Seasonality of coronary artery deaths in New South Wales, Australia

Background: Complex temporal variations in coronary deaths, including diurnal, weekly, and seasonal trends, have been reported worldwide. Objective: To describe the magnitude of seasonal changes in coronary artery deaths in New South Wales, Australia. Design: Hospital morbidity data, mortality statistics, and meteorological data were modelled using time series techniques to determine seasonality of coronary deaths. Data were also analysed to determine whether there was an increase in deaths before or after the Christmas and New Year holidays. Results: A clear seasonality of coronary deaths was shown, with a peak in July. A mean of 2.8 excess coronary deaths per 100 deaths was estimated to occur from June to August each year, with a mean annual excess of 224 winter deaths a year. Mortality data did not show an increase in coronary death ratios before (p = 0.626) or after (p = 0.813) the Christmas and New Year holidays in December. Conclusions: There is a higher incidence of coronary deaths in winter, which may reflect winter respiratory infections, the direct effect of cold, seasonal changes in lipid concentration, and other factors associated with winter. Hospitals should have contingency plans during the winter months to manage larger numbers of cardiac admissions.