Christmas holiday triggers of myocardial infarction
Anneli Olsson1, Ida Thorén1, Moman A Mohammad1
1Department of Cardiology, Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden.
Insights
Christmas holidays are linked to more heart attacks (myocardial infarction, MI). Stress and emotional distress, not just diet, appear to be key triggers during this period, suggesting ways to reduce holiday cardiac events.
Area of Science:
- Cardiology
- Public Health
- Psychosomatic Medicine
Background:
- Christmas holidays are associated with a higher incidence of myocardial infarction (MI).
- Potential triggers for MI during this festive period require investigation to mitigate associated risks.
Purpose of the Study:
- To assess potential triggers of myocardial infarction (MI) during the Christmas holidays.
- To compare emotional and behavioral factors in patients experiencing MI during Christmas versus a control group.
Main Methods:
- A nationwide, retrospective case-control study using postal surveys.
- Identified MI patients during Christmas 2018-2019 via SWEDEHEART registry.
- Compared MI patients with a matched control group on self-reported triggers.
Main Results:
- Patients experiencing MI during Christmas reported significantly higher levels of stress, depression, and worry compared to controls.
- Increased food and sweets consumption was noted in both groups, but more pronounced in the control group.
- No significant increases in anger, quarrels, economic worries, or medication non-compliance were found.
Conclusions:
- Elevated stress and emotional distress are identified as potential contributors to the 'holiday heart attack' phenomenon.
- Understanding these triggers can inform strategies to reduce excess MIs and cardiovascular burden during holiday seasons.
- This research highlights the impact of psychological factors on cardiovascular events during peak holiday periods.
Abstract:
Objectives: Christmas holidays have been associated with the highest incidence of myocardial infarction (MI). We wanted to assess possible triggers of MI during Christmas. Design: A nationwide, retrospective postal survey with case-control design. All individuals suffering an MI during the Christmas holidays 2018 and 2019 in Sweden were identified through the SWEDEHEART registry and a control group matched in age and gender with chronic coronary syndrome who did not seek medical attention during Christmas were asked for participation. Subjects completed a questionnaire asking them to rate 27 potential MI-triggers as having occurred more or less than usual. Results: A total of 189 patients suffering an MI on Christmas Eve, Christmas Day, or Boxing Day, and 157 patients in the control group responded to the questionnaire, representing response rates of 66% and 62%, respectively. Patients with MI on Christmas experienced more stress (37% vs. 21%, p = .002), depression (21% vs. 11%, p = .024), and worry (26% vs. 10%, p < .001) compared to the control group. The food and sweets consumption was increased in both groups, but to a greater extent in the control group (33% vs. 50%, p = .002 and 32% vs. 43%, p = .031). There were no increases in quarrels, anger, economic worries, or reduced compliance with medication. Conclusions: Patients suffering MI on Christmas holiday experienced higher levels of stress and emotional distress compared to patients with chronic coronary syndrome, possibly contributing to the phenomenon of holiday heart attack. Understanding what factors increase the number of MI on Christmas may help reduce the excess number of MIs and cardiovascular burden.
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