title: Relation of ST-Segment Elevation Myocardial Infarction to Daily Ambient Temperature and Air Pollutant Levels in a Japanese Nationwide Percutaneous Coronary Intervention Registry.
abstract: Effects of daily fluctuation of ambient temperature and concentrations of air pollutants on acute cardiovascular events have not been well studied. From January 2011 to December 2012, a total of 56,863 consecutive ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention were registered from 929 institutes with median interinstitutional distance of 2.6 km. We constructed generalized linear mixed models in which the presence or absence of patients with STEMI per day per institute was included as a binomial response variable, with daily meteorologic and environmental data obtained from their respective observatories nearest to the institutes (median distance of 9.7 and 5.6 km) as the explanatory variables. Both lower mean temperature and increase in maximum temperature from the previous day were independently associated with the STEMI occurrence throughout the year (odds ratio [OR] 0.925, 95% confidence interval [CI] 0.915 to 0.935, per 10°C, p <0.001; and OR 1.012, 95% CI 1.009 to 1.015, per °C, p <0.001, respectively). Decrement in minimum temperature from -4 days to -3 days before the event date was marginally associated with the STEMI occurrence, only during the wintertime (OR 0.991, 95% CI 0.982 to 0.999, per °C, p = 0.03). As for the air pollutants, nitrogen oxides and suspended particle matter were not correlated with the occurrence of STEMI after adjusting for the meteorologic and livelihood variables. Both the absolute value and relative change in the ambient temperature were associated with the occurrence of STEMI; the associations with the air pollutant levels were less clear after adjustment for these meteorologic variables in Japan.
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
authors.forename: Kyohei
authors.initials: K
authors.lastname: Yamaji
authors.affiliation: Department of Cardiology, Keio University, Tokyo, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
authors.affiliation: Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.affiliation: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University, Kyoto, Japan. Electronic address: taketaka@kuhp.kyoto-ua.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000032:analysis*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D062645:Percutaneous Coronary Intervention; D012042:Registries; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000453:epidemiology*; D012621:Seasons; D013696:Temperature
chemical_list: D000393:Air Pollutants