PMID- 23580786
OWN - NLM
STAT- MEDLINE
DCOM- 20140217
LR  - 20211021
IS  - 1554-6179 (Electronic)
IS  - 1539-4182 (Print)
IS  - 1539-4182 (Linking)
VI  - 11
IP  - 2
DP  - 2013 Jun
TI  - Circadian patterns of ST elevation myocardial infarction in the new millennium.
PG  - 66-72
LID - 10.3121/cmr.2013.1120 [doi]
AB  - OBJECTIVE: Nearly four decades ago, a circadian pattern of acute myocardial 
      infarction (AMI) with a peak in the early morning waking hours was described. The 
      goal of the present study was to determine whether major changes in lifestyle and 
      significant advances in medical therapy have altered this pattern in the 
      intervening years. DESIGN: Retrospective chart review. SETTING: Tertiary care 
      hospital in central Wisconsin. METHODS: We examined circadian patterns of ST 
      elevation myocardial infarction (STEMI) in 519 patients diagnosed with STEMI over 
      a 5-year period. Time of symptom onset was obtained from patient self-reports in 
      the medical record and was recorded over 24 hours. RESULTS: We observed a 
      circadian pattern of STEMI occurrence with a morning peak at approximately 11:30 
      AM. This pattern was highly significant in patients who were not using 
      beta-blockers (P <0.0001) and had no history of diabetes (P <0.0001), but was 
      otherwise absent. The circadian pattern appeared to be attenuated in patients of 
      a younger age, female gender, or who used statins or aspirin. Peak STEMI 
      occurrence was earlier in smokers than non-smokers. CONCLUSIONS: Despite 
      significant lifestyle changes and medical advances in the nearly four decades 
      since a circadian pattern of AMI occurrence was first described, patients with 
      STEMI had a circadian pattern of symptom onset with a morning peak. Use of 
      beta-blockers and a history of diabetes mellitus abolished this pattern. Other 
      modifying factors, including medications, age, and gender attenuated, but did not 
      abolish, the circadian pattern.
FAU - Kanth, Rajan
AU  - Kanth R
AD  - Department of Internal Medicine, Marshfield Clinic, Marshfield, WI 54449, USA.
FAU - Ittaman, Sunitha
AU  - Ittaman S
FAU - Rezkalla, Shereif
AU  - Rezkalla S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130411
PL  - United States
TA  - Clin Med Res
JT  - Clinical medicine & research
JID - 101175887
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Aspirin/therapeutic use
MH  - Cardiology/*trends
MH  - Circadian Rhythm/*physiology
MH  - *Electrocardiography
MH  - Female
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
MH  - Life Style
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/*physiopathology
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Tertiary Care Centers
MH  - Wisconsin
PMC - PMC3692391
OTO - NOTNLM
OT  - Beta-blockers
OT  - Circadian rhythm
OT  - Diabetes
OT  - Myocardial infarction
EDAT- 2013/04/13 06:00
MHDA- 2014/02/18 06:00
PMCR- 2013/06/01
CRDT- 2013/04/13 06:00
PHST- 2013/04/13 06:00 [entrez]
PHST- 2013/04/13 06:00 [pubmed]
PHST- 2014/02/18 06:00 [medline]
PHST- 2013/06/01 00:00 [pmc-release]
AID - cmr.2013.1120 [pii]
AID - 0110066 [pii]
AID - 10.3121/cmr.2013.1120 [doi]
PST - ppublish
SO  - Clin Med Res. 2013 Jun;11(2):66-72. doi: 10.3121/cmr.2013.1120. Epub 2013 Apr 11.