Circadian Variations and Associated Factors in Patients with Ischaemic Heart Disease
Marisa Estarlich1,2,3, Carmen Tolsa1, Isabel Trapero1
1Department of Nursing, University of Valencia, 46010 Valencia, Spain.
Insights
Ischaemic heart disease symptoms show a circadian pattern, with pain onset more frequent in the morning and winter. This pattern influences heart attack location and hospital stay, regardless of individual risk factors.
Area of Science:
- Cardiology
- Chronobiology
- Public Health
Background:
- Circadian rhythms are implicated in cardiovascular diseases.
- Cardiovascular risk factors can influence these daily rhythms.
Purpose of the Study:
- To investigate the timing of ischaemic heart disease (IHD) symptom onset.
- To correlate symptom onset with date, time, day of week, season, myocardial infarction (AMI) location, severity, and patient characteristics.
Main Methods:
- Retrospective cross-sectional study.
- Analysis of 244 IHD patients from La Ribera Hospital, Spain.
- Examination of symptom onset timing and clinical outcomes.
Main Results:
- Ischaemic pain onset was most frequent in the morning and during winter.
- Weekend presentation showed the lowest incidence of ischaemic events.
- Afternoon pain onset correlated with longer hospital stays.
- Nighttime pain onset was linked to subendocardial infarction location.
Conclusions:
- The Spanish population exhibits a circadian pattern in AMI onset.
- Symptom onset timing influences AMI location and hospital stay duration.
- This circadian pattern appears consistent across patients with varying individual risk factors.
Abstract:
Circadian rhythms have been identified in cardiovascular diseases, and cardiovascular risk factors can modify the circadian rhythm. The purpose of this study was to describe the onset of ischaemic heart disease symptomatology in relation to the date and time, the day of the week of presentation, the season, AMI location and severity and the level of influence of individual patient characteristics in a retrospective cross-sectional study involving 244 ischaemic heart disease patients from the intensive care unit of La Ribera Hospital (Spain). The onset of pain was more frequent in the morning, the season with the highest frequency of ischaemic events was winter, and the lowest incidence was during weekends. Regarding the severity of ischaemic heart disease, the circadian rhythm variables of weekdays vs. weekends and seasons did not show a significant association. The length of hospital stay was associated with the onset of pain in the afternoon. The onset of pain at night was associated with the subendocardial location of the infarction. In conclusion, living in a Mediterranean country, the Spanish population showed a circadian pattern of AMI, where the onset of pain has an influence on AMI location and on the length of hospital stay and is the same in patients with different individual risk factors.
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