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The Incidence, Risk Factors, and Chronobiology of Acute Myocardial Infarction Ten Years After Hurricane Katrina

Published online by Cambridge University Press:  12 April 2018

John C. Moscona*
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Matthew N. Peters
Affiliation:
Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Rohit Maini
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Paul Katigbak
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Bradley Deere
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Holly Gonzales
Affiliation:
Division of Cardiovascular Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Christopher Westley
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Hassan Baydoun
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Kapil Yadav
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Patrick Ters
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Ahmad Jabbar
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Alaa Boulad
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Indrajeet Mahata
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Taraka V. Gadiraju
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Ryan Nelson
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
Sudesh Srivastav
Affiliation:
Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
Anand Irimpen
Affiliation:
Heart & Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana
*
Correspondence and reprint requests to John Moscona, MD, 3442 Vincennes Place, New Orleans, LA 70125 (e-mail: jcmoscona@gmail.com).

Abstract

Objective

The purpose of this study was to investigate the 10-year impact of Hurricane Katrina on the incidence of acute myocardial infarction (AMI) along with contributing risk factors and any alteration in chronobiology of AMI.

Methods

A single-center, retrospective, comparison study of AMI incidence was performed at Tulane University Health Sciences Center from 2 years before Hurricane Katrina to 10 years after Hurricane Katrina. A 6-year, pre-Katrina and 10-year, post-Katrina cohort were also compared according to pre-specified demographic, clinical, and chronobiological data.

Results

AMI incidence increased from 0.7% (150/21,079) to 2.8% (2,341/84,751) post-Katrina (P<0.001). The post-Katrina cohort had higher rates of coronary artery disease (36.4% vs. 47.9%, P=0.01), diabetes mellitus (31.3% vs. 39.9%, P=0.04), hyperlipidemia (45.4% vs. 59.3%, P=0.005), smoking (34.4% vs. 53.8%, P<0.001), drug abuse (10.2% vs. 15.4%, P=0.02), psychiatric illness (6.7% vs. 14.9%, P<0.001), medication non-adherence (7.3% vs. 15.3%, P<0.001), and lack of employment (7.2% vs. 16.4%, P<0.001). The post-Katrina group had increased rates of AMI during nights (29.8% vs. 47.8%, P<0.001) and weekends (16.1% vs. 29.1%, P<0.001).

Conclusions

Even 10 years after the storm, Hurricane Katrina continues to be associated with increased incidence of AMI, higher prevalence of traditional cardiovascular and psychosocial risk factors, and an altered chronobiology of AMI toward nights and weekends. (Disaster Med Public Health Preparedness. 2019;13:217–222)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

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Footnotes

The institutional review board at the Tulane Office of Human Research Protection approved the study, waiving the requirement for informed consent.

References

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