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Is there any effect of chronobiological changes on coronary angioplasty?
A Temizhan1, I Dinçer, G Pamir
1Department of Cardiology, Numune Education and Research Hospital, and Ankara-Turkey. temizhan@usa.net
Insights
Timing of percutaneous transluminal coronary angioplasty (PTCA) impacts patient outcomes. Procedures performed between 10:30 a.m. and 12:30 p.m. were associated with a higher risk of acute ischemic events post-PTCA.
Area of Science:
- Cardiology
- Chronobiology
- Interventional Cardiology
Background:
- Acute ischemic events often exhibit diurnal variations, potentially linked to morning thrombus formation.
- Understanding procedural timing's influence on post-angioplasty complications is crucial for patient safety.
Purpose of the Study:
- To investigate if the timing of percutaneous transluminal coronary angioplasty (PTCA) influences the occurrence of immediate postprocedural ischemic events.
- To determine if time-dependent variations observed in spontaneous ischemic events also apply to events following PTCA and stent implantation.
Main Methods:
- A study of 349 consecutive patients undergoing elective single-vessel angioplasty.
- Patients were monitored for immediate postprocedural ischemic events.
- Procedure end times were categorized into 2-hour intervals to analyze complication rates based on timing.
Main Results:
- No significant difference in clinical presentation was noted between groups.
- Patients with complications had higher cholesterol levels (P < 0.05).
- Procedures ending between 10:30 a.m. and 12:30 p.m. were identified as an independent risk factor for adverse outcomes (P = 0.043).
Conclusions:
- Postprocedural complications following angioplasty are significantly related to the time of day the procedure is performed.
- Patients undergoing angioplasty, particularly during late morning hours, may require closer monitoring for immediate ischemic events.
Aims:
We hypothesized that If there is a chronobiologic variation in the development of acute ischaemic events which is mainly attributed to the tendency for thrombus formation in the morning hours, same time dependent variations must also be seen in the development of ischaemic events after percutaneous transluminal coronary angioplasty (PTCA) and PTCA with stent implantation.
Methods:
Enrolled in this study were 349 consecutive patients with single vessel disease and undergoing elective single vessel angioplasty. Patients had been observed for the development of immediate postprocedural ischaemic events. Working hours of our laboratory were divided into 2-hourly intervals in order to define the ending time of procedure. Analysis of acute complications was carried out according to the ending time of procedure.
Results:
There was no difference with regard to clinical presentation, but patients who had complications had higher blood cholesterol level (P < 0.05). Patients with stent implantation had more adverse events than the PTCA group, but this difference did not reach the statistical significance (P = 0.07). The time interval between 10:30 a.m.-12:30 p.m. was found to be an independent risk factor for the negative outcomes (P = 0.043, Relative Risk 4838).
Conclusion:
The results of our study have demonstrated that postprocedural complications after angioplasty is related to the procedure time These patients may be observed more closely for the development of immediate postprocedural ischaemic events.