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新西兰心肌梗死住院率和缺血性心脏病死亡率的季节性变化

Seasonal Variation in Myocardial Infarction Hospitalisations and Ischaemic Heart Disease Deaths in New Zealand.

作者信息

Bassett David, Woodward Alistair J, Read Joshua

机构信息

Radiology, Tauranga Hospital, Tauranga, NZL.

Epidemiology and Biostatistics, The University of Auckland, Auckland, NZL.

出版信息

Cureus. 2025 Mar 22;17(3):e81005. doi: 10.7759/cureus.81005. eCollection 2025 Mar.

Abstract

Background Seasonal variation in the incidence of myocardial infarction (MI) has been reported, but the literature is conflicting regarding its magnitude and geographical differences. This study examined the seasonal variation in MI incidence and ischaemic heart disease (IHD) mortality across three New Zealand cities: Auckland, Wellington, and Christchurch. Methods This multi-centre retrospective cohort study used New Zealand Ministry of Health data from 2005 to 2014. Poisson regression analysis was conducted, controlling for age, city, and secular trends. Event counts were grouped by season and multivariate models calculated seasonal event ratios with summer as the reference season. Results From 2005 to 2014, there were 42,846 MI hospitalisations and 15,466 deaths from IHD. Compared to summer, winter had 1,278 additional MI hospitalisations and 1,100 more IHD-related deaths. Winter-to-summer event ratios were 1.29 (95% confidence interval (CI): 1.15-1.45, p<0.001, χ²=900.84) for MI hospitalisations and 1.35 (95% CI: 1.28-1.43, p<0.001, χ²=61.10) for IHD mortality. The seasonal effect was most pronounced among those aged 80 years and older. No statistically significant differences were observed between cities, genders, ethnicities, or socioeconomic groups. Conclusion MI incidence varies by season, peaking during the winter and declining in summer. Given the substantial seasonal burden, targeted interventions such as public awareness campaigns, influenza vaccinations, improved indoor heating, and energy subsidies for vulnerable populations may help reduce winter cardiovascular disease (CVD) risk.

摘要

背景 已有报道称心肌梗死(MI)发病率存在季节性变化,但关于其变化幅度和地域差异的文献存在矛盾之处。本研究调查了新西兰三个城市(奥克兰、惠灵顿和克赖斯特彻奇)心肌梗死发病率和缺血性心脏病(IHD)死亡率的季节性变化。方法 这项多中心回顾性队列研究使用了新西兰卫生部2005年至2014年的数据。进行了泊松回归分析,对年龄、城市和长期趋势进行了控制。事件计数按季节分组,多变量模型以夏季作为参照季节计算季节性事件比率。结果 2005年至2014年期间,有42,846例心肌梗死住院病例以及15,466例缺血性心脏病死亡病例。与夏季相比,冬季心肌梗死住院病例增加了1,278例,缺血性心脏病相关死亡病例增加了1,100例。冬季与夏季的事件比率,心肌梗死住院病例为1.29(95%置信区间(CI):1.15 - 1.45,p<0.001,χ²=900.84),缺血性心脏病死亡率为1.35(95%CI:1.28 - 1.43,p<0.001,χ²=61.10)。季节性效应在80岁及以上人群中最为明显。在城市、性别、种族或社会经济群体之间未观察到统计学上的显著差异。结论 心肌梗死发病率随季节变化,冬季达到峰值,夏季下降。鉴于季节性负担较重,开展公众意识宣传活动、流感疫苗接种、改善室内供暖以及为弱势群体提供能源补贴等针对性干预措施可能有助于降低冬季心血管疾病(CVD)风险。

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