI cases by month and season in such a way that all months and seasons would have standard 30 and 90 days, respectively.
During the entire period of the study, more patients with aMI were hospitalized in winter [30.7%, 95% confidence limits (CL) 28.1 to 33.3%]. In spring the percentage of aMI cases hospitalized was 24.5% (CL 22.1-27%), in summer 23.2% (CL 20.1-25.6%) and in autumn 21.6% (CL 19.2 -24%). There were 42.35% more cases hospitalized in winter than in autumn. The monthly distribution showed that March was the month with the most aMI cases (10.83%, CL 9.06-12.6% ) and October with the fewest (6%, CL 4.65-7.35%). The percentage of patients with AI hospitalized in winter was 30.5% (CL 28.8-32.2%), in spring 25.2% (23.6-26.7), in summer 23.5% (CL 22-25%) and in autumn 20.8% (CL 19.4-22.3%). The correlation coefficient (r) between the distribution of aMI and AI was 0.73 (P<0.01).
Our results indicate that (1) there is a seasonal distribution in aMI with the winter being the season of the highest incidence of aMI and autumn of the lowest and (2) there is a significant correlation of the distribution of aMI to AI cases, which is of interest in the understanding of the pathogenesis of acute coronary syndromes.
有证据表明，急性心肌梗死（aMI）在一年中的某些季节和月份更为频发。近来，各种感染因子被认为与动脉粥样硬化的发生有关。在本研究中，我们记录了aMI的季节分布情况，并评估了其与急性全身感染（AIs）的关系。
本研究纳入了1988年至1998年期间在罗德岛综合医院住院的1196例aMI患者，以及1993年至1998年期间的2976例AIs患者。排除了岛上的外国人或访客，以避免他们对年度分布产生影响。我们按照所有月份和季节分别具有标准的30天和90天的方式，对aMI和AIs病例的绝对数量进行逐月和逐季校正。
在整个研究期间，冬季住院的aMI患者更多[30.7%，95%置信区间（CL）28.1%至33.3%]。春季住院的aMI病例百分比为24.5%（CL 22.1% - 27%），夏季为23.2%（CL 20.1% - 25.6%），秋季为21.6%（CL 19.2% - 24%）。冬季住院病例比秋季多42.35%。月度分布显示，3月是aMI病例最多的月份（10.83%，CL 9.06% - 12.6%），10月最少（6%，CL 4.65% - 7.35%）。冬季住院的AIs患者百分比为30.5%（CL 28.8% - 32.2%），春季为25.2%（23.6% - 26.7%），夏季为23.5%（CL 22% - 25%），秋季为20.8%（CL 19.4% - 22.3%）。aMI和AIs分布之间的相关系数（r）为0.73（P<0.01）。
我们的结果表明：（1）aMI存在季节分布，冬季是aMI发病率最高的季节，秋季最低；（2）aMI的分布与AIs病例之间存在显著相关性，这对于理解急性冠脉综合征的发病机制具有重要意义。
