title: Effect of Hurricane Katrina on incidence of acute myocardial infarction in New Orleans three years after the storm.
abstract: To detect a long-term increase in the incidence of acute myocardial infarction (AMI) after Hurricane Katrina and to investigate the pertinent contributing factors, we conducted a single-center retrospective cohort observational study. The patients admitted with AMI to Tulane University Hospital in the 2 years before Katrina and the 3 years after the hospital reopened were identified from the hospital medical records. The pre- and post-Katrina groups were compared for prespecified demographic and clinical data. In the 3-year post-Katrina group, 418 admissions (2.0%) for AMI occurred of a total census of 21,092 patients compared to 150 (0.7%) of a census of 21,079 in the 2-year pre-Katrina group (p <0.0001). The post-Katrina group had a greater prevalence of unemployment (p <0.0001), lack of medical insurance (p <0.001), smokers (p <0.01), medical noncompliance (p <0.0001), first-time hospitalizations (p <0.001), history of coronary artery disease (p <0.01), multiple vessel disease (p <0.05), and percutaneous coronary interventions (p <0.0001). The mean age of onset of AMI decreased from 62 years before Katrina to 59 years after Katrina (p <0.05), and a significantly greater percentage of patients were men (p <0.05). No significant differences were found between the two groups in terms of race, substance abuse, and a history of hypertension or diabetes mellitus. Our data suggest that chronic stress after natural disasters may significantly affect cardiovascular risk factors such as tobacco abuse and increase medical noncompliance. In conclusion, our data is consistent with a significant change in the overall health of the population and support the need for additional study into the health effects of chronic stress after natural disasters.
authors.affiliation: Heart and Vascular Institute, Tulane University, New Orleans, Louisiana, USA.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Jiao
authors.forename: Socrates V
authors.initials: SV
authors.lastname: Kakoulides
authors.forename: John
authors.initials: J
authors.lastname: Moscona
authors.forename: Jabar
authors.initials: J
authors.lastname: Whittier
authors.forename: Sudesh
authors.initials: S
authors.lastname: Srivastav
authors.forename: Patrice
authors.initials: P
authors.lastname: Delafontaine
authors.forename: Anand
authors.initials: A
authors.lastname: Irimpen
mesh_terms: D017677:Age Distribution; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology; D055867:Cyclonic Storms; D004190:Disasters; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D010343:Patient Admission / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D014478:Unemployment / Q000706:statistics & numerical data