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(Circulation. 2009;120:735-742.)
© 2009 American Heart Association, Inc.

Epidemiology and Prevention

Air Temperature and the Occurrence of Myocardial Infarction in Augsburg, Germany

Kathrin Wolf, MSc; Alexandra Schneider, PhD; Susanne Breitner, PhD; Stephanie von Klot, PhD; Christa Meisinger, MD, MPH; Josef Cyrys, PhD; Heiko Hymer, BSc; H. -Erich Wichmann, MD, PhD; Annette Peters, PhD, for the Cooperative Health Research in the Region of Augsburg (KORA) Study Group

From Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany (K.W., A.S., S.B., S.v.K., C.M., J.C., H.H., H.-E.W., A.P.); Harvard School of Public Health, Boston, Mass (S.v.K.); Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany (C.M.); Environmental Science Center, University of Augsburg, Augsburg, Germany (J.C.); and Ludwig-Maximilians University of Munich, Institute of Medical Data Management, Biometrics and Epidemiology, Munich, Germany (H.-E.W., A.P.).

Correspondence to Kathrin Wolf, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Ingolstaedter Landstr 1, 85764 Neuherberg, Germany. E-mail kathrin.wolf{at}helmholtz-muenchen.de

Received August 20, 2008; accepted January 20, 2009.

Background— Air temperature changes have been associated with cardiovascular mortality and morbidity. The objective of this study was to examine in detail the registry-based myocardial infarction (MI) rates and coronary deaths in relation to air temperature in the area of Augsburg, Germany.

Methods and Results— Between 1995 and 2004, the Monitoring Trends and Determinants on Cardiovascular Diseases/Cooperative Health Research in the Region of Augsburg (MONICA/KORA) registry recorded 9801 cases of MI and coronary deaths. Over the same period, meteorological parameters and air pollutant concentrations were measured in the study region. Poisson regression analyses adjusting for time trend, relative humidity, season, and calendar effects were used to estimate immediate, delayed, and cumulative temperature effects on the occurrence of MIs. The daily rates of total MI, nonfatal and fatal events, and incident and recurrent events were analyzed. For the total MI cases, a 10°C decrease in 5-day average temperature was associated with a relative risk of 1.10 (95% confidence interval, 1.04 to 1.15). The effect of temperature on the occurrence of nonfatal events showed a delayed pattern, whereas the association with fatal MI was more immediate. No association could be observed for recurrent events. The effects of temperature decreases on total MI cases were more pronounced in years with higher average temperatures and were visible in summer.

Conclusions— We observed an inverse relationship between temperature and MI occurrence not only during winter but also during summer. Thus, our results suggest not a pure "cold effect" but an influence of unusual temperature decreases.

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Circulation 2009 120: 717. [Extract] [Full Text]