Impact of Morning Onset on the Incidence of Recurrent Acute Coronary Syndrome and Progression of Coronary Atherosclerosis in Acute Myocardial Infarction.
Circ J
; 81(3): 361-367, 2017 Feb 24.
Article
in En
| MEDLINE
| ID: mdl-28090071
ABSTRACT
BACKGROUND:
The relationship between time of onset of acute myocardial infarction (MI) and long-term clinical outcome has not been completely understood. We hypothesized that morning onset acute MI may be associated with adverse cardiac events.MethodsâandâResults:
This study involved 663 patients who underwent primary percutaneous coronary intervention (PCI). The main outcome measures were cardiac death, recurrent acute coronary syndrome (ACS), and re-hospitalization for heart failure. Major adverse cardiac events (MACE) were defined as a composite of individual adverse outcomes. Morning onset acute MI occurred in 212 patients (32.0%); they had higher rates of recurrent ACS (13% vs. 8%, P=0.03) and MACE (21% vs. 14%, P=0.012) than the patients with other times of onset. The PCI rate for progressive lesions was also higher than for patients with other times of onset (23% vs. 14%, P=0.013). On multivariate Cox regression analysis, morning onset was an independent predictor of recurrent ACS, MACE, and PCI for progressive lesions, with adjusted hazard ratios of 1.34 (95% CI 1.06-2.92, P=0.030), 1.51 (95% CI 1.02-2.23, P=0.038), and 1.58 (95% CI 1.03-2.42, P=0.037), respectively.CONCLUSIONS:
Morning onset may be associated with increased risk of recurrent ACS and coronary atherosclerosis progression.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Acute Coronary Syndrome
/
Percutaneous Coronary Intervention
/
ST Elevation Myocardial Infarction
Type of study:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Circ J
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2017
Type:
Article