解放军医学院学报2026，Vol.47Issue(1)：32-40,50,10.DOI:10.12435/j.issn.2095-5227.25092401
"候鸟"人群急性心肌梗死的临床特点及迁徙所致的气温变化对其急性心肌梗死亚型的影响
Clinical characteristics of acute myocardial infarction in migrant bird population and impact of migration-induced temperature changes on AMI subtypes
摘要
Abstract
Background Multiple studies have indicated a close relationship between temperature and the occurrence of acute myocardial infarction(AMI).However,there is limited reporting on the impact of temperature variation due to short-term migration across different climate zones on AMI,as well as the clinical characteristics of the affected population.Objective To investigate the clinical features of AMI in the seasonal migrants and explore the role of temperature variation in the onset of AMI among this cohort.Methods We consecutively enrolled AMI patients who were hospitalized and underwent coronary angiography at Hainan Hospital of PLA General Hospital during the winter months from 2012 to 2022.Based on travel history,patients were divided into the seasonal migrant cohort and the local resident cohort.Baseline characteristics,coronary angiography findings,interventional treatment strategies,and in-hospital outcomes were compared between the two cohorts.Subsequently,propensity score matching(PSM)was employed to balance the baseline characteristics between the two groups before comparison.A further comparison was made of the clinical characteristics of the two types of AMI within the seasonal migrants.A piecewise regression model was employed to examine the nonlinear relationship between the arrival-to-onset interval and acute ST-segment elevation myocardial infarction(STEMI)in seasonal migrants with AMI.Additionally,a multivariable Logistic regression model was used to evaluate the association between the temperature difference and STEMI in seasonal migrants with AMI.Results A total of 514 patients were included,comprising 350(68.1％)seasonal migrants with AMI and 164(31.9％)local residents with AMI.Compared to local residents,the seasonal migrants were older([63.1±11.6]years vs[59.6±11.6]years,P=0.001),had a higher proportion of female patients(22.0％vs 11.0％,P=0.004),more pre-existing risk factors,and a higher incidence of in-hospital cardiogenic shock(18.0％vs 11.0％,P=0.042).Moreover,after PSM,their risk of in-hospital cardiogenic shock remained significantly higher than that of the local residents(21.3％vs 9.8％,P=0.013).Segmented regression model revealed a threshold effect in the relationship between the arrival-to-onset interval and different AMI subtypes among seasonal migrant patients.When the arrival-to-onset interval was≤31 d,it demonstrated a significant inverse association with the probability of STEMI(OR=0.928,95％CI:0.880-0.979,P=0.006).Furthermore,multivariable Logistic regression analysis indicated a significant positive correlation between the temperature difference and STEMI in seasonal migrants with AMI(OR=1.079,95％CI:1.035-1.125,P<0.001).For every 1℃ increase in temperature difference,the probability of STEMI increased significantly by 7.9％.Conclusion Seasonal migrants with AMI are at a higher risk of in-hospital cardiogenic shock;a threshold effect exists in the relationship between the arrival-to-onset interval and STEMI in this population,and the temperature difference is an independent risk factor for STEMI in seasonal migrants with AMI.关键词
急性心肌梗死/气温变化/"候鸟"人群/拐点效应/危险因素Key words
acute myocardial infarction/temperature variation/seasonal migrants/breakpoint effect/risk factor分类
医药卫生引用本文复制引用
王建,付振虹,周伯宁,党子杰,张昕,焦阳,宿永康,黄浩呈,王继航,沈明志.."候鸟"人群急性心肌梗死的临床特点及迁徙所致的气温变化对其急性心肌梗死亚型的影响[J].解放军医学院学报,2026,47(1):32-40,50,10.基金项目
海南省重点研发项目(ZDYF2023SHFZ145) （ZDYF2023SHFZ145）
