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Triggers of acute coronary syndromes
Stephen J Servoss1, James L Januzzi, James E Muller
1Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA02114, USA.
Insights
Sudden cardiac events and deaths often occur unexpectedly. Research into triggers for myocardial infarction (MI) aims to identify acute causes and develop new preventive strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Pathophysiology
Background:
- Despite advances, half of coronary artery disease deaths occur outside hospitals.
- Major cardiac events frequently affect individuals without prior risk factors.
- Identifying acute triggers for myocardial infarction (MI) and sudden death is crucial.
Purpose of the Study:
- To investigate the triggers of acute myocardial infarction (MI).
- To understand the role of various factors in triggering cardiac events.
- To explore novel therapeutic and preventive targets through trigger research.
Main Methods:
- Review of existing literature on myocardial infarction (MI) triggers.
- Analysis of time and activity dependency of MI onset.
- Investigation of pathophysiological changes associated with triggers.
Main Results:
- Myocardial infarction (MI) onset shows circadian, circaseptan, and circannual variations.
- Identified triggers include heavy exertion, sexual activity, anger, mental stress, substance use (cocaine, marijuana), and air pollution.
- Pathophysiological study of triggers may reveal insights into vulnerable plaque and thrombosis.
Conclusions:
- Understanding triggers of MI is essential for reducing out-of-hospital cardiac deaths.
- Triggering factors provide potential targets for novel preventive and therapeutic interventions.
- Further research into the pathophysiology of triggered events can improve patient outcomes.
Abstract:
Despite recent progress in prevention of coronary heart disease, approximately 50% of the deaths from coronary artery disease continue to occur out of hospital, and many major cardiac events occur in individuals not previously known to be at risk. These facts create the need to identify the acute causes of myocardial infarction (MI) and sudden death, which has led to a rapid growth in interest over the last 15 years in the field of triggering research. Since initial observations that the incidence of MI onset was time and activity dependent with circadian, circaseptan, and circannual variation, triggering of MI by heavy exertion, sexual activity, anger, mental stress, cocaine and marijuana use, and exposure to air pollution has been demonstrated. Study of the pathophysiological changes produced by these triggers may provide novel therapeutic and preventive targets by a more thorough understanding of vulnerable plaque disruption and coronary thrombosis.