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

Author

Catherine Gebhard, Caroline E Gebhard, Barbara E Stähli, Foued Maafi, Marie-Jeanne Bertrand, Karin Wildi, Annik Fortier, Zurine Galvan Onandia, Aurel Toma, Zheng W Zhang, David C Smith, Vincent Spagnoli, and Hung Q Ly

Subjects
Medicine, Science
Abstract

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.

Published
2018
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2. Hockey Games and the Incidence of ST-Elevation Myocardial Infarction

Author

Foued Maafi, Caroline E. Gebhard, Catherine Gebhard, Aurel Toma, Zurine Galvan, Barbara E. Stähli, Karin Wildi, Marie-Jeanne Bertrand, Hung Q. Ly, Zheng W. Zhang, and David C. Smith

Subjects
Male, Canada, medicine.medical_specialty, Population, 030204 cardiovascular system & hematology, Coronary Angiography, 03 medical and health sciences, Ice hockey, Sex Factors, 0302 clinical medicine, Risk Factors, St elevation myocardial infarction, Internal medicine, Myocardial Revascularization, Humans, Medicine, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Correlation of Data, Social Behavior, education, Aged, Retrospective Studies, education.field_of_study, business.industry, Incidence, Incidence (epidemiology), Hazard ratio, Age Factors, Middle Aged, medicine.disease, Confidence interval, Hospitalization, Increased risk, Hockey, ST Elevation Myocardial Infarction, Female, Cardiology and Cardiovascular Medicine, business, human activities, Stress, Psychological
Abstract

Background The association between diagnosed acute ST-elevation myocardial infarction (STEMI) and hockey games in the Canadian population is unknown. Methods We retrospectively analyzed the association between hockey games of the National Hockey League Montreal Canadiens and daily hospital admissions for acute STEMI at the Montreal Heart Institute, Canada. Results Between June 2010 and December 2014, a total of 2199 patients (25.9% women; mean age, 62.6 ± 12.4 years) were admitted for acute STEMI. An increase in STEMI admissions was observed the day after a hockey game of the Montreal Canadiens in the overall population (from 1.3 ± 1.2 to 1.5 ± 1.3), however, this difference was not significant ( P = 0.1). The number of STEMI admissions increased significantly from 0.9 ± 1.0 to 1.2 ± 1.0 per day in men ( P = 0.04), but not in women ( P = 0.7). The association between ice hockey matches and STEMI admission rates was strongest after a victory of the Montreal Canadiens. Accordingly, an increased risk for the occurrence of STEMI was observed in the overall population (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.0-1.3; P = 0.037) when the Montreal Canadiens won a match. This association was present in men (HR, 1.2; 95% CI, 1.03-1.4; P = 0.02) but not in women ( P = 0.87), with a most pronounced effect seen in younger men (younger than 55 years; HR, 1.4; 95% CI, 1.1-1.8; P = 0.009). Conclusions Although a weak association between hockey games and hospital admissions for STEMI was found in our overall population, the event of a hockey game significantly increased the risk for STEMI in younger men. Preventive measures targeting behavioural changes could positively affect this risk.

Published
2018
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