Increased plaque rupture forms peak incidence of acute myocardial infarction in winter
Increased plaque rupture forms peak incidence of acute myocardial infarction in winter
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DOI：
10.1016/j.ijcard.2020.07.011
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发表时间：
2020-12-01
影响因子：
3.5
通讯作者：
Akasaka, Takashi
中科院分区：
文献类型：
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作者：
Katayama, Yosuke;Tanaka, Atsushi;Akasaka, Takashi
背景：近年来，心血管疾病的发病率和预后受到了广泛的关注。寒冷的环境温度增加急性心肌梗死（AMI）的发病率的原因尚不清楚。我们研究了AMI发病时的环境温度与AMI患者的罪犯病变形态之间的关系。方法：我们研究了202例AMI患者接受光学相干断层扫描（OCT）。根据环境温度将参与者分为较低（n = 100）和较高（n = 102）温度组。结果：AMI发病时的中位体温为16.6 ℃。在较低温度下，斑块破裂的患病率较高（较低66% vs.较高45%，p = 0.003），而OCT侵蚀在较高温度组中更常见（较低13% vs.较高26%，p = 0.021）。结论：冬季AMI发病高峰是由斑块破裂增加形成的，提示环境温度对AMI发病有影响。(C)2020 Elsevier B.V.保留所有权利。
Background: It has been widely documented that circannual variation has an impact on the incidence and prognosis of cardiovascular diseases. It is unclear why cold ambient temperature increase the incidence of acutemyocardial infarction (AMI). We investigated the relationship between the ambient temperature at the onset of AMI, the morphology of the culprit lesion in patients with AMI.Methods: We investigated 202 consecutive patients with AMI who underwent optical coherence tomography (OCT). The participants were divided into lower (n = 100) and higher (n = 102) temperature groups based on the ambient temperature. The culprit lesion morphology was compared between the two groups.Results: The median temperature at the onset of AMI was 16.6 degrees C. The prevalence of plaque ruptures was higher at lower temperatures (lower 66% vs. higher 45%, p = .003), where as OCT-erosion was more frequent in the higher temperature group (lower 13% vs. higher 26%, p = .021). The lower temperature group showedmore cholesterol crystals (lower 71% vs. higher 54%, p = .014).Conclusion: The peak incidence of AMI in the winter is formed by increased plaque rupture, suggesting environmental temperature has an influence on the pathogenesis of AMI. (C) 2020 Elsevier B.V. All rights reserved.