Temperature and myocardial infarction among migrants in Kuwait

Heart. 2025 Jan 22:heartjnl-2024-324629. doi: 10.1136/heartjnl-2024-324629. Online ahead of print.

Abstract

Background: Kuwait, one of the world's hottest countries, faces increasing temperatures due to climate change. With a large migrant population predominantly employed in physically demanding jobs, the exact effects and burdens of temperature exposure on cardiovascular risk among this population remain unknown. This study aimed to investigate the relationship between temperature and myocardial infarction (MI) risk among migrants in Kuwait.

Methods: MI hospital admissions data from 17 public hospitals in Kuwait from 2000 to 2017 were collected. Meteorological data, including daily temperatures and humidity, were obtained from monitoring stations. A time series analysis was conducted to examine the association between temperature and MI hospitalisation. A distributed lag non-linear model was used to study the lagged association of temperature. Seasonality, relative humidity and day of the week were adjusted for in the model. Excess hospitalisations attributed to temperature variations were calculated.

Results: A total of 26 839 MI cases were examined. The optimal temperature with the lowest MI cases was 39.2°C. Elevated MI risks were associated with both hot and cold temperatures above or below this threshold, particularly at shorter lag days. Hot temperatures showed a pronounced association at lag 0, while cold temperatures demonstrated a weak effect at lag 7. The cumulative risk of MI for cold temperatures was higher than the risk for hot temperatures. Annually, 300 (20.1%) MI cases can be attributed to all cool days (below 39.2°C). Very hot days (above 39.2°C) contributed to about 9 (0.6%) MI cases each year among migrants in Kuwait.

Conclusion: The study revealed a substantial burden of both hot and cold ambient temperatures and the risk of MI at shorter lag days among the migrant population in Kuwait. This study provides valuable insights for government officials to mitigate exposure to extreme temperatures, especially in occupational settings.

Keywords: Cardiovascular Diseases; Electronic Health Records; Epidemiology; Myocardial Infarction.