Daylight saving time transitions and acute myocardial infarction
1Division of Cardiology, Department of Internal Medicine, University Hospital Centre Split, Split, Croatia. viktor.culic@st.t-com.hr
Chronobiology International
|May 22, 2013
Summary
Daylight saving time (DST) transitions increase acute myocardial infarction (AMI) risk, especially in the first four workdays after spring and autumn shifts. Risk factors include sex, employment, and medication, highlighting DST as a chronobiological trigger for AMI.
Area of Science:
- Cardiology
- Chronobiology
- Public Health
Background:
- Daylight saving time (DST) transitions have been anecdotally linked to increased acute myocardial infarction (AMI) incidence.
- Previous studies often failed to isolate DST's impact from other situational or clinical factors.
- Understanding DST's independent effect is crucial for public health advisories and preventative strategies.
Purpose of the Study:
- To independently assess the influence of DST transitions on AMI incidence.
- To control for confounding factors like physical exertion, emotional stress, and cardiovascular risk factors.
- To identify patient characteristics and medications that modify AMI risk post-DST.
Main Methods:
- Analysis of detailed data from 2412 patients, including AMI timing, triggers, and clinical factors.
- Comparison of AMI incidence during the initial workdays after DST transitions versus control periods.
- Multivariate regression analysis to determine independent predictors of AMI in the post-transitional period.
Main Results:
- AMI incidence increased by 29% (IR 1.29) in spring and 44% (IR 1.44) in autumn during the first four workdays post-DST.
- Excess AMI risk was observed on Mondays in spring, and Tuesdays/Thursdays in autumn.
- Independent predictors varied by season, including sex, physical activity, employment status, and medication use (e.g., beta-blockers, calcium antagonists).
Conclusions:
- DST transitions appear to be a significant chronobiological factor contributing to AMI onset.
- The risk of AMI following DST shifts is influenced by individual characteristics such as sex and employment.
- Medication adherence, particularly cardiovascular drugs, may mitigate DST-related AMI risk.
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