The Interaction Effects of Meteorological Factors and Air Pollution on the Development of Acute Coronary Syndrome

Ching-Hui Huang,Heng-Cheng Lin,Hung-Kai Huang,Chia-Chu Chang,Chen-Dao Tsai,Ie-Bin Lian

doi:10.1038/srep44004

Abstract

This study investigated the interaction effects of meteorological factors and air pollutants on the onset of acute coronary syndrome (ACS). Data of ACS patients were obtained from the Taiwan ACS Full Spectrum Registry and comprised 3164 patients with a definite onset date during the period October 2008 and January 2010 at 39 hospitals. Meteorological conditions and air pollutant concentrations at the 39 locations during the 488-day period were obtained. Time-lag Poisson and logistic regression were used to explore their association with ACS incidence. One-day lag atmospheric pressure (AP), humidity, particulate matter (PM2.5, and PM10), and carbon monoxide (CO) all had significant interaction effects with temperature on ACS occurrence. Days on which high temperatures (>26 °C) and low AP (<1009 hPa) occurred the previous day were associated with a greater likelihood of increased incidence of developing ACS. Typhoon Morakot was an example of high temperature with extremely low AP associated with higher ACS incidence than the daily average. Combinations of high concentrations of PM or CO with low temperatures (<21 °C) and high humidity levels with low temperatures were also associated with increased incidence of ACS. Atmospheric pollution and weather factors have synergistic effects on the incidence of ACS.

Highlights

Concern to healthcare authorities in that country
In this study we explored the relationship between meteorological parameters and acute coronary syndrome (ACS) incidence using data on patients registered in the Taiwan ACS Full Spectrum Registry, a database established to identify predictors of outcomes of patients with ACS one year after hospital discharge at 39 medical centers and regional hospitals across Taiwan[15]
ST-elevation myocardial infarction (STEMI) was defined in patients who presented with acute chest pain or overwhelming shortness of breath together with persistent electrocardiographic ST elevation of >1 mm in two or more contiguous leads, or with a new or presumed new left-bundle branch block pattern on electrocardiography

Summary

Introduction

Concern to healthcare authorities in that country. most studies on the impact of extreme weather on cardiovascular events have been conducted in the United States and have focused mainly on Hurricane Katrina and Hurricane Sandy[13,14]. Large-scale studies on the relationship between typhoons and other extreme weather events on incidence of cardiovascular events such as ACS in Asia are needed. It is important to understand whether certain environmental factors play a role in the development of ACS. The study period investigated in this study was October 2008 to January 2010, and included the days during which typhoon Morakot (7–9 August 2009) affected Taiwan. This typhoon was the most severe in half a century and caused catastrophic damage island wide. We chose to focus on Morakot because it serves as an extreme meteorological example with which to study the relationship between ACS and environmental factors

Methods

Results

Discussion

Conclusion