Ornato J P, Peberdy M A, Chandra N C, Bush D E
Division of Cardiology, Virginia Commonwealth University-Medical College of Virginia, Richmond 23298, USA.
J Am Coll Cardiol. 1996 Dec;28(7):1684-8. doi: 10.1016/s0735-1097(96)00411-1.
The purpose of this study was to determine whether the rate of hospital admission for acute myocardial infarction (AMI) varies seasonally in a large, prospective U.S. registry.
Identification of specific patterns in the timing of the onset of AMI is of importance because it implies that there are triggers external to the atherosclerotic plaque. Using death certificate data, most investigators have noted a seasonal pattern to the death rate from AMI. However, it is unclear whether this observation is due to variation in the prevalence of AMI or to other factors that may alter the likelihood of a fatal outcome.
We examined the seasonal mean number of cases of AMI (adjusted for the length of days in each season) that were submitted to the National Registry of Myocardial Infarction (NRMI) by 138 high volume core hospitals over a 3-year period (December 21, 1990 through December 20, 1993) during which the number of hospitals participating in the Registry was stable. Data were analyzed using general linear modeling and analysis of variance.
High volume core hospitals reported 83,541 cases of AMI to the Registry during the study period. Approximately 10% more such cases were entered into the Registry in winter or spring than in summer (p < 0.05). The same trends were seen in both northern and southern states, men and women, patients < 70 versus > or = 70 years of age and those with Q wave versus non-Q wave AMI.
We conclude that there is a seasonal pattern to the reporting rate of cases of AMI in the NRMI. This observation further supports the hypothesis that acute cardiovascular events may be triggered by events that are external to the atherosclerotic plaque.
本研究旨在确定在美国一个大型前瞻性登记处中，急性心肌梗死（AMI）的住院率是否存在季节性变化。
识别AMI发病时间的特定模式很重要，因为这意味着动脉粥样硬化斑块外部存在触发因素。大多数研究人员利用死亡证明数据注意到AMI死亡率存在季节性模式。然而，尚不清楚这一观察结果是由于AMI患病率的变化还是其他可能改变致命结局可能性的因素所致。
我们检查了138家高容量核心医院在3年期间（1990年12月21日至1993年12月20日）提交给国家心肌梗死登记处（NRMI）的AMI病例的季节性平均数量（根据每个季节的天数进行调整），在此期间参与登记处的医院数量稳定。使用一般线性模型和方差分析对数据进行分析。
在研究期间，高容量核心医院向登记处报告了83,541例AMI病例。冬季或春季进入登记处的此类病例比夏季多约10%（p < 0.05）。在北部和南部各州、男性和女性、年龄<70岁与≥70岁的患者以及有Q波与无Q波AMI的患者中均观察到相同趋势。
我们得出结论，NRMI中AMI病例的报告率存在季节性模式。这一观察结果进一步支持了急性心血管事件可能由动脉粥样硬化斑块外部的事件触发的假设。
