Unità Operativa Complessa di Cardiologia, Ospedale Santa Maria Goretti, Latina, Italy.
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy.
Int J Cardiol. 2019 Nov 1;294:1-5. doi: 10.1016/j.ijcard.2019.07.006. Epub 2019 Jul 3.
The impact of seasonal changes on the incidence of acute myocardial infarction has been incompletely appraised, especially in the modern era of primary percutaneous coronary intervention (PPCI). We aimed to appraise the overall and season-specific impact of climate changes on the daily rate of PCCI.
Details on PPCI and climate changes were retrospectively collected in three high-volume Italian institutions with different geographical features. The association between rate of PPCI and temperature, atmospheric pressure (ATM), humidity and rainfall was appraised with Poisson models, with overall analyses and according to season of the year.
Details on 6880 days with a total of 4132 PPCI were collected. Overall adjusted analysis showed that higher minimum atmospheric pressure 3 days before PPCI were associated with lower risk (regression coefficient = 0.999 [95% confidence interval 0.998-1.000], p = 0.030). Focusing on season, in Winter PPCI rates were increased by lower same day mean temperature (0.973 [0.956-0.990], p = 0.002) and lower rainfall (0.980 [0.960-1.000], p = 0.049). Conversely, in Spring greater changes in atmospheric pressure 3 days before PPCI were associated with increased risk (1.023 [1.002-1.045], p = 0.032), with similar effects in Summer for minimum temperature on the same day (1.022 [1.001-1.044], p = 0.040).
Climate has a significant impact on the risk of PPCI in the current era, with a complex interplay according to season. Higher risk risk is expected with lower minimum atmospheric pressure in the preceding days, lower rainfall in Winter, greater changes in atmospheric pressure in Spring, and higher temperatures in Summer. These findings have important implications for prevention strategies.
季节变化对急性心肌梗死发病率的影响尚未得到充分评估，尤其是在经皮冠状动脉介入治疗（PPCI）的现代时代。我们旨在评估气候变化对 PPCI 日发生率的整体和特定季节的影响。
在具有不同地理特征的三个意大利大容量机构中，回顾性地收集了有关 PPCI 和气候变化的详细信息。使用泊松模型评估 PPCI 率与温度、大气压（ATM）、湿度和降雨量之间的关联，进行总体分析并按季节进行分析。
共收集了 6880 天 4132 例 PPCI 的详细信息。总体调整分析表明，PPCI 前 3 天的最低大气压升高与风险降低相关（回归系数=0.999 [95%置信区间 0.998-1.000]，p=0.030）。按季节来看，在冬季，当日平均温度较低（0.973 [0.956-0.990]，p=0.002）和降雨量较低（0.980 [0.960-1.000]，p=0.049）时，PPCI 率会增加。相反，在春季，PPCI 前 3 天大气压变化较大与风险增加相关（1.023 [1.002-1.045]，p=0.032），夏季当日最低温度也有类似影响（1.022 [1.001-1.044]，p=0.040）。
在当前时代，气候对 PPCI 的风险有重大影响，且根据季节的不同，其相互作用也较为复杂。预计前几天的最低大气压升高、冬季降雨量减少、春季大气压变化较大、夏季温度升高，风险会增加。这些发现对预防策略有重要意义。
