Int J Cardiol:冬季心梗发病率高,主要因斑块破裂!日本学者研究

2020-07-24 朱朱 中国循环杂志

日本研究者发现,就气温来说,急性心肌梗死有两个发病高峰,进一步分析显示,在天气较冷时,心肌梗死的发生主要是因为斑块破裂;而在天气比较暖和时,主要是因为冠脉斑块腐蚀而发病。

日本研究者发现,就气温来说,急性心肌梗死有两个发病高峰,在10°C和20°C左右发病风险最高。


进一步分析显示,在天气较冷时,心肌梗死的发生主要是因为斑块破裂;而在天气比较暖和时,主要是因为冠脉斑块腐蚀而发病。


研究者对2016年1月至2017年12月两年期间连续收治的202例接受光学相干断层扫描(OCT)检查的急性心肌梗死患者治疗进行了分析。


该研究将开始出现胸痛的时间作为心肌梗死的发病时间,以患者心梗发作时的中位温度(16.6°C)区分为较低温度发病组(100例)和较高温度发病组(102例)。


研究者发现,气温在10°C和20°C左右时是急性心肌梗死的两个发病高峰。


在较低温度发病组中,斑块破裂的发生率高于较高温度发病组( 66% vs 45%);而较高温度发病组中斑块侵蚀的发生率较高(13% vs 26%)。


较低温度发病组患者冠脉斑块有胆固醇结晶的可能性更高(71% vs 54%)。冠脉斑块有胆固醇结晶的患者的平均体温明显低于冠脉斑块没有胆固醇结晶的患者(36.1°C vs 36.4°C)。


研究者指出,寒冷的环境气温对急性心肌梗死发作有明显影响。


冬季时血压高于夏季,有研究表明,冬季血压持续升高可导致冠心病风险增加21%。因此,人们认为,寒冷季节急性心肌梗死的发生主要与血压升高有关。


但该研究表明,天气较冷时心梗发病风险较高,而此时斑块破裂的发生率也较高,而两组患者的血压相似。该研究为理解寒冷天气血管病的发病机制提供了新的思路。


另外,气温较低时体温也会变低,体温较低时容易引发胆固醇结晶,而胆固醇结晶一般位于罪犯斑块的表层,容易导致斑块破裂,从而导致心肌梗死发作。


研究者表示,对于不同病因导致的心肌梗死,治疗方式也各有侧重。斑块破裂的患者建议置入支架,而斑块侵蚀的患者则应优选抗栓治疗和药物治疗。

 

原始出处:

