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Changing chronobiology of cardiovascular outcome following prophylaxis

Vinu Mulavarickal Jose1, Navneet Sharma, Debasish Hota

  • 1Department of Pharmacology, PGIMER, Chandigarh 160012, India. vishnujose@hotmail.com

Nepal Medical College Journal : NMCJ
|June 28, 2007
PubMed

Insights

Cardiovascular events like myocardial infarction and stroke occur more in the morning. This study found a shift in event timing for patients on secondary prophylaxis, with increased evening and early morning occurrences.

Area of Science:

  • Cardiology
  • Chronobiology
  • Epidemiology

Background:

  • Cardiovascular events such as myocardial infarction and stroke exhibit a diurnal pattern, with a known morning peak.
  • The impact of secondary prophylaxis on the timing of these events remains less understood.

Purpose of the Study:

  • To investigate potential alterations in the time pattern of cardiovascular events among patients receiving secondary prophylaxis.
  • To explore the relationship between prophylaxis and the diurnal variation of cardiovascular events.

Main Methods:

  • A pilot nested case-control study was conducted.
  • Data collected included demographics, cardiovascular history, event timing, medication history, and compliance.
  • Eighty-four patients on prophylaxis and 135 control patients were analyzed.

Main Results:

  • Patients on secondary prophylaxis showed a reversed time distribution of cardiovascular events, with peaks in the evening and early morning, unlike the morning peak in controls.
  • While not statistically significant, the odds of events were higher between 4 PM-8 AM for those on prophylaxis.
  • Age and antihypertensive use did not show significant differences in event timing patterns.

Conclusions:

  • Secondary prophylaxis may alter the diurnal pattern of cardiovascular events, potentially increasing risk during evening and early morning hours.
  • Further research is needed to elucidate the mechanisms behind this evening/early morning increase in cardiovascular events, particularly in patients on prophylaxis.

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