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Circadian and seasonal variations in patients with acute STEMI: A retrospective, single PPCI center study

Napohn Chongprasertpon1, John Joseph Coughlan1, Ciara Cahill1

  • 1a Department of Cardiology , University Hospital Limerick , Co. Limerick , Ireland.

Chronobiology International
|August 2, 2018
PubMed

Insights

ST-segment elevation myocardial infarction (STEMI) incidence is higher during daytime hours, but 30-day mortality for STEMI patients treated with primary percutaneous coronary intervention (PPCI) shows no chronological patterns related to time of day or season.

Area of Science:

  • Cardiology
  • Public Health

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
  • Primary percutaneous coronary intervention (PPCI) is the standard reperfusion therapy for STEMI.
  • Understanding temporal patterns in STEMI incidence and mortality is crucial for resource allocation and patient outcomes.

Purpose of the Study:

  • To investigate chronological patterns in STEMI incidence.
  • To determine if STEMI presentation time (day vs. night, weekday vs. weekend) impacts 30-day mortality.
  • To assess seasonal variations in STEMI incidence.

Main Methods:

  • Retrospective observational analysis of 876 STEMI patients treated with PPCI.
  • Data collected from University Hospital Limerick's electronic Cardiology STEMI database (2012-2016).
  • Statistical analysis included Independent Samples t Test, ANOVA, and Pearson's Chi-Squared test.

Main Results:

  • STEMI incidence was significantly higher during 0800-2259 hours (46.9/hr) compared to 2300-0759 hours (19.1/hr) (p < 0.001).
  • No significant association was found between 30-day mortality and weekend/weekday presentation (p = 0.81) or off/in-hour presentation (p = 0.86).
  • No seasonal variation in STEMI incidence was observed using international or Celtic calendars.

Conclusions:

  • STEMI incidence exhibits a diurnal pattern, with a higher rate during daytime and early evening hours.
  • 30-day mortality for STEMI patients undergoing PPCI is not influenced by the time of presentation (on-hours vs. off-hours, weekend vs. weekday).
  • There is no evidence of seasonal variation in STEMI incidence at this center.

Keywords:
ST-segment elevation myocardial infarctioncircadian variationout of hoursprimary percutaneous coronary interventionseasonal variationweekend

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