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温度对急性心肌梗死每日急诊就诊的短期影响及阈值温度

Short-term effect of temperature on daily emergency visits for acute myocardial infarction with threshold temperatures.

作者信息

Lee Suji, Lee Eunil, Park Man Sik, Kwon Bo Yeon, Kim Hana, Jung Dea Ho, Jo Kyung Hee, Jeong Myung Ho, Rha Seung-Woon

机构信息

Department of Public Health, Graduate School, Korea University, Seoul, South Korea; Graduate School of Public Health, Graduate School, Korea University, Seoul, Korea.

Department of Public Health, Graduate School, Korea University, Seoul, South Korea; Department of Preventive Medicine, College of medicine, Korea University, Seoul, Korea; Graduate School of Public Health, Graduate School, Korea University, Seoul, Korea.

出版信息

PLoS One. 2014 Apr 25;9(4):e94070. doi: 10.1371/journal.pone.0094070. eCollection 2014.

Abstract

BACKGROUND

The relationship between temperature and myocardial infarction has not been fully explained. In this study, we identified the threshold temperature and examined the relationship between temperature and emergency admissions due to MI in Korea.

METHODS

Poisson generalized additive model analyses were used to assess the short-term effects of temperature (mean, maximum, minimum, diurnal) on MI emergency visits, after controlling for meteorological variable and air pollution (PM10, NO2). We defined the threshold temperature when the inflection point showed a statistically significant difference in the regression coefficients of the generalized additive models (GAMs) analysis. The analysis was performed on the following subgroups: geographical region, gender, age (<75 years or ≥ 75 years), and MI status (STEMI or non-STEMI).

RESULTS

The threshold temperatures during heat exposure were for the maximum temperature as 25.5-31.5°C and for the mean temperature as 27.5-28.5°C. The threshold temperatures during cold exposure were for the minimum temperature as -2.5-1.5°C. Relative risks (RRs) of emergency visits above hot temperature thresholds ranged from 1.02 to 1.30 and those below cold temperature thresholds ranged from 1.01 to 1.05. We also observed increased RRs ranged from 1.02 to 1.65 of emergency visits when temperatures changes on a single day or on successive days.

CONCLUSIONS

We found a relationship between temperature and MI occurrence during both heat and cold exposure at the threshold temperature. Diurnal temperature or temperature change on successive days also increased MI risk.

摘要

背景

温度与心肌梗死之间的关系尚未完全阐明。在本研究中,我们确定了阈值温度,并探讨了韩国温度与因心肌梗死导致的急诊入院之间的关系。

方法

采用泊松广义相加模型分析来评估温度(平均温度、最高温度、最低温度、日温差)对心肌梗死急诊就诊的短期影响,同时控制气象变量和空气污染(PM10、NO2)。当广义相加模型(GAMs)分析的回归系数在拐点处显示出统计学显著差异时,我们定义为阈值温度。分析在以下亚组中进行:地理区域、性别、年龄(<75岁或≥75岁)以及心肌梗死状态(ST段抬高型心肌梗死或非ST段抬高型心肌梗死)。

结果

热暴露期间的阈值温度,最高温度为25.5 - 31.5°C,平均温度为27.5 - 28.5°C。冷暴露期间的阈值温度,最低温度为 - 2.5 - 1.5°C。高于热温度阈值时急诊就诊的相对风险(RRs)范围为1.02至1.30,低于冷温度阈值时范围为1.01至1.05。我们还观察到,当单日或连续几日温度变化时,急诊就诊的RRs增加范围为1.02至1.65。

结论

我们发现在阈值温度下,热暴露和冷暴露期间温度与心肌梗死发生之间存在关联。日温差或连续几日的温度变化也会增加心肌梗死风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f29/4000206/d3529f8fc83e/pone.0094070.g001.jpg

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