Ryti NRI, Junttila MJ, Antikainen H, et al. Coronary stenosis as a modifier of the effect of cold spells on the risk of sudden cardiac death: a case-crossover study in Finland. BMJ Open 2018;8:e020865. doi: 10.1136/bmjopen-2017-020865
Coronary stenosis as a modifier of the effect of cold spells on the risk of sudden cardiac death : a case-crossover study in Finland
|Author:||Ryti, Niilo R I1; Junttila, M Juhani2; Antikainen, Harri3;|
1Center for Environmental and Respiratory Health Research (CERH), University of Oulu
2Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital
3Geography Research Unit, University of Oulu
4Department of Forensic Medicine, University of Oulu
|Online Access:||PDF Full Text (PDF, 0.2 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2018110947757
|Publish Date:|| 2018-11-09
Objective: To test the a priori hypothesis that the association between cold spells and ischaemic sudden cardiac death (SCD) is modified by the severity of coronary stenosis.
Methods: The home coordinates of 2572 autopsy-verified cases of ischaemic SCD aged ≥35 in the Province of Oulu, Finland, were linked to 51 years of weather data. Cold spell was statistically defined for each home address as unusually cold weather pertinent to the location and time of year. We estimated the occurrence of cold spells during the hazard period (7 days preceding death) and reference periods (the same calendar days over 51 years) in a case-crossover setting applying conditional logistic regression, controlling for temporal trends and stratifying by severity of coronary stenosis.
Results: The association between cold spells and ischaemic SCD was stronger among patients with 75%–95% stenosis (OR 2.03; 95% CI 1.31 to 3.17), and weaker to non-existent among patients with <75% stenosis (OR 0.97; 95% CI 0.37 to 2.55) or coronary total occlusion (100% stenosis) (OR 1.01; 95% CI 0.52 to 1.96). Lack of calcium-channel blockers and statin therapy seemed to accentuate the role of stenosis during cold spells.
Conclusions: We provide evidence that the association between cold spells and ischaemic SCD is modified by the severity of coronary stenosis. The findings suggest that disturbances in coronary circulation play part in the pathogenesis of SCD during cold weather.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3121 Internal medicine
This work was funded by the Research Council for Health, Academy of Finland (grant nos 266314 and 267435), University of Oulu Strategic Funding for CERH, Emil Aaltonen Foundation, Sigrid Juselius Foundation and Foundation for Cardiovascular Disease. The funders of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report or the decision to submit the article for publication. The authors are independent from funders.
|Academy of Finland Grant Number:||
266314 (Academy of Finland Funding decision)
267435 (Academy of Finland Funding decision)
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