1
|
Guo Y, Cui L, Li L, Wang Z, Fang C, Yu B. Circadian rhythm pattern of symptom onset in patients with ST-segment elevation myocardial infarction in the Chinese population. Front Cardiovasc Med 2024; 11:1393390. [PMID: 39720211 PMCID: PMC11666443 DOI: 10.3389/fcvm.2024.1393390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 11/25/2024] [Indexed: 12/26/2024] Open
Abstract
Background The peak incidence of cardiovascular diseases (CVD) usually occurs in the morning. This study aimed to investigate the exact distribution pattern of peak incidence of ST-segment elevation myocardial infarction (STEMI) in the Chinese population, and to explore whether it is associated with the prognosis. Methods This study included 7,805 patients with STEMI from the multicenter, prospective AMI cohort in China, for whom had a definite time of symptom onset. In the overall population and the predefined subgroup populations, the circadian rhythms of STEMI onset were statistically analyzed. Then patients were divided into four groups based on the time of onset (6 h interval) to assess the association of symptom onset time and major adverse cardiovascular and cerebrovascular events (MACCE) after discharge. Results The onset of STEMI had a bimodal distribution: a well-defined primary peak at 8:38 AM [95% confidence interval (CI): 7:49 to 9:28 AM], and a less well-defined secondary peak at 12:55 PM (95% CI: 7:39 AM to 18:10 PM) (bimodal: P < 0.001). A similar bimodal circadian rhythm pattern was observed in subgroups of patients with STEMI defined with respect to day of the week, age, sex, and coronary risk factors. Notedly, the two peaks on Sunday were significantly later than other days, and the secondary peaks became clear and concentrated. In addition, no significant difference was found in MACCE among the four groups (P = 0.905). Conclusions In the Chinese population, the onset of STEMI exhibited a bimodal circadian rhythm pattern, with a clear primary peak and a less clear secondary peak. One-year clinical outcomes were unrelated to the timing of STEMI onset.
Collapse
Affiliation(s)
- Yibo Guo
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Lina Cui
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Lulu Li
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Zhuozhong Wang
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Chao Fang
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Bo Yu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| |
Collapse
|
2
|
Janke AT, Gettel CJ, Haimovich A, Kocher KE, Krumholz HM, Venkatesh AK. Changes in Emergency Department Arrival Times for Acute Myocardial Infarction During the COVID-19 Pandemic Suggest Delays in Care Seeking. Circ Cardiovasc Qual Outcomes 2022; 15:e008402. [PMID: 35105172 PMCID: PMC8833230 DOI: 10.1161/circoutcomes.121.008402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Alexander T. Janke
- Department of Emergency Medicine (A.T.J., C.J.G., A.H., A.K.V.), Yale School of Medicine, New Haven, CT
| | - Cameron J. Gettel
- Department of Emergency Medicine (A.T.J., C.J.G., A.H., A.K.V.), Yale School of Medicine, New Haven, CT
| | - Adrian Haimovich
- Department of Emergency Medicine (A.T.J., C.J.G., A.H., A.K.V.), Yale School of Medicine, New Haven, CT
| | - Keith E. Kocher
- Departments of Emergency Medicine (K.E.K.) and Learning Health Sciences (K.E.K.), University of Michigan Medical School, Ann Arbor
| | - Harlan M. Krumholz
- Section of Cardiovascular Medicine (H.M.K.), Yale School of Medicine, New Haven, CT
- Centers for Outcomes Research and Evaluation (H.M.K., A.K.V.), Yale School of Medicine, New Haven, CT
| | - Arjun K. Venkatesh
- Department of Emergency Medicine (A.T.J., C.J.G., A.H., A.K.V.), Yale School of Medicine, New Haven, CT
- Centers for Outcomes Research and Evaluation (H.M.K., A.K.V.), Yale School of Medicine, New Haven, CT
| |
Collapse
|