Risk of sudden cardiac death in relation to season-specific cold spells: a case-crossover study in Finland.

Autor:	Ryti NRI; Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, Oulu, Finland., Mäkikyrö EMS; Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, Oulu, Finland., Antikainen H; Department of Geography, University of Oulu, Oulu, Finland., Hookana E; Department of Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland., Junttila MJ; Department of Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland., Ikäheimo TM; Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, Oulu, Finland., Kortelainen ML; Department of Forensic Medicine, University of Oulu, Oulu, Finland., Huikuri HV; Department of Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland., Jaakkola JJK; Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, Oulu, Finland.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2017 Nov 10; Vol. 7 (11), pp. e017398. Date of Electronic Publication: 2017 Nov 10.
DOI:	10.1136/bmjopen-2017-017398
Abstrakt:	Objective: To test a priori hypothesis of an association between season-specific cold spells and sudden cardiac death (SCD). Methods: We conducted a case-crossover study of 3614 autopsy-verified cases of SCD in the Province of Oulu, Finland (1998-2011). Cold spell was statistically defined by applying an individual frequency distribution of daily temperatures at the home address during the hazard period (7 days preceding death) and 50 reference periods (same calendar days of other years) for each case using the home coordinates. Conditional logistic regression was applied to estimate ORs for the association between the occurrence of cold spells and the risk of SCD after controlling for temporal trends. Results: The risk of SCD was associated with a preceding cold spell (OR 1.33; 95% CI 1.00, 1.78). A greater number of cold days preceding death increased the risk of SCD approximately 19% per day (OR 1.19; 95% CI 1.07 to 1.32). The association was strongest during autumn (OR 2.51; 95% CI 1.27 to 4.96) and winter (OR 1.70; 95% CI 1.13 to 2.55) and lowest during summer (OR 0.42; 95% CI 0.15 to 1.18) and spring (OR 0.89; 95% CI 0.45 to 1.79). The association was stronger for ischaemic (OR 1.55; 95% CI 1.12 to 2.13) than for non-ischaemic SCD (OR 0.68; 95% CI 0.32 to 1.45) verified by medicolegal autopsy. Conclusions: Our results indicate that there is an association between cold spells and SCD, that this association is strongest during autumn, when the weather event is prolonged, and with cases suffering ischaemic SCD. These findings are subsumed with potential prevention via weather forecasting, medical advice and protective behaviour. Competing Interests: Competing interests: None declared. (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
Databáze:	MEDLINE
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