Triggers of acute myocardial infarction regarding its site

Meta-analysis of possible external triggers of acute myocardial infarction

“…The morning peak of onset [1,2,5] seems to be slightly blunted in trigger-related infarctions [28], but it remains unclear whether the risk that some external event will trigger a myocardial infarction varies throughout the day, or during the week [52 -54] or year [54,55]. Besides gender differences observed in this metaanalysis, some studies provided support for the possibility that particular triggers have varying importance in different patient subgroups according to infarction site [34] or infarction type [31]. Furthermore, although it is difficult to assess an individual's reactivity to emotional stress, there is some evidence to suggest that patients with lower levels of educational attainment [33] are also at greater risk that emotional stress culminates in an acute myocardial infarction.…”

“…One study investigated only infarction onsets during sleep [32]. When the same populations were reported twice [33,34], only the more descriptive [23] or longer [31] study was included in the meta-analysis. Most of the data about patients in whom possible triggers, as defined by the authors, preceded the infarction onset or onsets occurring during sleep were abstracted from text and tables.…”

Acute risk factors for myocardial infarction

“…This may explain a link between physical effort and anterior infarction [96] since intensity of such biomechanical stress correlates with intensity of heart work. In contrast, inferior infarctions are more associated with the presence of emotional stress, exposure to severe weather, overeating and nicotine abuse [96].…”

“…This may explain a link between physical effort and anterior infarction [96] since intensity of such biomechanical stress correlates with intensity of heart work. In contrast, inferior infarctions are more associated with the presence of emotional stress, exposure to severe weather, overeating and nicotine abuse [96]. Transient vasospasm, however, may more frequently involve the right coronary artery and may have a more important role in triggering infarctions at this site [97,98] or may be an important internal triggering mechanism of emotional stress [40].…”

Acute myocardial infarction preceded by potential triggering activities: Angiographic and clinical characteristics

“…Gender-related differences, such as physical exertion and overeating were more likely to precipitate MI in men, while emotional stress was a more frequent potential trigger of events in women [2]. Age-related trigger differences in anterior and inferior MI have also been reported [3]. Patients with triggered MI have been shown to have a lower prevalence of angina, hypertension and diabetes mellitus compared to patients without triggers.…”