Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial Infarction: The INTERHEART Study
Authors' conclusion
Physical exertion and anger or emotional upset are triggers associated with first AMI in all regions of the world, in men and women, and in all age groups, with no significant effect modifiers.
Study context
- Population
- Cases of first acute myocardial infarction (AMI), INTERHEART, 52 countries
- Participants
- 12,461 AMI cases
- Comparison
- Physical activity vs Anger or emotional upset
- Physical activityn = 1,650
- Anger or emotional upsetn = 1,752
- Outcome
- AMI occurring within 1 hour of triggers
- Follow-up
- 1 hour
Methodological details52 countries
- 52 countries
Main finding
As reported in the abstract
AMI · within 1 hour of trigger
Odds ratio (99% CI)
Physical activity
2.31(1.96–2.72)
Anger or emotional upset
2.44(2.06–2.89)
Observational data: associations, not effects.
Further findings
AMI with both physical activity and anger or emotional upset in the case period · 1 hour before symptom onset
| Comparison | OR (99% CI) | |
|---|---|---|
| Both physical activity and anger or emotional upsetP for interaction <0.001 | 3.05 (2.29–4.07) | |
| 0.20.5125Odds ratio (log scale) |
- AMI with both physical activity and anger or emotional upset in the case period: P for interaction <0.001
Effect modification of triggers
- No effect modification by geographical region, prior CVD, CV risk factor burden, CV prevention medications, or time of day or day of onset of AMI
Original publication
Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial Infarction: The INTERHEART Study. Circulation. Published 11 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it