Short-Term Effect of Temperature on Daily Emergency Visits for Acute Myocardial Infarction with Threshold Temperatures

Abstract

Background: The relationship between temperature and myocardial infarction has not been fully explained. In this study, we identified the threshold temperature and examined the relationship between temperature and emergency admissions due to MI in Korea. Methods: Poisson generalized additive model analyses were used to assess the short-term effects of temperature (mean, maximum, minimum, diurnal) on MI emergency visits, after controlling for meteorological variable and air pollution (PM10, NO2). We defined the threshold temperature when the inflection point showed a statistically significant difference in the regression coefficients of the generalized additive models (GAMs) analysis. The analysis was performed on the following subgroups: geographical region, gender, age (<75 years or >= 75 years), and MI status (STEMI or non-STEMI). Results: The threshold temperatures during heat exposure were for the maximum temperature as 25.5-31.5 degrees C and for the mean temperature as 27.5-28.5 degrees C. The threshold temperatures during cold exposure were for the minimum temperature as -22.5-1.5 degrees C. Relative risks (RRs) of emergency visits above hot temperature thresholds ranged from 1.02 to 1.30 and those below cold temperature thresholds ranged from 1.01 to 1.05. We also observed increased RRs ranged from 1.02 to 1.65 of emergency visits when temperatures changes on a single day or on successive days. Conclusions: We found a relationship between temperature and MI occurrence during both heat and cold exposure at the threshold temperature. Diurnal temperature or temperature change on successive days also increased MI risk.