The Impact of Circadian Variation on 12-Month Mortality in Patients With Acute Myocardial Infarction
Korean Circulation Journal
;
: 616-624, 2010.
Article
in English
| WPRIM
| ID: wpr-98810
ABSTRACT
BACKGROUND AND OBJECTIVES:
Although circadian variation in the onset of acute myocardial infarction (AMI) has been reported in a number of studies, not much is known about the impact of circadian variation on 12-month mortality. The aim of this study was to investigate the impact of circadian variation on 12-month mortality in patients with AMI. SUBJECTS ANDMETHODS:
Eight hundred ninety two patients (mean age 67+/-12; 66.1% men) with AMI who visited Kyungpook National University Hospital from November 2005 to December 2007 were included in this study. Patients were divided into groups based on four 6-hours intervals overnight (0000-0559); morning (0600-1159); afternoon (1200-1759) and evening (1800-2359).RESULTS:
Kaplan-Meier survival curves showed 12-month mortality rates of 9.6%, 9.1%, 12.1%, and 16.7% in the overnight, morning, afternoon, evening-onset groups, respectively (p=0.012). Compared with the morning-onset AMI group, the serum creatinine levels (p=0.002), frequency of Killip class > or =3 (p=0.004), and prescription rate of diuretics (p=0.011) were significantly higher in the evening-onset AMI group, while the left ventricular ejection fraction (p=0.012) was significantly lower. The proportion of patients who arrived in the emergency room during routine duty hours was significantly lower in evening-onset groups irrespective of the presence or absence of ST-segment elevation (p<0.001). According to univariate analysis, the 12-month mortality rate in the evening group was significantly higher compared to the morning group (hazard ratio 1.998, 95% confidence interval 1.196 to 3.338, p=0.008).CONCLUSION:
Patients with evening-onset AMI had poorer baseline clinical characteristics, and this might affect the circadian impact on 12-month mortality. Further studies are needed to clarify the role of circadian variation on the long-term outcome of AMI.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Stroke Volume
/
Circadian Rhythm
/
Creatinine
/
Diuretics
/
Emergencies
/
Kaplan-Meier Estimate
/
Prescriptions
/
Myocardial Infarction
Limits:
Humans
Language:
English
Journal:
Korean Circulation Journal
Year:
2010
Type:
Article
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