Low ambient temperature and incident myocardial infarction with or without obstructive coronary arteries: a Chinese nationwide study

医学 心肌梗塞 内科学 置信区间 心脏病学 冠状动脉疾病 优势比 冠状动脉 胸痛 逻辑回归 动脉
作者
Jia Huang,Qinglin He,Yixuan Jiang,Jennifer Ming Jen Wong,Jianxuan Li,Jiangdong Liu,Ruochen Wang,Renjie Chen,Yuxiang Dai,Junbo Ge
出处
期刊:European Heart Journal [Oxford University Press]
标识
DOI:10.1093/eurheartj/ehae711
摘要

Abstract Background and Aims Although non-optimum ambient temperature is a major non-traditional risk factor for acute myocardial infarction, there is no prior knowledge on whether non-optimum ambient temperature could differentially affect myocardial infarction with obstructive coronary artery disease (MI-CAD) and myocardial infarction with non-obstructive coronary arteries (MINOCA). Methods Using the Chinese Cardiovascular Association database-Chest Pain Center Registry, a nationwide, time-stratified, case-crossover investigation was conducted from 2015 to 2021. Meteorological data were obtained from an established satellite-based model, and daily exposures were assigned according to the onset of myocardial infarction in each patient. A conditional logistic regression model combined with distributed lag non-linear models (10 days) was used to estimate the exposure–response relationships. Results A total of 83 784 MINOCA patients and 918 730 MI-CAD patients were included. The risk of MINOCA and MI-CAD associated with low temperature occurred at lag 2 day and lasted to 1 week. Extremely low temperature was associated with a substantially greater odds ratio (OR) of MINOCA [OR 1.58, 95% confidence interval (CI) 1.31–1.90] than MI-CAD (unmatched: OR 1.32, 95% CI 1.23–1.43; equally matched by age and sex: OR 1.25, 95% CI 1.04–1.50), compared with the corresponding reference temperatures (30°C, 35°C, and 30°C). Stronger associations were observed for patients who were aged ≥65 years, female, or resided in the south. There was no significant difference for the impacts of high temperature on MINOCA and MI-CAD. Conclusions This nationwide study highlights the particular susceptibility of MINOCA patients to ambient low temperature compared with that of MI-CAD patients.
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