Culprit lesion characteristics and prognosis in STEMI with cold onset: an OCT study

Cold temperature exposure is associated with increased cardiovascular morbidity. However, limited research has explored plaque characteristics and prognosis in ST-segment elevation myocardial infarction (STEMI) patients diagnosed in cold temperatures. In the current study, 517 STEMI patients who underwent coronary optical coherence tomography examination were included and divided according to a median of the ambient temperature(11.5 °C). Our result shows that the cold temperature group exhibited higher proportions of plaque rupture, 78.1%, compared to 68.8% in the warm temperatures group. Besides, patients in the cold temperature group showed thinner minimum fibrous cap thickness (60.0 vs. 70.0 μm, p = 0.035). Furthermore, the cold temperature group showed a higher incidence rate of major adverse cardiac events (MACE), which includes cardiac death, recurrent nonfatal myocardial infarction, stroke, or hospitalization for heart failure (15.7% vs. 9.7%, p = 0.041). Moreover, cold temperature exposure at the onset independently predicted MACE (HR1.83 [95%CI 1.06–3.14], p = 0.029).