1Heart & Vascular Institute,Tulane University School of Medicine,New Orleans,Louisiana.
2Division of Cardiovascular Medicine,University of Maryland School of Medicine,Baltimore,Maryland.
Disaster Med Public Health Prep. 2019 Apr;13(2):217-222. doi: 10.1017/dmp.2018.22. Epub 2018 Apr 12.
The purpose of this study was to investigate the 10-year impact of Hurricane Katrina on the incidence of acute myocardial infarction (AMI) along with contributing risk factors and any alteration in chronobiology of AMI.
A single-center, retrospective, comparison study of AMI incidence was performed at Tulane University Health Sciences Center from 2 years before Hurricane Katrina to 10 years after Hurricane Katrina. A 6-year, pre-Katrina and 10-year, post-Katrina cohort were also compared according to pre-specified demographic, clinical, and chronobiological data.
AMI incidence increased from 0.7% (150/21,079) to 2.8% (2,341/84,751) post-Katrina (P<0.001). The post-Katrina cohort had higher rates of coronary artery disease (36.4% vs. 47.9%, P=0.01), diabetes mellitus (31.3% vs. 39.9%, P=0.04), hyperlipidemia (45.4% vs. 59.3%, P=0.005), smoking (34.4% vs. 53.8%, P<0.001), drug abuse (10.2% vs. 15.4%, P=0.02), psychiatric illness (6.7% vs. 14.9%, P<0.001), medication non-adherence (7.3% vs. 15.3%, P<0.001), and lack of employment (7.2% vs. 16.4%, P<0.001). The post-Katrina group had increased rates of AMI during nights (29.8% vs. 47.8%, P<0.001) and weekends (16.1% vs. 29.1%, P<0.001).
Even 10 years after the storm, Hurricane Katrina continues to be associated with increased incidence of AMI, higher prevalence of traditional cardiovascular and psychosocial risk factors, and an altered chronobiology of AMI toward nights and weekends. (Disaster Med Public Health Preparedness. 2019;13:217-222).
本研究旨在探讨卡特里娜飓风对急性心肌梗死（AMI）发病率的 10 年影响，以及相关致病因素和 AMI 昼夜节律变化。
在卡特里娜飓风前 2 年至飓风后 10 年，我们对杜兰大学健康科学中心的 AMI 发病率进行了单中心回顾性比较研究。还根据预先指定的人口统计学、临床和昼夜节律数据比较了 6 年前（卡特里娜飓风前）和 10 年后（卡特里娜飓风后）的队列。
AMI 发病率从飓风前的 0.7%（150/21079）增加到飓风后的 2.8%（2341/84751）（P<0.001）。飓风后队列的冠心病（36.4%比 47.9%，P=0.01）、糖尿病（31.3%比 39.9%，P=0.04）、高脂血症（45.4%比 59.3%，P=0.005）、吸烟（34.4%比 53.8%，P<0.001）、药物滥用（10.2%比 15.4%，P=0.02）、精神疾病（6.7%比 14.9%，P<0.001）、药物不依从（7.3%比 15.3%，P<0.001）和失业（7.2%比 16.4%，P<0.001）的发生率更高。与夜间（29.8%比 47.8%，P<0.001）和周末（16.1%比 29.1%，P<0.001）相比，飓风后组 AMI 的发生率更高。
即使在风暴发生 10 年后，卡特里娜飓风仍与 AMI 发病率增加、传统心血管和心理社会风险因素更为普遍以及 AMI 昼夜节律向夜间和周末改变有关。（灾难医学与公共卫生准备。2019；13：217-222）。
