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Stress following Hurricane Katrina may still be causing heart attacks years after the storm slammed Louisiana, according to a new study.

Doctors at Tulane University Hospital and Clinic found there was a threefold increase in the rate of heart attacks treated at the hospital since the August 2005 storm.

Dr. Anand Irimpen, the study’s senior author, said the study is too small to prove the storm is behind the increase.

Even so, most cardiologists in the area believe there has been such an effect, said Dr. Carl “Chip” Lavie, medical director for cardiac rehabilitation and prevention at Ochsner Health System in suburban New Orleans.

“Everyone feels they’ve lived this,” he said.

Many studies have documented increases in heart attacks after a major catastrophe. But this may be the first time anyone has found such an increase more than two years later, Lavie said.

The report is to be presented Sunday at the American College of Cardiology meeting in Orlando, Fla.

In the two years before Katrina, the researchers found heart attacks accounted for 150 of the 21,229 patients admitted to the downtown hospital. In the two years since the hospital reopened in early 2006, there were 246 heart attacks out of 11,282 patients – a change from about 0.7 percent of admissions to nearly 2.2 percent.

Post-Katrina heart attack patients also were more likely to need surgery or artery-opening procedures and less likely to have jobs or medical insurance than their pre-storm counterparts. They were more likely to smoke or to abuse drugs or alcohol, and less likely to be taking medicine prescribed to ward off strokes or heart attacks.

Because the study looked at a small number of patients at a single hospital, many questions remain open.

“Is Tulane seeing more heart attacks now because of Katrina, or are the heart attacks coming to Tulane that would have gone someplace else before the storm?” asked Lavie.

The two hospitals nearest Tulane’s are still shuttered.

Irimpen, a cardiologist, said he suggested the study because he was being called in much more often to treat heart attacks at Tulane. He said a contributing factor may be the bad habits that increase under stress, such as smoking, substance abuse and failing to take prescribed medicines.

“We’ve seen patients who had quit smoking and started again, patients who were exercising and say they haven’t exercised since Katrina,” Lavie said.

The research is one of the few multiyear studies of the heart and stress caused by war, terror or disaster, said Dr. Lori Mosca, director of preventive cardiology at New York Presbyterian Hospital

“It really underscores the long-term adverse effects of disasters and chronic stress on the heart,” she said.