Cardiac sequelae in Brooklyn after the September 11 terrorist attacks

Area of Science:

• Cardiology
• Public Health
• Emergency Medicine

Background:

• Terrorism, exemplified by the September 11, 2001 World Trade Center (WTC) attacks, is linked to increased stress-related disorders.
• Individuals in close proximity to such events are particularly vulnerable to these health impacts.

Purpose of the Study:

• To investigate cardiac events occurring in proximity to the WTC following the September 11, 2001 attacks.
• To determine if there was a significant change in cardiac diagnoses attributed to the WTC tragedy.

Main Methods:

• Analysis of 1,653 patient admissions to New York Methodist Hospital (4 miles from WTC) in the 60 days before and after September 11, 2001.
• Categorization of diagnoses including acute myocardial infarction (MI), unstable angina (UA), and tachyarrhythmia (TA).
• Comparison with cardiac event data from a similar period in 2000 to control for temporal variations.

Main Results:

• A significant difference (p = 0.008) in cardiac diagnoses proportions was observed post-September 11, 2001.
• Post-attack, there was a significant increase in acute MI (15.5% vs. 11.2%) and tachyarrhythmia (TA) (19.9% vs. 13.6%).
• Unstable angina (UA) showed a decrease (39.6% vs. 47.3%) after the attacks; no similar pattern emerged in 2000.

Conclusions:

• The September 11 attacks were associated with a significant rise in acute MI and TA, and a smaller rise in UA.
• Observed changes in cardiac events were not attributable to seasonal or temporal variations.
• Psychological stress resulting from the WTC attacks likely contributed to the increase in TA and progression to acute MI.