| Heat and risk of myocardial infarction: hourly level case-crossover analysis of MINAP database. | |
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MedLine Citation:
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PMID: 23243290 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To quantify the association between exposure to higher temperatures and the risk of myocardial infarction at an hourly temporal resolution. DESIGN: Case-crossover study. SETTING: England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. PARTICIPANTS: 24,861 hospital admissions for myocardial infarction occurring in 11 conurbations during the warmest months (June to August) of the years 2003-09. MAIN OUTCOME MEASURE: Odds ratio of myocardial infarction for a 1 °C increase in temperature. RESULTS: Strong evidence was found for an effect of heat acting 1-6 hours after exposure to temperatures above an estimated threshold of 20 °C (95% confidence interval 16 °C to 25 °C). For each 1 °C increase in temperature above this threshold, the risk of myocardial infarction increased by 1.9% (0.5% to 3.3%, P=0.009). Later reductions in risk seemed to offset early increases in risk: the cumulative effect of a 1 °C rise in temperature above the threshold was 0.2% (-2.1% to 2.5%) by the end of the third day after exposure. CONCLUSIONS: Higher ambient temperatures above a threshold of 20 °C seem to be associated with a transiently increased risk of myocardial infarction 1-6 hours after exposure. Reductions in risk at longer lags are consistent with heat triggering myocardial infarctions early in highly vulnerable people who would otherwise have had a myocardial infarction some time later ("short term displacement"). Policies aimed at reducing the health effects of hot weather should include consideration of effects operating at sub-daily timescales. |
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Authors:
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Krishnan Bhaskaran; Ben Armstrong; Shakoor Hajat; Andy Haines; Paul Wilkinson; Liam Smeeth |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2012-12-13 |
Journal Detail:
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Title: BMJ (Clinical research ed.) Volume: 345 ISSN: 1756-1833 ISO Abbreviation: BMJ Publication Date: 2012 |
Date Detail:
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Created Date: 2012-12-17 Completed Date: 2013-02-13 Revised Date: 2013-03-05 |
Medline Journal Info:
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Nlm Unique ID: 8900488 Medline TA: BMJ Country: England |
Other Details:
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Languages: eng Pagination: e8050 Citation Subset: AIM; IM |
Affiliation:
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Department of Non-communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Case-Control Studies Confidence Intervals Cross-Over Studies Electrocardiography England / epidemiology Female Hot Temperature / adverse effects* Humans Male Middle Aged Myocardial Infarction / epidemiology*, etiology Odds Ratio Registries Risk Factors Time Factors Wales / epidemiology Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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086091/Z/08/Z//Wellcome Trust; 098504/Z/12/Z//British Heart Foundation; FS/04/045//British Heart Foundation |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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