Circadian and seasonal variation in onset of acute myocardial infarction

Abstract

The aim was to investigate the circadian and seasonal variation of acute myocardial infarction (AMI). Clinical data of 3867 AMI patients hospitalized from November 2010 to October 2019 in the Border Yanbian Minority Autonomous Prefecture, China were collected, and 3158 patients with definite AMI onset times were analyzed. The clinical data analyzed included the time of onset, nationality, age, laboratory data. We divided the patients into 4 groups based on the timepoint of their AMI onsets: 00:00–05:59, 06:00–11:59, 12:00–17:59, and 18:00–23:59. We also divided the patients based on nationality: Chinese Korean and Han groups. We observed that there is a circadian rhythm in the incidence of AMI, and the peak of AMI is in the morning (7:00–9:00). Unexpectedly, the incidence of AMI was significantly lower in the cold winter than that of other 3 warm seasons (P < 0.01) and the peak of AMI presented at the months of the large contrast between day and night temperature difference (over 20°C) like May of Spring and October of Fall. Finally, there was no difference in circadian rhythm between Chinese Korean and Han, although these groups differed in age, body mass index, and the inflammatory cell level. These findings have shown a different seasonal and circadian variation in onset of AMI. Further studies are required to determine the pathophysiological mechanism(s) underlying these differences and to guide prevention of AMI for reducing its mortality and disability.

Diurnal Oscillations of Fibrinolytic Parameters in Patients with Acute Myocardial Infarction and Their Relation to Platelet Reactivity: Preliminary Insights

“…A potential mechanism behind this shift is a response to thrombotic risk. In the literature, there is a common agreement on circadian variation in the occurrence of AMI, with a peak incidence in the morning [ 30 , 31 , 32 ].…”

Translation and psychometric evaluation of a scale to measure the fear of activity in Chinese patients with coronary artery disease

“…From their perspectives, studies showed that patients with CAD who performed regular physical activity in the afternoon or evening may be safer than those who exercised in the morning (Lian et al, 2014 ; Zhao et al, 2016 ). The onset occurrence peaks of ischemic heart disease (Estarlich et al, 2022 ) and myocardial infarction (Xin et al, 2022 ) are usually in the morning. Patients who exercised in the morning were at a higher risk of acute myocardial infarction than those exercised in the afternoon and evening (Zhao et al, 2016 ).…”

Circadian aspects of mortality in hospitalized patients: A retrospective observation from a large cohort

“…Vascular events in previous reports which show an excess of death between 06:00 and noon are in line with our in‐hospital mortality pattern, indicating the possible existence of similar underlying mechanism related to in‐hospital mortality, although the physiological mechanism of circadian variation is not well understood and remains speculative. Those events include myocardial angina, acute myocardial infarction, cardiac arrest, arrhythmias (de Rueda et al, 2022 ; Muller et al, 1989 ; Xin et al, 2022 ), deep venous thrombosis, pulmonary thromboembolism (Bilora et al, 2001 ; Colantonio et al, 1989 ; Damnjanović, 2018 ; Gallerani et al, 1994 ), and stroke (ischemic and haemorrhagic strokes and transient ischemic attacks) (Argentino et al, 1990 ; Elliott, 1998 ; Yang et al, 2022 ). The implication for nursing care is that strengthening monitor for patients with those disorders at certain time may be needed.…”