Olsson Anneli, Mohammad Moman A, Rylance Rebecca, Platonov Pyotr G, Sparv David, Erlinge David
Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, EA-blocket, Lund 221 85, Sweden.
Eur Heart J Open. 2023 Feb 16;3(2):oead011. doi: 10.1093/ehjopen/oead011. eCollection 2023 Mar.
Internal and external triggers affect seasonal and circadian variations of myocardial infarction (MI). We aimed to assess sex differences in the common triggers of MI.
A nationwide, retrospective, cross-sectional postal survey study was conducted. Individuals who experienced a MI during holidays and weekdays were identified through the SWEDEHEART registry. Twenty-seven potential MI triggers were rated in regards to occurring more or less than usual during the last 24 h before the MI. Three areas were covered: activities, emotions, and food or alcohol consumption. A logistic regression model was used to identify sex differences for each trigger and odds ratios (ORs) were reported. Four hundred and fifty-one patients, of whom 317 were men, responded. The most commonly reported triggers were stress (35.3%), worry (26.2%), depression (21.1%), and insomnia (20.0%). Women reported emotional triggers including sadness [OR 3.52, 95% confidence interval (CI) 1.92-6.45], stress (OR 2.38, 95% CI 1.52-3.71), insomnia (OR 2.31, 95% CI 1.39-3.81), and upset (OR 2.69, 95% CI 1.47-4.95) to a greater extent than men. Outdoor activity was less reported by women (OR 0.35, 95% CI 0.14-0.87). No significant sex differences were found in other activities or food and alcohol consumption.
Self-experienced stress and distress were higher among women prior to MI compared with men. Understanding sex perspectives in acute triggers may help us find preventive strategies and reduce the excess numbers of MI.
内在和外在触发因素会影响心肌梗死（MI）的季节性和昼夜节律变化。我们旨在评估MI常见触发因素中的性别差异。
开展了一项全国性的回顾性横断面邮寄调查研究。通过瑞典心脏注册系统识别出在节假日和工作日发生MI的个体。针对MI发生前最后24小时内27种潜在的MI触发因素，就其发生频率高于或低于平常进行评分。涵盖三个方面：活动、情绪以及食物或酒精摄入。使用逻辑回归模型确定每种触发因素的性别差异，并报告比值比（OR）。451名患者作出回应，其中317名男性。最常报告的触发因素是压力（35.3%）、担忧（26.2%）、抑郁（21.1%）和失眠（20.0%）。女性报告的情绪触发因素包括悲伤[比值比3.52，95%置信区间（CI）1.92 - 6.45]、压力（比值比2.38，95% CI 1.52 - 3.71）、失眠（比值比2.31，95% CI 1.39 - 3.81）和心烦（比值比2.69，95% CI 1.47 - 4.95），程度均高于男性。女性报告的户外活动较少（比值比0.35，95% CI 0.14 - 0.87）。在其他活动或食物及酒精摄入方面未发现显著的性别差异。
与男性相比，女性在MI发生前自我体验到的压力和痛苦更高。了解急性触发因素中的性别观点可能有助于我们找到预防策略并减少MI的超额发病数。
