PLoS ONE (Jan 2020)

Seasonality of ventricular fibrillation at first myocardial infarction and association with viral exposure.

  • Charlotte Glinge,
  • Thomas Engstrøm,
  • Sofie E Midgley,
  • Michael W T Tanck,
  • Jeppe Ekstrand Halkjær Madsen,
  • Frants Pedersen,
  • Mia Ravn Jacobsen,
  • Elisabeth M Lodder,
  • Nour R Al-Hussainy,
  • Niels Kjær Stampe,
  • Ramona Trebbien,
  • Lars Køber,
  • Thomas Gerds,
  • Christian Torp-Pedersen,
  • Thea K Fischer,
  • Connie R Bezzina,
  • Jacob Tfelt-Hansen,
  • Reza Jabbari

DOI
https://doi.org/10.1371/journal.pone.0226936
Journal volume & issue
Vol. 15, no. 2
p. e0226936

Abstract

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AIMS:To investigate seasonality and association of increased enterovirus and influenza activity in the community with ventricular fibrillation (VF) risk during first ST-elevation myocardial infarction (STEMI). METHODS:This study comprised all consecutive patients with first STEMI (n = 4,659; aged 18-80 years) admitted to the invasive catheterization laboratory between 2010-2016, at Copenhagen University Hospital, Rigshospitalet, covering eastern Denmark (2.6 million inhabitants, 45% of the Danish population). Hospital admission, prescription, and vital status data were assessed using Danish nationwide registries. We utilized monthly/weekly surveillance data for enterovirus and influenza from the Danish National Microbiology Database (2010-2016) that receives copies of laboratory tests from all Danish departments of clinical microbiology. RESULTS:Of the 4,659 consecutively enrolled STEMI patients, 581 (12%) had VF before primary percutaneous coronary intervention. In a subset (n = 807), we found that VF patients experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with the patients without VF (OR 3.39, 95% CI 1.76-6.54). During the study period, 2,704 individuals were diagnosed with enterovirus and 19,742 with influenza. No significant association between enterovirus and VF (OR 1.00, 95% CI 0.99-1.02), influenza and VF (OR 1.00, 95% CI 1.00-1.00), or week number and VF (p-value 0.94 for enterovirus and 0.89 for influenza) was found. CONCLUSION:We found no clear seasonality of VF during first STEMI. Even though VF patients had experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with patients without VF, no relationship was found between enterovirus or influenza exposure and occurrence of VF.