Circadian Periodicity of Ischemic Heart Disease

Fabbian, Fabio; Bhatia, Subir; Giorgi, Alfredo De; Maietti, Elisa; Bhatia, Sravya M.; Shanbhag, Anusha; Deshmukh, Abhishek

doi:10.1016/j.hfc.2017.05.003

Cited by 23 publications

(10 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding is in concordance with previous findings from various MI populations [2–4, 6]. The morning triggering for both MINOCA and MI may be due to a synergistic effect of environmental and physiological factors, including increases in physical or mental stress [17] and circadian variations in cardiovascular, hormonal and metabolic functioning [2]. In our MINOCA population patients ≤65 years, most of which were employed, had an increased risk for MINOCA throughout the day while for the mostly retired patients aged >65, the increased risk for MINOCA was limited to the morning.…”

Section: Discussionsupporting

confidence: 94%

“…The risk for MINOCA proved to be most common in the early morning with a peak at 8 AM. This finding is in concordance with previous findings from various MI populations [2–4, 6]. The morning triggering for both MINOCA and MI may be due to a synergistic effect of environmental and physiological factors, including increases in physical or mental stress [17] and circadian variations in cardiovascular, hormonal and metabolic functioning [2].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Circadian onset and prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA)

et al. 2019

View full text Add to dashboard Cite

Background Many acute cardiovascular events such as myocardial infarction (MI) follow circadian rhythms. Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a newly noticed entity with limited data on onset pattern and its impact on prognosis. Material and methods In this observational study of Swedish MINOCA patients registered in the SWEDEHEART registry between 2003–2013 and followed until December 2013 we identified 9,092 unique patients with MINOCA out of 199,163 MI admissions in total. Incidence rate ratios (IRR) were calculated for whole hours, parts of the day, weekdays, months, seasons and major holidays. Results The mean age was 65.5 years, 62.0% were women and 16.6% presented with STEMI. The risk for MINOCA proved to be most common in the morning (IRR = 1.70, 95% CI [1.63–1.84]) with a peak at 08.00 AM (IRR = 2.25, 95% CI [1.96–2.59]) and on Mondays (IRR = 1.28, 95% CI [1.18–1.38]). No altered risk was detected during the different seasons, the Christmas and New Year holidays or the Swedish Midsummer festivities. There was no association between time of onset of MINOCA and short- or long-term prognosis. Conclusion The onset of MINOCA shows a circadian and circaseptan variation with increased risk at early mornings and Mondays, similar to previous studies on all MI, suggesting stress related triggering. However, during holidays were traditional MI increase, we did not see any increase for MINOCA. No association was detected between time of onset and prognosis, indicating that the underlying pathological mechanisms of MINOCA and the quality of care are similar at different times of onset but triggering mechanism may be more active early mornings and Mondays.

show abstract

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 92%

Circadian onset and prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA)

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The relationship between AMI onset-time and the clinical outcomes is controversial [2,3,[6][7][8]13]. A metaanalysis including 30 studies on AMI and 19 studies on sudden cardiac death showed that more than 27% of morning AMIs and more than 22% of sudden cardiac deaths were attributable to a morning excess of risk [13]. While Fournier et al reported that patients with a night-onset AMI (between 00:00 and 05:59) had the worst 30-day mortality [3].…”

Section: Discussionmentioning

confidence: 99%

Contemporary Impact of circadian symptom-onset patterns of acute ST-Segment elevation myocardial infarction on long-term outcomes after primary percutaneous coronary intervention

Peng

Sun

et al. 2020

Annals of Medicine

View full text Add to dashboard Cite

Background Daytime variation with regard to onset time of ST-elevation myocardial infarction (STEMI) symptoms has been observed. Nevertheless, with the advanced medical therapy, it is not uncertainty if a similar circadian pattern of STEMI symptom onset occurs, as well as its possible impact on clinical outcomes. Few long-term data are available. We assess the impact of circadian symptom-onset patterns of STEMI on major adverse cardiovascular events (MACE) in more contemporary patients treated with primary percutaneous coronary intervention (PPCI). Methods and results A total of 1099 consecutive STEMI patients undergoing PPCI ≤12h from symptom onset during 2013 to 2019 were classified into 4 groups by 6-h intervals according to time-of-day at symptom onset: night (0:00–5:59), morning (6:00–11:59), afternoon (12:00–17:59), and evening (18:00–23:59). Incidence of MACE including cardiovascular death and nonfatal MI during a median follow-up of 48 months was compared among the 4 groups. A morning peak of symptom onset of STEMI was detected during the period 06:00–11:59 ( p < .001). Compared with other three 6-h intervals, the incidence of long-term MACE during night onset-time (18.8%, 10.1%, 10.7% and 12.4%, p = .020) was significant higher that was driven by more mortality (13.1%, 6.5%, 7.1%and 7.7%, p = .044). Night symptom-onset STEMI was independently associated with subsequent MACE (hazard ratio = 1.57, 95%CI: 1.09–2.27, p = .017) even after multivariable adjustment. Conclusions Circadian variation of STEMI symptom-onset with morning predominance still exists in contemporary practice. Night symptom-onset STEMI was independently associated with increased risk of MACE in Chinese patients treated with PPCI.

