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[Cardiovascular risk factors in the circadian rhythm of acute myocardial infarction]

Juan B López Messa1, José R Garmendia Leiza, María D Aguilar García

  • 1Unidad de Cuidados Intensivos, Hospital Río Carrión, Palencia, Spain. jlomessa@telefonica.net

Revista Espanola De Cardiologia
|September 18, 2004
PubMed

Insights

Acute myocardial infarction onset follows a daily pattern, peaking in the late morning. Cardiovascular risk factors like diabetes, smoking, and reinfarction alter this natural circadian rhythm.

Area of Science:

  • Cardiology
  • Chronobiology
  • Public Health

Background:

  • Acute myocardial infarction (AMI) exhibits temporal patterns.
  • Understanding the circadian rhythm of AMI is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the influence of modifiable cardiovascular risk factors on the circadian rhythm of AMI onset.
  • To analyze the temporal patterns of AMI symptom onset in a large patient cohort.

Main Methods:

  • Retrospective analysis of 54,249 patients from the Spanish ARIAM study.
  • Cosinor analysis with three sinusoids (24, 12, and 8 hours) to assess circadian rhythm.
  • Examination of variables including age, sex, hypertension, diabetes, smoking, and reinfarction.

Main Results:

  • AMI symptom onset demonstrated a significant circadian rhythm (P< .01), with a peak at 10:07 am and a trough at 4:46 am.
  • All analyzed subgroups showed a circadian rhythm.
  • Patients with diabetes, reinfarction, or smoking history exhibited a bimodal sinusoid curve, indicating altered rhythm.

Conclusions:

  • The time of symptom onset in acute myocardial infarction patients follows a distinct circadian rhythm.
  • Modifiable risk factors such as diabetes, smoking, and prior reinfarction significantly modify the standard circadian rhythm of AMI onset.
Abstract

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