The earthquake and tsunami that struck Japan in 2011 have been linked to an increase in fatal MI among survivors, researchers reported.
The researchers analyzed the long-term effects of the disaster on fatal and nonfatal MI, stratifying participants by residence based on severity of impact (low-impact zone vs. high-impact zone).
Motoyuki Nakamura, MD, from the department of internal medicine at Iwate Medical University in Morioka, Japan, and colleagues calculated standardized incidence ratios (SIRs) for fatal and nonfatal MI in each zone during 2011 and subsequent years.
During the 4 years after the disaster, there were no statistically significant differences in SIRs for nonfatal MI, according to the researchers.
The same was true for fatal MI in the low-impact zone, Nakamura and colleagues wrote.
However, the SIR in the high-impact zone was elevated in 2011 (1.8; 95% CI, 1.32-2.28) and the trend continued in 2012 (2.06; 95% CI, 1.55-2.57), 2013 (1.99; 95% CI, 1.49-2.48) and 2014 (2.12; 95% CI, 1.62-2.63), they found.
The researchers also found that during the 4 years after the disaster, SIRs for fatal MI by municipal region were correlated with percentage of inundated area in the region (r = 0.83; P < .001) and with number of deaths in the region due to the tsunami (r = 0.77; P < .005), but there was no link between SIR for fatal MI and a region’s maximum seismic intensity (r = 0.43; P = .12).
“The present long-term study has shown that the incidence of fatal MI was only increased in the tsunami zone,” Nakamura and colleagues wrote. “The mechanisms underlying this prolonged increase in the incidence of fatal MI after the tsunami are not known.”
They wrote that because the tsunami caused many people to be displaced from their homes for a long time, “it seems likely that a major tsunami can have a long-term psychological impact on survivors, in the form of posttraumatic stress disorder, depression, anxiety and sleep disorder. Emotionally stressful events, including natural disasters, have been suggested to contribute to both the long-term risk [for CAD] and the progression of coronary atherosclerosis; furthermore, they may contribute to triggering [ACS], including sudden cardiac death.” – by Erik Swain
The authors report no relevant financial disclosures.