García‐Lledó, Alberto;
Rodríguez‐Martín, Sara;
Tobías, Aurelio;
García‐de‐Santiago, Elvira;
Ordobás‐Gavín, María;
Ansede‐Cascudo, Juan Carlos;
Alonso‐Martín, Joaquin;
de Abajo, Francisco J.
Relationship Between Influenza, Temperature, and Type 1 Myocardial Infarction: An Ecological Time‐Series Study
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Media type:
E-Article
Title:
Relationship Between Influenza, Temperature, and Type 1 Myocardial Infarction: An Ecological Time‐Series Study
Contributor:
García‐Lledó, Alberto;
Rodríguez‐Martín, Sara;
Tobías, Aurelio;
García‐de‐Santiago, Elvira;
Ordobás‐Gavín, María;
Ansede‐Cascudo, Juan Carlos;
Alonso‐Martín, Joaquin;
de Abajo, Francisco J.
Description:
<jats:sec xml:lang="en">
<jats:title>Background</jats:title>
<jats:p xml:lang="en">Previous studies investigating the relationship of influenza with acute myocardial infarction (AMI) have not distinguished between AMI types 1 and 2. Influenza and cold temperature can explain the increased incidence of AMI during winter but, because they are closely related in temperate regions, their relative contribution is unknown.</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Methods and Results</jats:title>
<jats:p xml:lang="en">The temporal relationship between incidence rates of AMI with demonstrated culprit plaque (type 1 AMI) from the regional primary angioplasty network and influenza, adjusted for ambient temperature, was studied in Madrid region (Spain) during 5 influenza seasons (from June 2013 to June 2018). A time‐series analysis with quasi‐Poisson regression models and distributed lag‐nonlinear models was used. The incidence rate of type 1 AMI according to influenza vaccination status was also explored. A total of 8240 cases of confirmed type 1 AMI were recorded. The overall risk ratio (RR) of type 1 AMI during epidemic periods, adjusted for year, month, and temperature, was 1.23 (95% CI, 1.03–1.47). An increase of weekly influenza rate of 50 cases per 100 000 inhabitants resulted in an RR for type 1 AMI of 1.16 (95% CI, 1.09–1.23) during the same week, disappearing 1 week after. When adjusted for influenza, a decrease of 1ºC in the minimum temperature resulted in an increase of 2.5% type 1 AMI. Influenza vaccination was associated with a decreased risk of type 1 AMI in subjects aged 60 to 64 years (RR, 0.58; 95% CI, 0.47–0.71) and ≥65 years (RR, 0.53; 95% CI, 0.49–0.57).</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Conclusions</jats:title>
<jats:p xml:lang="en">Influenza and cold temperature were both independently associated with an increased risk of type 1 AMI, whereas vaccination was associated with a reduced risk among older patients.</jats:p>
</jats:sec>