Abstract
ObjectiveThe objective of this study was to explore the time distribution patterns of the onset of chest pain in subjects with acute ST-elevation myocardial infarction in a Chinese population.MethodsA total of 1467 patients with acute ST-elevation myocardial infarction were enrolled from 2003 to 2010. The hourly, daily, monthly, seasonal and day-of-week fluctuations in the prevalence of acute ST-elevation myocardial infarction were analyzed.ResultsA peak was found between the morning hours of 07:31 and 08:30. A second peak was observed between 14:31 and 15:30, and a third peak was found between 23:31 and 00:30 (p<0.001). The monthly maximum was recorded in November and the minimum was in April (p<0.001). The number of daily cases was greatest in autumn and lowest in the spring (p = 0.001). Day-of-the-week variations of ST-elevation acute myocardial infarction were not found, except in patients more than 75-years-old.ConclusionsPeriodic variations in the frequency of ST-elevation acute myocardial infarction in Chinese patients showed significant differences with regard to diurnal, monthly and seasonal patterns. The exact mechanisms underlying these circadian variations require further study.
Highlights
Various studies have reported circadian variation in patients with acute myocardial infarction (AMI) [1,2,3,4,5]
A meta-analysis of studies on circadian variation in myocardial infarction and sudden cardiac death demonstrated that the impact is significant, because about one out of every 11 AMIs and one out of every 15 sudden cardiac deaths occur in the morning [6]
Clinical characteristics according to sex Seasonal distribution of STelevation myocardial infarction (STEMI)
Summary
Various studies have reported circadian variation in patients with acute myocardial infarction (AMI) [1,2,3,4,5]. A meta-analysis of studies on circadian variation in myocardial infarction and sudden cardiac death demonstrated that the impact is significant, because about one out of every 11 AMIs and one out of every 15 sudden cardiac deaths occur in the morning [6]. Observational study using a multicenter online registry of 4573 patients diagnosed with AMI in Korea showed that the highest incidence of AMI occurred between 08:00 (24-hour clock) and noon, with the number of cases being highest in the winter and lowest in the autumn [9]. Differences in the circadian variation of AMI in many regions of the world and in different ethnic groups
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