Baylin Ana, Hernandez-Diaz Sonia, Siles Xinia, Kabagambe Edmond K, Campos Hannia
Department of Community Health, Brown University, 121 South Main Street, Providence, RI 02903, USA.
Ann Epidemiol. 2007 Feb;17(2):112-8. doi: 10.1016/j.annepidem.2006.05.004.
There are no data for factors that could trigger myocardial infarction (MI) in the context of lifestyles in developing countries.
Using a case-crossover design, we assessed the effect of heavy physical exertion, sexual activity, acute respiratory tract infections, and gastroenteritis as triggers for MI in 530 survivors of a first MI from Costa Rica.
Relative risks (RRs) for MI in the hour after heavy physical exertion and 2 hours after sexual activity were 4.94 (95% confidence interval [CI], 3.73-6.54) and 5.47 (95% CI, 2.71-11.02). Risk for MI after heavy physical exertion was greater for patients with poor physical fitness or elevated underlying cardiovascular risk (p < 0.0001 and p = 0.06, tests of homogeneity). RRs for acute respiratory tract infection and gastroenteritis were 1.48 (95% CI, 0.92-2.38) and 1.27 (95% CI, 0.95-1.69), respectively. Patients with three or more risk factors had an RR for MI for gastroenteritis of 2.08 (95% CI, 1.31-3.28).
Our results confirm previous studies in developed countries showing that heavy physical exertion and sexual activity are potential triggers for MI, and their effect is modified by physical fitness and underlying cardiovascular risk. Additional studies that explore the biologic effects of gastroenteritis as triggers of MI are warranted.
在发展中国家的生活方式背景下，尚无关于可能引发心肌梗死（MI）的因素的数据。
采用病例交叉设计，我们评估了剧烈体力活动、性活动、急性呼吸道感染和肠胃炎作为来自哥斯达黎加的530例首次心肌梗死幸存者发生心肌梗死的触发因素的影响。
剧烈体力活动后1小时和性活动后2小时发生心肌梗死的相对风险（RRs）分别为4.94（95%置信区间[CI]，3.73 - 6.54）和5.47（95%CI，2.71 - 11.02）。身体状况不佳或潜在心血管风险升高的患者，剧烈体力活动后发生心肌梗死的风险更高（p < 0. , 0001和p = 0.06，齐性检验）。急性呼吸道感染和肠胃炎的RRs分别为1.48（95%CI，0.92 - 2.38）和1.27（95%CI，0.95 - 1.69）。有三个或更多风险因素的患者，肠胃炎导致心肌梗死的RR为2.08（95%CI，1.31 - 3.28）。
我们的结果证实了发达国家先前的研究，表明剧烈体力活动和性活动是心肌梗死的潜在触发因素，其影响因身体素质和潜在心血管风险而改变。有必要进行更多研究来探索肠胃炎作为心肌梗死触发因素的生物学效应。