show abstract

“…Adataink megerősítik a "Monday and Morning" találó rövid összefoglalást, amelyet a GISSI-vizsgálatban említettek [6]. Az infarktusos események hétfő reggeli halmozódását számos egyéb vizsgálat is egyértelműen megerősítette [7][8][9][10], csakúgy, mint Fabbian [11] metaanalízise. A legtöbb adattal szemben egy japán vizsgálat a nők esetén szombati napon észlelte a legnagyobb incidenciát, amit a hét végén megnövekedett háziasszonyi feladatokkal magyarázott [12].…”

Section: Megbeszélésunclassified

A heveny szívinfarktus gyakoriságának és az általa okozott halálozás diurnalis és szezonális jellemzői Magyarországon

Ferenci

Jánosi

2021

View full text Add to dashboard Cite

Összefoglaló. Bevezetés: A heveny szívinfarktus gyakoriságának és halálozásának napi és szezonális ingadozása fontos epidemiológiai adat, régóta kutatás tárgya. Célkitűzés: A szívinfarktus gyakoriságának, az általa okozott halálozásnak diurnalis és szezonális vizsgálata nagy esetszámú, válogatás nélküli betegcsoport adatainak elemzésével. Módszer: A szerzők a Nemzeti Szívinfarktus Regiszterben 2014. 01. 01. és 2017. 12. 31. között regisztrált betegek adatait dolgozták fel. Az adatok többváltozós vizsgálatára általánosított additív modelleket használtak. Eredmények: Három év alatt 30 333, ST-elevációval nem járó infarktus (NSTEMI) és 23 667, ST-elevációval járó infarktus (STEMI) miatt kezelt beteg adatait rögzítettük. A betegek utánkövetésének medián értéke 563 nap volt. Szívinfarktusra utaló panasz – mindkét infarktustípus esetén – reggel 7 és 8 óra között jelentkezett a leggyakrabban, NSTEMI esetén este 20 óra körül is találtak egy második gyakorisági csúcsot. A hét napjai a gyakoriság szempontjából szignifikáns eltérést mutattak (p<0,001): hétfőn magasabb, hétvégén lényegesen alacsonyabb incidenciát találtunk. Az éven belüli mintázat mindkét nemi, életkori és infarktustípus szerinti csoportban konzisztens: tavasszal a legmagasabb, nyáron a legalacsonyabb az incidencia (p<0,001). Az incidencia munkaszüneti napokon alacsonyabb volt (p = 0,0053 STEMI-nél, p<0,001 NSTEMI-nél). A halálozás többszempontos analízise azt igazolta, hogy a hét napjai itt is eltértek, hétvégén magasabb halálozás igazolódott (p<0,001). A munkaszüneti napoknak ugyanakkor nem volt szignifikáns hatásuk a halálozásra (p = 0,4542), és az évszakok halálozási adatai sem különböztek (p = 0,0677). Következtetés: A szívinfarktus gyakrabban fordult elő hétfőn, a reggeli órákban és az évszakok esetén tavasszal. A halálozás hétvégén nagyobb volt, mint munkanapokon. Orv Hetil. 2021; 162(14): 555–560. Summary. Introduction: Daily and seasonal variation of the incidence and mortality of acute myocardial infarction has long been the subject of research. Objective: Investigation of the diurnal and seasonal pattern of the incidence and mortality of myocardial infarction by analyzing data from a large number of consecutive patients. Method: The authors processed the data of patients registered in the Hungarian Myocardial Infarction Registry between 01. 01. 2014 and 31. 12. 2017. Generalized additive models were used for the multivariate investigation of the data. Results: 30 333 patients treated for non-ST elevation myocardial infarction (NSTEMI) and 23 667 patients with ST elevation myocardial infarction (STEMI) were recorded. The median follow-up was 563 days. Patients’ complaints most commonly occurred between 7:00 and 8:00 a.m. for both types of infarction with a secondary peak at 20:00 p.m. for NSTEMI. The days of week were significantly different (p<0.001) with a higher incidence on Monday, and lower at the weekend. The seasonal pattern was consistent in every age and sex group and according to the type of infarction: incidence was the highest in spring and the lowest in summer (p<0.001). The incidence was lower on public holidays (p = 0.0053 for STEMI, p<0.001 for NSTEMI). Multivariate analysis of mortality revealed that the days of week are significantly different here as well (p<0.001) with a higher mortality at the weekends. The effect of public holidays was non-significant (p = 0.4542) as was seasonality (p = 0.0677) in mortality. Conclusion: Myocardial infarction occurs more often in the morning hours, on Monday, and – as far as seasonal variation – in spring. The mortality at the end of the week is greater than on working days. Orv Hetil. 2021; 162(14): 555–560.

show abstract

Circadian Periodicity of Ischemic Heart Disease

Cited by 23 publications

References 56 publications

Circadian onset and prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA)

Circadian onset and prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA)

Contemporary Impact of circadian symptom-onset patterns of acute ST-Segment elevation myocardial infarction on long-term outcomes after primary percutaneous coronary intervention

A heveny szívinfarktus gyakoriságának és az általa okozott halálozás diurnalis és szezonális jellemzői Magyarországon

Contact Info

Product

Resources

About