Correlation Between Atmospheric Environment And The Incidence Of Acute Myocardial Infarction In Zhangjiakou Area

Objective:To analyze whether there is a temporal distributional law of acute myocardial infarction（AMI）in Zhangjiakou area.And,to discuss the relationship between atmospheric environment and acute myocardial infarction（AMI）,as well as the functional relationship between meteorological factors,demographic factors,and traditional AMI risk factors in the pathogenesis of acute myocardial infarction.Methods:A retrospective analysis of 7 hospitals in Zhangjiakou area,one of which is a third-grade first-class hospital,and six county-level hospitals,from January 1,2014 to December 31,2016 was submitted for AMI admission.To keep detail record of the general clinical data such as the time of onset,gender,age,history of hypertension,history of diabetes,history of smoking,etc.Atmospheric environmental data were taken from the Meteorological Bureau and Environmental Monitoring Center Station of Zhangjiakou City,Hebei Province.Specifically,the atmospheric environmental data of the day,the day before and the two days before the AMI frequent occurrence were collected continuously,which included the daily average temperature（°C）,the daily maximum temperature（°C）,the daily minimum temperature（°C）,daily temperature change（°C）,daily average air pressure（hPa）,daily maximum air pressure（hPa）,daily minimum air pressure（hPa）,daily average wind speed（m/s）,the daily highest wind speed（m/s）,daily maximum wind speed（m/s）,sunshine hours（hr）,daily average relative humidity（%）and other meteorological data and daily air quality index AQI,daily PM_2.5（μg/m³）,daily PM₁₀（μg/m³）and other air pollution data.To analyze whether the incidence of AMI has seasonal and monthly distribution patterns,and use the logistic multi-factor regression model to analyze the impact of atmospheric environment on the frequent occurrence of AMI.To compare the meteorological factors between different demographic factors and traditional risk factors of AMI in frequent and non-frequency days of AMI,as well as the daily and non-frequency daily air pollution indicators of AMI.Results:1.The number of monthly average AMI cases in Zhangjiakou area reaches the peak during spring,while the valley during summer.The overall monthly average number of AMI cases in April was higher than those in the remaining months.2.The daily temperature change of the AMI frequency nearly three days was significantly higher than that of the non-frequency days,the difference was statistically significant（P<0.01）;the average relative humidity of the AMI frequency nearly three days was lower than that of the non-frequency days,the difference was statistically significant（P<0.05）.3.（1）Among male patients,the daily temperature change on the day and the 2 days before AMI frequency was significantly greater than that on non-frequency days,the difference was statistically significant（P<0.01）,and the previous daily temperature change of AMI was more than that of the non-frequency days,the difference was statistically significant（P<0.05）;among female patients,there was no difference in meteorological factors between the frequent and non-frequency of AMI（P>0.05）.（2）Among patients with age≤55,the highest wind speed and the maximum wind speed of the day before AMI frequency were less than that of the non-frequency days,the difference was statistically significant（P<0.05）.Among patients over 55 years old and less than or equal to 65years old,the diurnal temperature of the day of AMI frequency was more than that of non-frequency days,the difference was statistically significant（P<0.05）,while the average daily wind speed,the highest wind speed,and maximum wind speed of the frequency days were significantly lower than that on the non-frequency days,the difference was statistically significant（P<0.01）.In patients older than 65 years,the average relative humidity of the frequency days was less than that of the non-frequency days,the difference was statistically significant（P<0.05）.（3）Among the smokers,the diurnal temperature of the day and two days before AMI frequency was significantly higher than that of the non-frequency days,the difference was statistically significant（P<0.01）,and the sunshine duration of the two days before AMI frequency was greater than that on the non-frequency days,the difference was statistically significant（P<0.05）.The humidity of the day before AMI frequency was less than that of the non-frequency days,the difference was statistically significant（P<0.05）.（4）Among the hypertensive patients,there was no difference in meteorological factors between the frequent and non-frequency of AMI（P>0.05）.（5）Among the patients with diabetes,the average temperature and minimum temperature of the AMI occurred nearly three days,and the highest temperature on the day and the day before the AMI occurred were lower than that of the non-frequency days,the difference was statistically significant（P<0.05）.The average air pressure of the two days before the AMI frequency,the highest pressure of the previous day and the first two days of the AMI frequency were greater than that of the non-frequency days,the difference was statistically significant（P<0.05）.4.（1）The Zhangjiakou area had no pollution for 950 days between2014 and 2016,accounting for 86.67%of the total observation days;117days of mild pollution,accounting for 10.67%of the total observation days;moderate and severe pollution for 29 days,accounting for 2.46%of the total observation days.（2）There was no difference in the concentration of AQI,PM_2.5.5 and PM₁₀ between the frequency and non-frequency days of AMI（P>0.05）.5.The results of single factor logistic regression analysis showed that the temperature and humidity of AMI frequency nearly three days were statistically significant（P<0.05）.The multivariate logistic regression model did not find that the atmospheric environmental factor in Zhangjiakou area was independent risk factors for AMI.Conclusions:1.The incidence of monthly average AMI in Zhangjiakou area is the highest in spring and the lowest in summer,and is higher in April than that in other months.2.The daily temperature change of the AMI frequency nearly three days is significantly higher than that of the non-frequency days,and the average relative humidity of the AMI frequency nearly three days is lower than that of the non-frequency days.3.There is no difference in the concentration of AQI,PM_2.5.5 and PM₁₀between the frequency and non-frequency days of AMI（P>0.05）.4.Atmospheric environmental factors such as temperature,air pressure,wind speed and PM_2.5.5 in Zhangjiakou area are not independent risk factors for AMI.