Daylight Saving Time and Acute Myocardial Infarction: A Meta-Analysis.

Roberto Manfredini,Lamberto Manzoli,Maria Elena Flacco,Alfredo De Giorgi,Rosaria Cappadona,Francesca Bravi,Fabio Fabbian,Tiziano Carradori

doi:10.3390/jcm8030404

Roberto Manfredini, Lamberto Manzoli + Show 6 more

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Background: The available evidence on the effects of daylight saving time (DST) transitions on major cardiovascular diseases is limited and conflicting. We carried out the first meta-analysis aimed at evaluating the risk of acute myocardial infarction (AMI) following DST transitions. Methods: We searched cohort or case-control studies evaluating the incidence of AMI, among adults (≥18 y), during the weeks following spring and/or autumn DST shifts, versus control periods. The search was made in MedLine and Scopus, up to 31 December 2018, with no language restriction. A summary odds ratio of AMI was computed after: (1) spring, (2) autumn or (3) both transitions considered together. Meta-analyses were also stratified by gender and age. Data were combined using a generic inverse-variance approach. Results: Seven studies (>115,000 subjects) were included in the analyses. A significantly higher risk of AMI (Odds Ratio: 1.03; 95% CI: 1.01–1.06) was observed during the two weeks following spring or autumn DST transitions. However, although AMI risk increased significantly after the spring shift (OR: 1.05; 1.02–1.07), the incidence of AMI during the week after winter DST transition was comparable with control periods (OR 1.01; 0.98–1.04). No substantial differences were observed when the analyses were stratified by age or gender. Conclusion: The risk of AMI increases modestly but significantly after DST transitions, supporting the proposal of DST shifts discontinuation. Additional studies that fully adjust for potential confounders are required to confirm the present findings.

Highlights

Since decades, it has been shown that light-dark alternation influences the synchronization of circadian rhythms of most human systems [1]
Some studies reported a higher risk of cardiovascular diseases following daylight saving time (DST) transitions and it has been hypothesized that even a minor change in time schedule—such as the 1-h switch applied in about 60 countries worldwide—may cause a considerable stress for the body [4]
The bibliographic search was performed by two independent investigators (RM, LM) up to 31 December 2018, using the following search terms: (daylight saving time (Title/Abstract) OR DST (Title/Abstract)) OR (circadian rhythm (Title/Abstract) OR circadian misalignment (Title/Abstract)) OR (sleep (Title/Abstract) OR sleep deprivation (Title/Abstract)) OR (chronobiology (Title/Abstract)) AND (myocardial infarction (Title/Abstract) OR acute myocardial infarction (AMI) (Title/Abstract))

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Introduction

It has been shown that light-dark alternation influences the synchronization of circadian rhythms of most human systems [1]. Some studies reported a higher risk of cardiovascular diseases following daylight saving time (DST) transitions and it has been hypothesized that even a minor change in time schedule—such as the 1-h switch applied in about 60 countries worldwide—may cause a considerable stress for the body [4]. Because of these health concerns, in 2018 some northern Europe countries formally requested the European Parliament to abolish DST [10]. Additional studies that fully adjust for potential confounders are required to confirm the present findings

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