title: Short-term exposure to environmental parameters and onset of ST elevation myocardial infarction. The CARDIO-ARSIF registry.
abstract: BACKGROUND
  Environmental parameters have been reported to be triggers of acute myocardial infarction (MI). However, the individual role of each parameter is unknown. We quantified the respective association of climate parameters, influenza epidemics and air pollutants with the onset of ST elevation MI (STEMI) in Paris and the surrounding small ring.
  
  
  METHODS
  Data from the CARDIO-ARSIF registry (Paris and small ring STEMI population), Météo France (Climate), GROG (Influenza epidemic) and AIRPARIF (Air Pollution) were analyzed. The association between short-term exposure (1 day lag time) to environmental parameters and STEMI occurrence was quantified by time series modeling of daily STEMI count data, using Poisson regression with generalized additive models.
  
  
  RESULTS
  Between 2003 and 2008, 11,987 <24H STEMI confirmed by angiography were adjudicated. There was a 5.0% excess relative risk (ERR) of STEMI per 10°C decrease in maximal temperature (95% CI 2.1% to 7.8%: p=0.001) and an 8.9% ERR (95% CI 3.2% to 14.9%: p=0.002) during an influenza epidemic after adjustment on week-days and holidays. Associations were consistent when short-term exposure varied from 2 to 7 days. Associations between lower temperatures and STEMI were stronger in magnitude when influenza epidemic was present. Short-term exposure to climatic parameters or pollutants was not associated with STEMI.
  
  
  CONCLUSIONS
  The present population based registry of STEMI suggests that short-term exposure to lower temperature and influenza epidemic is associated with a significant excess relative risk of STEMI. Subjects at risk for MI may benefit from specific protections against cold temperature and influenza infection.
authors: Institut Mutualiste Montsouris, Paris, France.
authors: Christophe
authors: C
authors: Caussin
authors: INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Sylvie
authors: S
authors: Escolano
authors: INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Hazrije
authors: H
authors: Mustafic
authors: Agence Régionale de Santé d'Ile de France, Paris, France.
authors: Sophie
authors: S
authors: Bataille
authors: INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Muriel
authors: M
authors: Tafflet
authors: Observatoire Régional de Santé d'Ile de France, Paris, France.
authors: Edouard
authors: E
authors: Chatignoux
authors: SAMU 78, CH Versailles, France.
authors: Yves
authors: Y
authors: Lambert
authors: Hôpital Foch, Suresnes, France; ICPS, Massy, France.
authors: Hakim
authors: H
authors: Benamer
authors: ICPS, Quincy, France.
authors: Philippe
authors: P
authors: Garot
authors: INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Patricia
authors: P
authors: Jabre
authors: Hôpital Bichat, Paris, France.
authors: Laurent
authors: L
authors: Delorme
authors: Hôpital Cochin, France.
authors: Olivier
authors: O
authors: Varenne
authors: Hôpital Henri Mondor, Créteil, France.
authors: Emmanuel
authors: E
authors: Teiger
authors: Department of Cardiology, CH Versailles, France.
authors: Bernard
authors: B
authors: Livarek
authors: INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Jean-Philippe
authors: JP
authors: Empana
authors: INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France. Electronic address: christian.spaulding@egp.aphp.fr.
authors: Christian
authors: C
authors: Spaulding
authors: INSERM Unit 970 Paris Cardiovascular Research Center, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Xavier
authors: X
authors: Jouven
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects; D002980:Climate; D017023:Coronary Angiography; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D012042:Registries; D012307:Risk Factors
chemical_list: D000393:Air Pollutants
keywords: Acute coronary syndrome; Air pollutants; Climate; Influenza; Myocardial infarction