title: Natural disasters and myocardial infarction: the six years after Hurricane Katrina.
abstract: OBJECTIVE
  To determine the prolonged effect of Hurricane Katrina on the incidence and timing of acute myocardial infarction (AMI) in the city of New Orleans.
  
  
  METHODS
  Our study population consisted of 1476 patients with AMI before (August 29, 1999, to August 28, 2005) and after (February 14, 2006, to February 13, 2012) Hurricane Katrina at Tulane University Health Sciences Center to determine post-Katrina alterations in the occurrence and timing of AMI.
  
  
  RESULTS
  Compared with pre-Katrina values, there was a more than 3-fold increase in the percentage of admissions for AMI during the 6 years after Hurricane Katrina (P<.001). The percentage of admissions for AMI after Hurricane Katrina increased significantly on nights (P<.001) and weekends (P<.001) and decreased significantly on mornings (P<.001), Mondays (P<.001), and weekdays (P<.001). Patients with AMI after Hurricane Katrina also had significantly higher rates of psychiatric comorbidities (P=.01), smoking (P<.001), lack of health insurance (P<.05), and unemployment (P<.001).
  
  
  CONCLUSIONS
  These results indicate that the effect of natural disasters on the occurrence of AMI may persist for at least a 6-year period and may be related to various factors including population shifts, alterations in the health care system, and the effects of chronic stress and associated behaviors.
authors.affiliation: Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA. Electronic address: mattpeters25@gmail.com.
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Peters
authors.affiliation: Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA.
authors.forename: John C
authors.initials: JC
authors.lastname: Moscona
authors.affiliation: Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA.
authors.forename: Morgan J
authors.initials: MJ
authors.lastname: Katz
authors.affiliation: Tulane University Heart and Vascular Institute, New Orleans, LA.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Deandrade
authors.affiliation: Tulane University Heart and Vascular Institute, New Orleans, LA.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Quevedo
authors.affiliation: Tulane University Heart and Vascular Institute, New Orleans, LA.
authors.forename: Sumit
authors.initials: S
authors.lastname: Tiwari
authors.affiliation: Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Burchett
authors.affiliation: Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Turnage
authors.affiliation: Tulane University Heart and Vascular Institute, New Orleans, LA.
authors.forename: Kanwar Y
authors.initials: KY
authors.lastname: Singh
authors.affiliation: Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, LA.
authors.forename: Edmond N
authors.initials: EN
authors.lastname: Fomunung
authors.affiliation: Tulane University Heart and Vascular Institute, New Orleans, LA.
authors.forename: Sudesh
authors.initials: S
authors.lastname: Srivastav
authors.affiliation: Tulane University Heart and Vascular Institute, New Orleans, LA.
authors.forename: Patrice
authors.initials: P
authors.lastname: Delafontaine
authors.affiliation: Tulane University Heart and Vascular Institute, New Orleans, LA; Southeast Louisiana Veterans Affairs Medical Center, New Orleans, LA.
authors.forename: Anand M
authors.initials: AM
authors.lastname: Irimpen
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D055867:Cyclonic Storms; D004190:Disasters; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D055820:New Orleans; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D016019:Survival Analysis; D013997:Time Factors