Weather and risk of ST-elevation myocardial infarction revisited: Impact on young women

• Published in: PloS one 2018-04, Vol.13 (4), p.e0195602-e0195602
• Main Authors: Gebhard, Catherine, Gebhard, Caroline E, Stähli, Barbara E, Maafi, Foued, Bertrand, Marie-Jeanne, Wildi, Karin, Fortier, Annik, Galvan Onandia, Zurine, Toma, Aurel, Zhang, Zheng W, Smith, David C, Spagnoli, Vincent, Ly, Hung Q
• Format: Article
• Language: English
• Subjects: Age; Biology and Life Sciences; Cardiovascular disease; Complications and side effects; Daylight; Earth Sciences; Environmental impact; Health aspects; Health risk assessment; Heart; Heart attack; Heart attacks; High temperature; Medicine and Health Sciences; Men; Mortality; Myocardial infarction; Risk factors; Snow; Snowfall; Temperature; Temperature dependence; Temperature effects; Young women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0195602

During the last decade, the incidence and mortality rates of ST-elevation myocardial infarction (STEMI) has been steadily increasing in young women but not in men. Environmental variables that contribute to cardiovascular events in women remain ill-defined. A total of 2199 consecutive patients presenting with acute ST-elevation myocardial infarction (STEMI, 25.8% women, mean age 62.6±12.4 years) were admitted at the Montreal Heart Institute between June 2010 and December 2014. Snow fall exceeding 2cm/day was identified as a positive predictor for STEMI admission rates in the overall population (RR 1.28, 95% CI 1.07-1.48, p = 0.005), with a significant effect being seen in men (RR 1.30, 95% CI 1.06-1.53, p = 0.01) but not in women (p = NS). An age-specific analysis revealed a significant increase in hospital admission rates for STEMI in younger women ≤55 years, (n = 104) during days with higher outside temperature (p = 0.004 vs men ≤55 years) and longer daylight hours (p = 0.0009 vs men ≤55 years). Accordingly, summer season, increased outside temperature and sunshine hours were identified as strong positive predictors for STEMI occurrence in women ≤55 years (RR 1.66, 95% CI 1.1-2.5, p = 0.012, RR 1.70, 95% CI 1.2-2.5, p = 0.007, and RR 1.67, 95% CI 1.2-2.5, p = 0.011, respectively), while an opposite trend was observed in men ≤55 years (RR for outside temperature 0.8, 95% CI 0.73-0.95, p = 0.01). The impact of environmental variables on STEMI is age- and sex-dependent. Higher temperature may play an important role in triggering such acute events in young women.