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Temporal changes in myocardial infarction incidence rates are associated with periods of perceived psychosocial stress: A SWEDEHEART national registry study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.ORCID iD: 0000-0001-9402-7404
Department of Psychology, Umeå University.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.ORCID iD: 0000-0002-1591-7407
2017 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 191, p. 12-20Article in journal (Refereed) Published
Abstract [en]

BackgroundPsychosocial stress might trigger myocardial infarction (MI). Increased MI incidence coincides withrecurrent time periods during the year perceived as particularly stressful in the population.

MethodsA stress-triggering hypothesis on the risk of MI onset was investigated with Swedish population data on MIhospital admission date and symptom onset date (N = 156,690; 148,176) as registered from 2006 through 2013 in thenational quality registry database Swedish Web-system for Enhancement and Development of Evidence-based care in Heartdisease Evaluated According to Recommended Therapies (SWEDEHEART). Poisson regression was applied to analyze dailyMI rates during days belonging to the Christmas and New Year holidays, turns of the month, Mondays, weekends, andsummer vacation in July compared with remaining control days.

ResultsAdjusted incidence rate ratios (IRRs) for MI rates were higher during Christmas and New Year holidays(IRR = 1.07 [1.04-1.09],Pb.001) and on Mondays (IRR = 1.11 [1.09-1.13],Pb.001) and lower in July (IRR = 0.92 [0.90-0.94],Pb.001) and over weekends (IRR = 0.88 [0.87-0.89],Pb.001), yet not during the turns of the month (IRR = 1.01[1.00–1.02],P= .891). These findings were also predominantly robust with symptom onset as alternative outcome, whenadjusting for both established and some suggested-but-untested confounders, and in 8 subgroups.

ConclusionsFluctuations in daily MI incidence rates are systematically related to time periods of presumed psychosocialstress. Further research might clarify mechanisms that are amenable to clinical alteration.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 191, p. 12-20
National Category
Cardiac and Cardiovascular Systems Psychology
Identifiers
URN: urn:nbn:se:uu:diva-325846DOI: 10.1016/j.ahj.2017.05.015ISI: 000410302800003PubMedID: 28888265OAI: oai:DiVA.org:uu-325846DiVA, id: diva2:1117140
Available from: 2017-06-28 Created: 2017-06-28 Last updated: 2017-12-19Bibliographically approved

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