Abstract
BackgroundSome studies suggest that transitions to and from daylight saving time (DST) have an influence on acute myocardial infarction (AMI) incidence. However, the available publications have a number of limitations e.g. regarding sample size, exclusion of fatal AMI cases, precise assessment of AMI onset, and consideration of possible confounders, and they were conducted in countries with different geographical location. The objective of this study was to examine the association of DST transitions with AMI incidence recorded in the population-based German MONICA/KORA Myocardial Infarction Registry.MethodsThe study sample consisted of 25,499 coronary deaths and non-fatal AMI cases aged 25–74 years. We used Poisson regression with indicator variables for the 3 days or the week after the spring and the autumn transition and adjusted for potential confounders to model the association between DST transitions and AMI incidence. In addition, we built an excess model by calculating observed over expected events per day.ResultsOverall, no significant changes of AMI risk during the first 3 days or 1 week after the transition to and from DST were found. However, subgroup analyses on the spring transition revealed significantly increased risks for men in the first 3 days after transition (RR 1.155, 95 % CI 1.000–1.334) and for persons who took angiotensine converting enzyme (ACE) inhibitors prior to the AMI (3 days: RR 1.489, 95 % CI 1.151–1.927; 1 week: RR 1.297, 95 % CI 1.063–1.582). After the clock shift in autumn, patients with a prior infarction had an increased risk to have a re-infarction (3 days: RR 1.319, 95 % CI 1.029–1.691; 1 week: RR 1.270, 95 % CI 1.048–1.539).ConclusionsSpecific subgroups such as men and persons with a history of AMI or prior treatment with ACE inhibitors, may have a higher risk for AMI during DST. Further studies which include data on chronotype and sleep duration are needed in order to confirm these results.
Highlights
Some studies suggest that transitions to and from daylight saving time (DST) have an influence on acute myocardial infarction (AMI) incidence
Risk ratios (RR) and corresponding 95 % confidence intervals (CI) of the 3 day indicators and the week indicators after time shift on the daily numbers of AMI are presented in Table 2 for the whole year time series, the periods reduced to months around the time shifts as well as the sensitivity analyses
We observed the strongest association with a RR of 1.102 for the 3 days after the spring shift for the reduced time series and the confounder model optimized for the excess model
Summary
Some studies suggest that transitions to and from daylight saving time (DST) have an influence on acute myocardial infarction (AMI) incidence. The objective of this study was to examine the association of DST transitions with AMI incidence recorded in the population-based German MONICA/KORA Myocardial Infarction Registry. More than 1.5 billion people in over 70 countries worldwide are subject of transitions to daylight saving time (DST) since some decades. In Germany, DST was introduced in 1980. It begins on the last Sunday in March. Studies on DST time shift, provide a unique possibility to investigate these effects in a “natural experiment” without confounding from individual characteristics since everyone is exposed at a given time point
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