Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia.
Environ Res. 2021 Nov;202:111691. doi: 10.1016/j.envres.2021.111691. Epub 2021 Jul 28.
Day-to-day change in ambient temperature is associated with acute myocardial infarction (AMI) attacks, but evidence is scarce about the effects of extreme temperatures on the risk of AMI within hours of exposure. This study investigated the hour-level associations between extreme temperatures and AMI occurrence. State-wide data on AMI patients and temperature during winter and summer of 2013-2015 were obtained for Queensland state of Australia. We employed a fixed time-stratified case-crossover analysis to quantify the risk of AMI associated with temperature within 24 h after exposure. Subgroups analyses by age, gender and disease history were also conducted. We observed a very acute effect of cold on men (occurred 9-10 h after exposure), women (19-22 h after exposure), and the elderly (4-20 h after exposure). Cold was associated with elevated AMI risk for men within 9 h (OR = 2.1, 95 % CI: 1.2-3.6), women within 19 h (OR = 2.5, 95 % CI: 1.0-6.0), and the elderly within 4 h (OR: 2.0, 95 % CI: 1.0-4.0). However, elevated risk of AMI associated with heat occurred 15 h later for men (OR: 3.9; 95 % CI: 1.1-13.9) and 23 h later for adults (OR: 4.1, 95 % CI: 1.1-15.4). People never suffered AMI and the elderly with diabetes or hyperlipidaemia were particularly vulnerable to cold. Those that were particularly vulnerable to heat were men never experienced AMI or having hypertension or having hyperlipidaemia as well as women ever suffered AMI. Effects of temperature on AMI risk at sub-daily timescales should be considered to prevent cardiac events.
日常环境温度变化与急性心肌梗死（AMI）发作有关，但关于暴露后数小时内极端温度对 AMI 风险的影响证据有限。本研究调查了极端温度与 AMI 发生之间的小时级关联。我们获得了澳大利亚昆士兰州 2013-2015 年冬季和夏季的 AMI 患者和温度的全州数据。我们采用固定时间分层病例交叉分析来量化暴露后 24 小时内温度与 AMI 风险之间的关系。还按年龄、性别和疾病史进行了亚组分析。我们观察到寒冷对男性（暴露后 9-10 小时）、女性（暴露后 19-22 小时）和老年人（暴露后 4-20 小时）的影响非常急性。寒冷与男性 AMI 风险升高有关，暴露后 9 小时内（OR=2.1，95%CI：1.2-3.6）、女性 19 小时内（OR=2.5，95%CI：1.0-6.0）和老年人 4 小时内（OR：2.0，95%CI：1.0-4.0）。然而，男性暴露后 15 小时（OR：3.9；95%CI：1.1-13.9）和成人暴露后 23 小时（OR：4.1，95%CI：1.1-15.4）与热相关的 AMI 风险升高。从未患过 AMI 的人和患有糖尿病或高脂血症的老年人特别容易受到寒冷的影响。那些特别容易受到高温影响的人是从未经历过 AMI 的男性或患有高血压或高脂血症的男性，以及经历过 AMI 的女性。应考虑亚日时间尺度上温度对 AMI 风险的影响，以预防心脏事件。
