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Circadian variations of ischemic burden among patients with myocardial infarction undergoing primary percutaneous

Stephane Fournier1, Eric Eeckhout, Fabio Mangiacapra

  • 1Cardiology, University Hospital Center, Lausanne, Switzerland.

American Heart Journal
|February 7, 2012
PubMed

Insights

Patients experiencing ST-elevation myocardial infarction (STEMI) symptoms between midnight and 6 AM have larger infarct sizes and higher mortality. This suggests the time of day impacts STEMI outcomes.

Area of Science:

  • Cardiology
  • Circadian Rhythms
  • Myocardial Infarction

Background:

  • Cardiovascular physiology exhibits circadian rhythms.
  • Experimental models suggest infarct size correlates with time of day.
  • Investigating circadian influence on ischemic burden in STEMI patients is crucial.

Purpose of the Study:

  • To determine if circadian rhythms influence ischemic burden in ST-elevation myocardial infarction (STEMI) patients.
  • To assess the impact of symptom onset time on infarct size and outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PPCI).

Main Methods:

  • 353 STEMI patients treated with PPCI were analyzed.
  • Symptom onset time, peak creatine kinase (CK), and 30-day mortality were recorded.
  • Patients were grouped into four 6-hour intervals based on symptom onset.

Main Results:

  • No significant differences in baseline characteristics or management were observed between groups.
  • Patients with symptom onset between 00:00-05:59 showed a 38.4% increase in peak CK levels (P < .05).
  • Thirty-day mortality was significantly higher for STEMI patients with symptom onset between 00:00-05:59 (P < .05).

Conclusions:

  • An independent correlation exists between STEMI infarct size, PPCI, and symptom onset time.
  • The time of day is a critical factor in assessing prognosis for myocardial infarction patients.
  • Circadian variations in physiological parameters may contribute to observed differences in STEMI outcomes.
Abstract

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