Abstract
BackgroundLittle is known about the causality and pathological mechanism underlying the association of seasonal variation with myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI).ObjectiveWe evaluated the association of seasonal effect with myocardial injury using cardiovascular magnetic resonance (CMR) imaging in STEMI patients undergoing primary percutaneous coronary intervention (PCI).MethodsIn 279 patients undergoing primary PCI for STEMI, CMR was performed for a median of 3.3 days after the index procedure. Of these, STEMI occurred in 56 patients in the winter (Winter group), 80 patients in the spring (Spring group), 76 patients in the summer (Summer group), and 67 patients in the autumn (Autumn group), respectively. We compared myocardial infarct size, extent of area at risk (AAR), myocardial salvage index (MSI) and microvascular obstruction (MVO) area as assessed by CMR according to the season in which STEMI occurred.ResultsIn the CMR analysis, the myocardial infarct size was not significantly different among the Winter group (21.0 ± 10.5%), the Spring group (19.6 ± 11.5%), the Summer group (18.6 ± 10.6%), and the Autumn group (21.1 ± 11.3%) (P = 0.475). The extent of AAR, MSI, and MVO areas were similar among the four groups. In the subgroup analysis, myocardial infarct size, extent of AAR, MSI, and MVO were not significantly different between the Harsh climate (winter + summer) and the Mild climate (spring + autumn) groups.ConclusionsSeasonal influences may not affect advanced myocardial injury in STEMI patients undergoing primary PCI.
Highlights
Seasonal variations influence the incidence of acute myocardial infarction (MI) [1]
We compared myocardial infarct size, extent of area at risk (AAR), myocardial salvage index (MSI) and microvascular obstruction (MVO) area as assessed by Cardiovascular magnetic resonance (CMR) according to the season in which segment elevation myocardial infarction (STEMI) occurred
The extent of AAR, MSI, and MVO areas were similar among the four groups
Summary
Seasonal variations influence the incidence of acute myocardial infarction (MI) [1]. Previous studies have reported that acute MI occurs more frequently in cold and hot weather, and that ambient temperature may play an important role in the development of acute MI [2]. Kloner et al [5] investigated seasonal variations in myocardial perfusion using enzymatic infarct size as estimated by the cumulative release of cardiac enzymes and reported that smaller infarct size was observed in the summer, but the causality and pathological mechanisms underlying the association of seasonal effects with myocardial injury remained unclear. Cardiovascular magnetic resonance (CMR) imaging can precisely assess the extent of myocardial injury and salvaged myocardium in acute MI patients [6,7]. We evaluated the association between seasonal variation and myocardial injury as assessed by CMR imaging in STEMI patients undergoing primary PCI. Little is known about the causality and pathological mechanism underlying the association of seasonal variation with myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI)
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