Barneto Valero MC, Garmendia Leiza JR, Ardura Fernández J, Casaseca de la Higuera JP, Andrés de Llano JM, Corral Torres E. [Relation between myocardial infarction and circadian rhythm in patients attended in a prehospital emergency service].
Med Clin (Barc) 2012;
139:515-21. [PMID:
22206796 DOI:
10.1016/j.medcli.2011.09.035]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Revised: 09/15/2011] [Accepted: 09/20/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES
The aim of this study is to analyze the presence of circadian rhythm in the time of onset of symptoms of acute myocardial infarction treated by a prehospital emergency system and the influence of modifiable cardiovascular risk factors and non-modifiable as modulators of that circadian rhythm.
PATIENTS AND METHODS
Retrospective analysis of 709 patients clinically diagnosed with acute myocardial infarction on-site in the prehospital setting. The variables were time to onset of symptoms, age, sex, previous ischemic heart disease, hypertension, diabetes mellitus, hyperlipidemia and smoking. We analyzed the rhythm with cosinor multiple sinusoid method, with 3 harmonics (24, 12 and 8h) for the adjustment.
RESULTS
The time of onset of pain showed circadian rhythm (P <,001), peaking at 10.39 and a valley at 4.28, showing a sinusoidal curve fitting bimodal aspect with a predominant morning peak and another evening one of lower amplitude. All subgroups categorized by the study variables showed circadian rhythm, with a cosine curve similar to the global infarction. Smokers had a predominantly evening peak.
CONCLUSIONS
Acute myocardial infarction shows a circadian rhythm. Smoking and diabetes mellitus can modify the standard incidence rate of occurrence of myocardial infarction.
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