Circadian variation of acute myocardial infarction and its influence on prognosis within 12 months Zeng
Haowei
Chen Rui
Chen Weiwei
Tan Buchuan
Yang Ping
Abstract：discuss the circadian variation of acute myocardial infarction (AMI) in Chinese population and relationship between it and patients’ prognosis within 12 months. Methods AMI patients (n=467) with definite diagnosis and AMI attack time were chosen from Department of Cardiology in China-Japan Union Hospital of Jilin University from Jan. 1, 2015 to Oct. 25, 2016 and their data was retrospectively analyzed. All patients were divided into morning group (AMI attacked from 06:00 am to 11:59 am, n=162) and other time group (n=305). The clinical basic materials, incidence of death or heart failure during hospitalization period, and all-cause mortality, re-onset acute coronary syndrome (ACS), re-hospitalization due to heart failure and major adverse cardiovascular events (MACE) during follow-up period after discharged were recorded, and results of coronary angiography were reexamined. Results One peak of AMI attack was found from 06:00 am to 07:59 am (13.27%) based on dividing 24 h into 2 h. One peak of AMI attack was found from 06:00 am to 11:59 am (34.69%) based on dividing 24 h into 6 h. The results of Kaplan-Meier survival curve analysis showed that the aggregation risks of MACE (76.3% vs. 50.3%, P=0.041) and re-hospitalization due to heart failure (53.5% vs. 39.3%, P=0.032) were higher in morning group within 12 months after discharged. The results of multi-factor COX regression analysis showed that AMI attacked from 06:00 am to 11:59 am was an independent risk factor of AMI (HR=6.458, 95%CI: 2.015~20.697, P=0.002) within 12 months after discharged. The results of reexamination of coronary angiography showed that the incidence rate of non-target vessel revascularization (NON-TVR) was higher in morning group (29.3% vs. 11.1%, P=0.019) during follow-up period. Conclusion The patients with AMI attack from 06:00 am to 11:59 am had higher aggregation rates of MACE and re-hospitalization due to heart failure and higher incidence rate of NON-TVR within 12 months after discharged. So more attention should be paid to them, follow-up should be enhanced and MACE should be disposed in time.
Keywords：Acute myocardial infarctionCircadian variationPrognosis
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1300-1305 )