@article{oai:hirosaki.repo.nii.ac.jp:00005520,
 author = {Senoo, Maiko and Yokoyama, Hiroaki and Kato, Tomo and Kudo, Natsumi and Yokono, Yoshikazu and Tsushima, Michiko and Toyama, Yuichi and Narita, Noritomo and Narita, Masato and Tomita, Hirofumi},
 issue = {1-4},
 journal = {弘前医学},
 month = {Mar},
 note = {Background: It remains uncertain whether snow shoveling has effects on long-term prognosis in patients with acute myocardial infarction（ AMI）.
Patients/Methods: Consecutive 355 patients who underwent emergency percutaneous coronary intervention within 24 hours of the AMI onset during the winter months （November to March） between 2008 and 2014 years were retrospectively studied.
Results: Of the 355 patients, 36（ 11%） had snow shoveling-related AMI, defined as the AMI onset during or within 6 hours after snow shoveling. These patients suffered fewer adverse cardiovascular events than the non-snow shoveling AMI patients during a median follow-up period of 3.8 years. Notably, snow shoveling did not affect the events for patients with left ventricular ejection fraction （LVEF） <40% at the acute phase, but it was a significant better predictor of events for those with LVEF ≥40%.
Conclusion: Snow shoveling may have important clinical implications for the AMI onset and the prognostic outcome in snowy areas.},
 pages = {136--145},
 title = {Prognostic Impact of Snow Shoveling for Patients with Acute Myocardial Infarction},
 volume = {69},
 year = {2019}
}