Winter months and cold weather, in more than any other time of year, pose a greater risk to people suffering from new (acute) or ongoing (chronic) cardiac events. In the Northern hemisphere, this time of year correlates with the Thanksgiving through New Year holidays², but there are similar studies in the Southern hemisphere (Australia) where cardiac events correlate with winter peaking in July.¹

“(a)bout one third more deaths from ischemic heart disease were recorded in December and January”⁴

Cold weather and the activities associated with winter weather events can result in the following conditions that may exacerbate underlying cardiac conditions, including Acute Coronary Syndrome (ACS). They include, but are not limited to:

• Constriction of blood vessels causing increased blood pressure⁴
• Higher likelihood of the formation of blood clots caused from broken plaques⁴
• Physical exertion during snow, ice, or sleet removal increasing burden on heart⁴
• Decreased vitamin D caused from less access to sunshine⁴
• Complications from influenza illness³
• Increased burden on heart from other underlying respiratory issues (including wood burning fires, bronchitis from colds, etc.)⁴

Researchers in the US indicate that “(a)bout one third more deaths from ischemic heart disease were recorded in December and January than from June through September”.⁴ Cardiac conditions can also be affected by changes in diet (increasing salt intake), increased alcohol consumption, emotional and financial stress, and/or delayed treatment by people experiencing symptoms.

This means that knowing and understanding there is an increase in cardiac events during these months, facilities can be better prepared to handle these patients. The ability to triage patients to care that can reduce additional necrosis of heart muscles cells is helped by serial troponin testing of patients presenting with chest pains and suspected of having an acute coronary syndrome. Inappropriate delay in seeking medical care, the possibility that staffing levels at hospitals and other healthcare facilities may be reduced during the holiday season, and holiday on-call scheduling, which may result in staff caring for patients with whom they are less familiar, are all factors that may pose unique challenges during holiday and/or winter seasons.⁴

UTILIZING TROPONIN

Rapid with-patient diagnostic testing, especially troponin, may increase the overall quality of care and drive timely treatment for patients experiencing ACS. Troponin is the preferred biomarker for aiding in the diagnosis of acute myocardial infarction and an acute myocardial infarction (MI), according to guidelines from the American College of Cardiology (ACC). Troponin tests can provide early detection of the elevation cycle and predict myocardial injury with cell death in order to prevent further damage.^5,6

Incorporating point-of-care serial troponin testing into standardized order sets and protocols for suspected ACS patients could lead to improved diagnostic accuracy for patients presenting with suspected acute MI.^7,8 In addition, administering point-of-care troponin testing may improve the time to result for these critical patients, and potentially decrease costs associated with traditional laboratory-based diagnostic testing.⁹

For more information on evidence-based approaches to diagnosis and treatment of the ACS patient, refer to ACC Accreditation Services: Guidelines for Troponin Testing