Royé Dominic, Zarrabeitia María Teresa, Fdez-Arroyabe Pablo, Álvarez Gutiérrez Alberto, Santurtún Ana
Departamento de Geografía, Universidade do Porto, Porto, Portugal.
Unidad de Medicina Legal y Toxicología, Departamento de Fisiología y Farmacología, Universidad de Cantabria, Santander, Cantabria, Spain.
Rev Esp Cardiol (Engl Ed). 2019 Aug;72(8):634-640. doi: 10.1016/j.rec.2018.07.009. Epub 2018 Sep 5.
The role of the environment on cardiovascular health is becoming more prominent in the context of global change. The aim of this study was to analyze the relationship between apparent temperature (AT) and air pollutants and acute myocardial infarction (AMI) and to study the temporal pattern of this disease and its associated mortality.
We performed a time-series study of admissions for AMI in Cantabria between 2001 and 2015. The association between environmental variables (including a biometeorological index, AT) and AMI was analyzed using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of these variables on AMI, a lag non-linear model was fitted in a generalized additive model.
The incidence rate and the mortality followed a downward trend during the study period (CC=-0.714; P=.0002). An annual pattern was found in hospital admissions (P=.005), with the highest values being registered in winter; a weekly trend was also identified, reaching a minimum during the weekends (P=.000005). There was an inverse association between AT and the number of hospital admissions due to AMI and a direct association with particulate matter with a diameter smaller than 10 μm.
Hospital admissions for AMI followed a downward trend between 2007 and 2015. Mortality associated with admissions due to this diagnosis has decreased. Predictive factors for this disease were AT and particulate matter with a diameter smaller than 10 μm.
在全球变化的背景下,环境对心血管健康的作用日益凸显。本研究旨在分析体感温度(AT)与空气污染物和急性心肌梗死(AMI)之间的关系,并研究该疾病及其相关死亡率的时间模式。
我们对2001年至2015年坎塔布里亚地区急性心肌梗死入院病例进行了时间序列研究。使用准泊松回归模型分析环境变量(包括生物气象指数,AT)与急性心肌梗死之间的关联。为评估这些变量对急性心肌梗死的潜在延迟和非线性影响,在广义相加模型中拟合了滞后非线性模型。
在研究期间,发病率和死亡率呈下降趋势(CC = -0.714;P = 0.0002)。在住院病例中发现了年度模式(P = 0.005),冬季的数值最高;还确定了每周的趋势,周末达到最低值(P = 0.000005)。体感温度与急性心肌梗死导致的住院人数之间存在负相关,与直径小于10μm的颗粒物存在正相关。
2007年至2015年期间,急性心肌梗死的住院人数呈下降趋势。因该诊断入院导致的死亡率有所下降。该疾病的预测因素是体感温度和直径小于10μm的颗粒物。