Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden.
JAMA Cardiol. 2018 Nov 1;3(11):1081-1089. doi: 10.1001/jamacardio.2018.3466.
Whether certain weather conditions modulate the onset of myocardial infarction (MI) is of great interest to clinicians because it could be used to prevent MIs as well as guide allocation of health care resources.
To determine if weather is associated with day-to-day incidence of MI.
DESIGN, SETTING, AND PARTICIPANTS: In this prospective, population-based and nationwide setting, daily weather data from the Swedish Meteorological and Hydrological Institute were extracted for all MIs reported to the Swedish nationwide coronary care unit registry, Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART), during 1998 to 2013 and then merged with each MI on date of symptom onset and coronary care unit. All patients admitted to any coronary care unit in Sweden owing to MI were included. A total of 280 873 patients were included, of whom 92 044 were diagnosed as having ST-elevation MI. Weather data were available for 274 029 patients (97.6%), which composed the final study population. Data were analyzed between February 2017 and April 2018.
The nationwide daily mean air temperature, minimum air temperature, maximum air temperature, wind velocity, sunshine duration, atmospheric air pressure, air humidity, snow precipitation, rain precipitation, and change in air temperature.
The nationwide daily counts of MI as outcome.
In 274 029 patients, mean (SD) age was 71.7 (12) years. Incidence of MI increased with lower air temperature, lower atmospheric air pressure, higher wind velocity, and shorter sunshine duration. The most pronounced association was observed for air temperature, where a 1-SD increase in air temperature (7.4°C) was associated with a 2.8% reduction in risk of MI (unadjusted incidence ratio, 0.972; 95% CI, 0.967-0.977; P <.001). Results were consistent for non-ST-elevation MI as well as ST-elevation MI and across a large range of subgroups and health care regions.
In this large, nationwide study, low air temperature, low atmospheric air pressure, high wind velocity, and shorter sunshine duration were associated with risk of MI with the most evident association observed for air temperature.
某些天气条件是否会影响心肌梗死 (MI) 的发作，这对临床医生来说非常重要，因为这可以用于预防 MI 发作，并指导医疗资源的分配。
确定天气是否与 MI 的日常发病有关。
设计、设置和参与者：在这个前瞻性、基于人群和全国范围内的研究中，从瑞典气象和水文研究所提取了 1998 年至 2013 年期间报告给瑞典全国性的冠心病监护病房登记处（瑞典 Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies [SWEDEHEART]）的所有 MI 的每日天气数据，然后与每个 MI 的发病日期和冠心病监护病房进行了合并。所有因 MI 而被收入瑞典任何冠心病监护病房的患者均被纳入研究。共纳入 280873 例患者，其中 92044 例被诊断为 ST 段抬高型 MI。天气数据可用于 274029 例患者（97.6%），这些患者构成了最终的研究人群。数据分析于 2017 年 2 月至 2018 年 4 月进行。
全国范围内每日平均气温、最低气温、最高气温、风速、日照时间、大气气压、空气湿度、雪量、雨量和气温变化。
MI 的全国每日发生率。
在 274029 例患者中，平均（SD）年龄为 71.7（12）岁。MI 的发生率随着气温降低、大气压降低、风速升高和日照时间缩短而升高。与空气温度的关联最为显著，空气温度每升高 1 个标准差（7.4°C），MI 的风险降低 2.8%（未校正发病率比，0.972；95%CI，0.967-0.977；P<0.001）。非 ST 段抬高型 MI 以及 ST 段抬高型 MI 以及广泛的亚组和医疗保健区域均有一致的结果。
在这项大规模的全国性研究中，低气温、低大气压、高风速和短日照时间与 MI 风险相关，与气温的关联最为显著。