Yosuke Katayama 1, Atsushi Tanaka 2, Akira Taruya 1, et al.Increased plaque rupture forms peak incidence of acute myocardial infarction in winter.Int J Cardiol. 2020 Jul 14;S0167-5273(20)33459-8. doi: 10.1016/j.ijcard.2020.07.011. Online ahead of print.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1823649, encodeId=c912182364968, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Mar 08 04:38:06 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676801, encodeId=5a1b16e6801d1, content=<a href='/topic/show?id=779a5e93579' target=_blank style='color:#2F92EE;'>#斑块破裂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57935, encryptionId=779a5e93579, topicName=斑块破裂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=924b27388112, createdName=手留余香, createdTime=Sat Jan 23 19:38:06 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782086, encodeId=6bd91e820861a, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Wed May 05 18:38:06 CST 2021, time=2021-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1294559, encodeId=05e512945598a, content=<a href='/topic/show?id=ca6e592189b' target=_blank style='color:#2F92EE;'>#日本#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59218, encryptionId=ca6e592189b, topicName=日本)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330152, encodeId=2b261330152ab, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1823649, encodeId=c912182364968, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Mar 08 04:38:06 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676801, encodeId=5a1b16e6801d1, content=<a href='/topic/show?id=779a5e93579' target=_blank style='color:#2F92EE;'>#斑块破裂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57935, encryptionId=779a5e93579, topicName=斑块破裂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=924b27388112, createdName=手留余香, createdTime=Sat Jan 23 19:38:06 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782086, encodeId=6bd91e820861a, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Wed May 05 18:38:06 CST 2021, time=2021-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1294559, encodeId=05e512945598a, content=<a href='/topic/show?id=ca6e592189b' target=_blank style='color:#2F92EE;'>#日本#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59218, encryptionId=ca6e592189b, topicName=日本)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330152, encodeId=2b261330152ab, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1823649, encodeId=c912182364968, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Mar 08 04:38:06 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676801, encodeId=5a1b16e6801d1, content=<a href='/topic/show?id=779a5e93579' target=_blank style='color:#2F92EE;'>#斑块破裂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57935, encryptionId=779a5e93579, topicName=斑块破裂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=924b27388112, createdName=手留余香, createdTime=Sat Jan 23 19:38:06 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782086, encodeId=6bd91e820861a, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Wed May 05 18:38:06 CST 2021, time=2021-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1294559, encodeId=05e512945598a, content=<a href='/topic/show?id=ca6e592189b' target=_blank style='color:#2F92EE;'>#日本#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59218, encryptionId=ca6e592189b, topicName=日本)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330152, encodeId=2b261330152ab, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1823649, encodeId=c912182364968, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Mar 08 04:38:06 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676801, encodeId=5a1b16e6801d1, content=<a href='/topic/show?id=779a5e93579' target=_blank style='color:#2F92EE;'>#斑块破裂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57935, encryptionId=779a5e93579, topicName=斑块破裂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=924b27388112, createdName=手留余香, createdTime=Sat Jan 23 19:38:06 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782086, encodeId=6bd91e820861a, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Wed May 05 18:38:06 CST 2021, time=2021-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1294559, encodeId=05e512945598a, content=<a href='/topic/show?id=ca6e592189b' target=_blank style='color:#2F92EE;'>#日本#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59218, encryptionId=ca6e592189b, topicName=日本)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330152, encodeId=2b261330152ab, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1823649, encodeId=c912182364968, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Mar 08 04:38:06 CST 2021, time=2021-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676801, encodeId=5a1b16e6801d1, content=<a href='/topic/show?id=779a5e93579' target=_blank style='color:#2F92EE;'>#斑块破裂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57935, encryptionId=779a5e93579, topicName=斑块破裂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=924b27388112, createdName=手留余香, createdTime=Sat Jan 23 19:38:06 CST 2021, time=2021-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1782086, encodeId=6bd91e820861a, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7532500500, createdName=12499e01m47暂无昵称, createdTime=Wed May 05 18:38:06 CST 2021, time=2021-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1294559, encodeId=05e512945598a, content=<a href='/topic/show?id=ca6e592189b' target=_blank style='color:#2F92EE;'>#日本#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59218, encryptionId=ca6e592189b, topicName=日本)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330152, encodeId=2b261330152ab, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sun Jul 26 01:38:06 CST 2020, time=2020-07-26, status=1, ipAttribution=)]

相关资讯

遇到胸痛患者ST段抬高,不能忽视这个!

胸痛是急诊科患者最常见的症状之一,我们报告一位55岁男性,因突发胸痛就诊于我院急诊科的患者,心电图下壁导联提示ST段抬高,服用硝酸甘油后心电图恢复正常,冠状动脉造影无明显狭窄,考虑为冠状动脉痉挛。

旋磨增3倍介入相关心梗风险!北大人民医院刘健等研究

经皮冠状动脉介入相关心肌梗死也称经皮冠状动脉介入后围术期心肌梗死,是经皮冠状动脉介入围术期的严重并发症。

4个心梗病例带来的启示:5大心梗不典型症状,医患都要警惕!

下面这4个来自基层一线的病例,大家可以参考一下,提高警惕。

急性心肌梗死,如何选择溶栓药物?

ST段抬高型心肌梗死(ST-segment elevationmyocardial infarction,STEMI)多为完全堵塞冠状动脉的红血栓所致,而红血栓的主要成分之一是纤维蛋白,溶栓药物能够直

Circulation:低衰减斑块负荷——心肌梗死风险的强大预测指标!??

心肌梗死的未来风险通常通过心血管风险评分、冠状动脉钙评分或冠状动脉狭窄严重程度来评估。Williams等评估了冠状动脉CT血管造影(CCTA)中未钙化的低衰减斑块负荷是否可能更好地预测心肌梗死的未来风

Circulation:改变鞘脂代谢可减轻心肌梗死后的心肌细胞死亡和炎症反应

鞘磷脂最近已成为心肌梗死(MI)后复发和死亡的生物标志物。几组研究表明,在急性心肌梗死期间,哺乳动物心脏组织中神经酰胺水平的升高与左心室细胞死亡率升高和心功能恶化有关。神经酰胺酶是唯一已知的水解促凋亡