Circadian variation of acute st segment elevation myocardial infarction by anatomic location in a Turkish cohort
Murat Celik1, Turgay Celik, Atila Iyısoy
1Department of Cardiology, Gulhane Military Medical Academy, School of Medicine, Etlik-Ankara, Turkey. benturgay@yahoo.com
Insights
This study found distinct daily patterns in the onset of ST-segment elevation myocardial infarction (STEMI) based on infarction location in Turkish patients. Anterior STEMI peaked in the afternoon and morning, while inferior STEMI peaked overnight and in the morning.
Area of Science:
- Cardiology
- Circadian Biology
- Epidemiology
Background:
- ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Understanding circadian variations in STEMI onset is crucial for patient management and public health.
- Previous research suggests diurnal patterns in myocardial infarction, but site-specific variations require further investigation.
Purpose of the Study:
- To investigate the relationship between the site of infarction (anterior vs. inferior) and circadian variation in STEMI onset.
- To analyze temporal patterns of STEMI occurrence in a Turkish population.
Main Methods:
- A retrospective study of 465 STEMI patients in Turkey.
- Patients were categorized into four 6-hour time intervals based on symptom onset.
- Characteristics of anterior vs. inferior STEMI cases were compared across these time intervals.
Main Results:
- Acute anterior STEMI showed significant circadian variation with bimodal peaks in the afternoon and morning, and a trough overnight.
- The incidence of anterior STEMI between 6 AM and 6 PM was 4.50 times higher than the average of the remaining 12 hours.
- Acute inferior STEMI also exhibited significant circadian variation with peaks from midnight to noon and a trough from noon to midnight.
Conclusions:
- Distinct circadian periodicity exists for anterior and inferior STEMI onset in the studied Turkish cohort.
- These differences may be attributed to the genetic and demographic characteristics of the Turkish population.
- Further research is warranted to elucidate the underlying mechanisms driving these site-specific circadian variations.
Background:
To evaluate the relationship between site of infarction (anterior vs. inferior) and circadian variation in patients with ST segment elevation myocardial infarction (STEMI) in a Turkish cohort.
Material/Methods:
This restrospective study enrolled 465 patients (407 male, mean age 65±7 years) with STEMI. Patients were then categorised into 4 6-hour increments according to the time of day during which the symptoms began (12:00 AM-06:00 AM, 06:00 AM-12:00 PM; 12:00 PM-06:00 PM and 06:00 PM-12:00 AM hours). Characteristics of patients by site of infarction (anterior vs. inferior) were compared.
Results:
The frequency of onset of acute anterior MI as determined by onset of pain demonstrated significant circadian variation among the 4 time periods, demonstrating bimodal peaks (afternoon and morning) and a trough between 06:00 PM to 06:00 AM. The incidence of occurrence of MI between 06:00 AM to 06:00 PM was 4.50 times that of the average frequency of the remaining 12 hours of the day. The frequency of onset of acute inferior MI as determined by onset of pain exhibited significant circadian variation among the 4 time periods, demonstrating bimodal peaks (midnight to 06:00 AM and 06:00 AM to noon) and a trough between noon to midnight. The incidence of occurrence of MI between midnight to noon was 4.25 times that of the average frequency of the remaining 12 hours of the day.
Conclusions:
Different circadian periodicity in the time of onset of STEMI was found regarding infarction site in a Turkish cohort. This may be related to genetic and⁄or demographic characteristics of the Turkish population.
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