Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Germany; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Am Coll Cardiol. 2024 Sep 24;84(13):1149-1159. doi: 10.1016/j.jacc.2024.07.006. Epub 2024 Sep 1.
Lower air temperature and cold spells have been associated with an increased risk of various diseases. However, the short-term effect of lower air temperature and cold spells on myocardial infarction (MI) remains incompletely understood.
The purpose of this study was to investigate the short-term effects of lower air temperature and cold spells on the risk of hospitalization for MI in Sweden.
This population-based nationwide study included 120,380 MI cases admitted to hospitals in Sweden during the cold season (October to March) from 2005 to 2019. Daily mean air temperature (1 km resolution) was estimated using machine learning, and percentiles of daily temperatures experienced by individuals in the same municipality were used as individual exposure indicators to account for potential geographic adaptation. Cold spells were defined as periods of at least 2 consecutive days with a daily mean temperature below the 10th percentile of the temperature distribution for each municipality. A time-stratified case-crossover design incorporating conditional logistic regression models with distributed lag nonlinear models using lag 0 to 1 (immediate) and 2 to 6 days (delayed) was used to evaluate the short-term effects of lower air temperature and cold spells on total MI, non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI).
A decrease of 1-U in percentile temperature at a lag of 2 to 6 days was significantly associated with increased risks of total MI, NSTEMI, and STEMI, with ORs of 1.099 (95% CI: 1.057-1.142), 1.110 (95% CI: 1.060-1.164), and 1.076 (95% CI: 1.004-1.153), respectively. Additionally, cold spells at a lag of 2 to 6 days were significantly associated with increased risks for total MI, NSTEMI, and STEMI, with ORs of 1.077 (95% CI: 1.037-1.120), 1.069 (95% CI: 1.020-1.119), and 1.095 (95% CI: 1.023-1.172), respectively. Conversely, lower air temperature and cold spells at a lag of 0 to 1 days were associated with decreased risks for MI.
This nationwide case-crossover study reveals that short-term exposures to lower air temperature and cold spells are associated with an increased risk of hospitalization for MI at lag 2 to 6 days.
较低的空气温度和寒冷天气与各种疾病的风险增加有关。然而，较低的空气温度和寒冷天气对心肌梗死（MI）的短期影响仍不完全清楚。
本研究旨在探讨较低的空气温度和寒冷天气对瑞典因 MI 住院风险的短期影响。
本基于人群的全国性研究纳入了 2005 年至 2019 年在瑞典寒冷季节（10 月至 3 月）期间因 MI 住院的 120,380 例患者。使用机器学习估算每日平均气温（1km 分辨率），并将个体在同一城市的每日气温百分位数用作个体暴露指标，以考虑潜在的地理适应性。寒冷天气定义为至少连续 2 天的日平均温度低于每个城市的温度分布的第 10 个百分位数。使用时间分层病例交叉设计，结合条件逻辑回归模型和分布滞后非线性模型，使用滞后 0 至 1（即时）和 2 至 6 天（延迟），评估较低的空气温度和寒冷天气对总 MI、非 ST 段抬高型心肌梗死（NSTEMI）和 ST 段抬高型心肌梗死（STEMI）的短期影响。
滞后 2 至 6 天的百分位温度每降低 1-U，总 MI、NSTEMI 和 STEMI 的风险显著增加，比值比（ORs）分别为 1.099（95%置信区间[CI]：1.057-1.142）、1.110（95%CI：1.060-1.164）和 1.076（95%CI：1.004-1.153）。此外，滞后 2 至 6 天的寒冷天气与总 MI、NSTEMI 和 STEMI 的风险增加显著相关，ORs 分别为 1.077（95%CI：1.037-1.120）、1.069（95%CI：1.020-1.119）和 1.095（95%CI：1.023-1.172）。相反，滞后 0 至 1 天的较低空气温度和寒冷天气与 MI 的风险降低相关。
本全国性病例交叉研究表明，短期暴露于较低的空气温度和寒冷天气与滞后 2 至 6 天因 MI 住院的风险增加相关。
