title: Could missile attacks trigger acute myocardial infarction?
abstract: OBJECTIVE
  During the Gulf war in 2003, Kuwait was targeted with missile attacks for 10 consecutive days. Our objective is to evaluate the influence of missile attacks on the incidence of acute myocardial infarction (AMI).
  
  
  RESULTS
  We retrospectively compared the number of admissions for AMI presenting to a major general hospital during missile attacks period (MAP) in 2003 with four control periods. MAP and each control period consisted of the same number of days (10 days). The four control periods were the 10 days immediately before and after MAP; and the same time period as MAP for the years 2001 and 2002. The number of admissions for AMI was highest during MAP, 21 cases compared to 14-16 cases in the four control periods, with a trend towards increase during MAP (incidence rate ratio = 1.59; 95% CI 0.95 to 2.66, p < 0.07). The number of admissions for AMI during the first 5 days of MAP was significantly higher compared to the first 5 days of the four control periods (incidence rate ratio = 2.43; 95% CI 1.23 to 4.26, p < 0.01). The observed AMI admission rate during the first 5 days of MAP was significantly higher than expected for a 5-day period in the years 2001, 2002 and 2003. This increase was specific to AMI and did not affect other acute cardiac conditions.
  
  
  CONCLUSIONS
  Missile attacks were associated with an increase in the incidence of AMI. This increase was specific to AMI and did not influence acute cardiac conditions.
authors.affiliation: Division of Cardiology, Mubarak Al-Kabeer Hospital, Kuwait. zubaid@hsc.edu.kw
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zubaid
authors.forename: Cheiyil G
authors.initials: CG
authors.lastname: Suresh
authors.forename: Lukman
authors.initials: L
authors.lastname: Thalib
authors.forename: Wafa
authors.initials: W
authors.lastname: Rashed
mesh_terms: D000208:Acute Disease; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007730:Kuwait; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology*; D012189:Retrospective Studies; D014857:Warfare