title: Triggering of acute myocardial infarction by different means of transportation.
abstract: BACKGROUND
  Prior studies have reported an association between traffic-related air pollution in urban areas and exacerbation of cardiovascular disease. We assess here whether time spent in different modes of transportation can trigger the onset of acute myocardial infarction (AMI).
  
  
  METHODS
  We performed a case-crossover study. We interviewed consecutive cases of AMI in the KORA Myocardial Infarction Registry in Augsburg, Southern Germany between February 1999 and December 2003 eliciting data on potential triggers in the four days preceding myocardial infarction onset.
  
  
  RESULTS
  A total of 1459 cases with known date and time of AMI symptom onset, who had survived 24 hours after the onset, completed the registry's standard interview on potential triggers of AMI. An association between exposure to traffic and AMI onset 1 hour later was observed (odds ratio: 3.2; 95% confidence interval [CI]: 2.7-3.9, p < 0.001). Using a car was the most common source of traffic exposure; nevertheless, times spent in public transport or on a bicycle were similarly associated with AMI onset 1 hour later. While the highest risk for AMI onset was within 1 hour of exposure to traffic, the elevated risk persisted for up to 6 hours. Women, patients aged 65 years or older, patients not part of the workforce, and those with a history of angina or diabetes exhibited the largest associations between times spent in traffic and AMI onset 1 hour later.
  
  
  CONCLUSIONS
  The data suggest that transient exposure to traffic regardless of the means of transportation may increase the risk of AMI transiently.
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Stephanie
authors.initials: S
authors.lastname: von Klot
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
authors.forename: Christine
authors.initials: C
authors.lastname: Meisinger
authors.forename: Allmut
authors.initials: A
authors.lastname: Hörmann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kuch
authors.forename: H Erich
authors.initials: HE
authors.lastname: Wichmann
mesh_terms: D000328:Adult; D000368:Aged; D001642:Bicycling; D016009:Chi-Square Distribution; D018592:Cross-Over Studies; D005260:Female; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology*; D016017:Odds Ratio; D012042:Registries; D012307:Risk Factors; D013997:Time Factors