Circadian variations of ischemic burden among patients with myocardial infarction undergoing primary percutaneous coronary intervention.
Am Heart J
; 163(2): 208-13, 2012 Feb.
Article
em En
| MEDLINE
| ID: mdl-22305838
ABSTRACT
BACKGROUND:
Several parameters of cardiovascular physiology and pathophysiology exhibit circadian rhythms. Recently, a relation between infarct size and the time of day at which it occurs has been suggested in experimental models of myocardial infarction. The aim of this study is to investigate whether circadian rhythms could cause differences in ischemic burden in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).METHODS:
In 353 consecutive patients with STEMI treated by PPCI, time of symptom onset, peak creatine kinase (CK), and follow-up at 30 days were obtained. We divided 24 hours into 4 time groups based on time of symptom onset (0000-0559, 0600-1159, 1200-1759, and 1800-2359).RESULTS:
There was no difference between the groups regarding baseline patients and management's characteristics. At multivariable analysis, there was a statistically significant difference between peak CK levels among patients with symptom onset between 0000 and 0559 when compared with peak CK levels of patients with symptom onset in any other time group (mean increase 38.4%, P < .05). Thirty-day mortality for STEMI patients with symptom onset occurring between 0000 and 0559 was significantly higher than any other time group (P < .05).CONCLUSION:
This study demonstrates an independent correlation between the infarct size of STEMI patients treated by PPCI and the time of the day at which symptoms occurred. These results suggest that time of the day should be a critical issue to look at when assessing prognosis of patients with myocardial infarction.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Angioplastia Coronária com Balão
/
Ritmo Circadiano
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Circulação Coronária
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Vasos Coronários
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Eletrocardiografia
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Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Am Heart J
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Suíça