Acute myocardial infarction and stress cardiomyopathy following the Christchurch earthquakes.
Acute myocardial infarction and stress cardiomyopathy following the Christchurch earthquakes.
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DOI：
10.1371/journal.pone.0068504
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Bridgman P
中科院分区：
文献类型：
--
作者：
Chan C;Elliott J;Troughton R;Frampton C;Smyth D;Crozier I;Bridgman P
新西兰克赖斯特彻奇在2010年9月4日凌晨4点36分和2011年2月22日中午12点51分分别发生了两次大地震，震级为7.1级和6.3级。这两起事件都造成了广泛的破坏。克赖斯特彻奇医院是该地区唯一的急性护理医院。它在两次地震后都保持了功能。我们能够检查两次地震对急性心脏表现的影响。对两次地震前3周和地震后5周在克赖斯特彻奇医院心脏病科住院的患者进行了分析，相应的对照期为2009年9月和2010年2月。根据诊断结果对患者进行分类：ST段抬高型心肌梗死、非ST段抬高型心肌梗死、应激性心肌病、不稳定型心绞痛、稳定型心绞痛、非心源性胸痛、心律失常等。在9月清晨地震后的前2周内，总入院率（p<0.003）、ST段抬高型心肌梗死（p<0.016）和非心源性胸痛（p<0.022）显著增加。这种模式在2月下午早些时候的地震之后就没有出现过。相反，有大量的应激性心肌病入院，在4天内有21例（95% CI 2.6-6.4）。第一次地震后发生应激性心肌病6例（95% CI 0.44 ~ 2.62）。统计分析表明，这是地震之间的显著差异（p<0.05）。9月清晨地震引发ST段抬高型心肌梗死大量增加，应激性心肌病病例较少。2月下午早些时候的地震引起的应激性心肌病明显更多。在一天中不同时间发生的两次大地震对急性心脏事件的影响不同。
Christchurch, New Zealand, was struck by 2 major earthquakes at 4:36am on 4 September 2010, magnitude 7.1 and at 12:51pm on 22 February 2011, magnitude 6.3. Both events caused widespread destruction. Christchurch Hospital was the region's only acute care hospital. It remained functional following both earthquakes. We were able to examine the effects of the 2 earthquakes on acute cardiac presentations. Patients admitted under Cardiology in Christchurch Hospital 3 week prior to and 5 weeks following both earthquakes were analysed, with corresponding control periods in September 2009 and February 2010. Patients were categorised based on diagnosis: ST elevation myocardial infarction, Non ST elevation myocardial infarction, stress cardiomyopathy, unstable angina, stable angina, non cardiac chest pain, arrhythmia and others. There was a significant increase in overall admissions (p<0.003), ST elevation myocardial infarction (p<0.016), and non cardiac chest pain (p<0.022) in the first 2 weeks following the early morning September earthquake. This pattern was not seen after the early afternoon February earthquake. Instead, there was a very large number of stress cardiomyopathy admissions with 21 cases (95% CI 2.6–6.4) in 4 days. There had been 6 stress cardiomyopathy cases after the first earthquake (95% CI 0.44–2.62). Statistical analysis showed this to be a significant difference between the earthquakes (p<0.05). The early morning September earthquake triggered a large increase in ST elevation myocardial infarction and a few stress cardiomyopathy cases. The early afternoon February earthquake caused significantly more stress cardiomyopathy. Two major earthquakes occurring at different times of day differed in their effect on acute cardiac events.