OBJECTIVES: We sought to investigate the impact of circadian patterns in the onset of acute myocardial infarction (AMI) on the practice of primary angioplasty. BACKGROUND: A circadian variation in the time of onset of AMI with a peak in the morning hours has been described. METHODS: We studied 1,702 consecutive patients with acute ST-segment elevation myocardial infarction treated with primary angioplasty. We observed circadian variation in frequency of symptom onset, hospital admission, and first balloon inflation. Circadian patterns of symptom onset, hospital admission, and balloon inflation are similar. RESULTS: A majority of patients have symptom onset (53%), hospital admission (53%), and first balloon inflation (52%) during routine duty hours (0800 to 1800 h). There were no differences in baseline clinical characteristics or treatment delays between routine duty hours and off-hours patients. Hospital admission between 0800 and 1800 was associated with an angioplasty failure rate of 3.8%, compared with 6.9% between 1800 and 0800, p < 0.01. Thirty-day mortality was 1.9% in patients with hospital admission between 0800 and 1800, compared with 4.2% in patients with hospital admission between 1800 and 0800, p < 0.01. CONCLUSIONS: Circadian variations may have a profound effect on the practice of primary angioplasty. A majority of patients are treated during routine duty hours. Patients treated during off-hours have a higher incidence of failed angioplasty and consequently a worse clinical outcome than patients treated during routine duty hours.
OBJECTIVES: We sought to investigate the impact of circadian patterns in the onset of acute myocardial infarction (AMI) on the practice of primary angioplasty. BACKGROUND: A circadian variation in the time of onset of AMI with a peak in the morning hours has been described. METHODS: We studied 1,702 consecutive patients with acute ST-segment elevation myocardial infarction treated with primary angioplasty. We observed circadian variation in frequency of symptom onset, hospital admission, and first balloon inflation. Circadian patterns of symptom onset, hospital admission, and balloon inflation are similar. RESULTS: A majority of patients have symptom onset (53%), hospital admission (53%), and first balloon inflation (52%) during routine duty hours (0800 to 1800 h). There were no differences in baseline clinical characteristics or treatment delays between routine duty hours and off-hours patients. Hospital admission between 0800 and 1800 was associated with an angioplasty failure rate of 3.8%, compared with 6.9% between 1800 and 0800, p < 0.01. Thirty-day mortality was 1.9% in patients with hospital admission between 0800 and 1800, compared with 4.2% in patients with hospital admission between 1800 and 0800, p < 0.01. CONCLUSIONS: Circadian variations may have a profound effect on the practice of primary angioplasty. A majority of patients are treated during routine duty hours. Patients treated during off-hours have a higher incidence of failed angioplasty and consequently a worse clinical outcome than patients treated during routine duty hours.
Authors: Sanneke Pm de Boer; Rohit M Oemrawsingh; Mattie J Lenzen; Nicolas M van Mieghem; Carl Schultz; K Martijn Akkerhuis; Maarten Ah van Leeuwen; Felix Zijlstra; Ron T van Domburg; Patrick Wjc Serruys; Eric Boersma Journal: Eur Heart J Acute Cardiovasc Care Date: 2012-04
Authors: Ann Coumbe; Ranjit John; Michael Kuskowski; Mehmet Agirbasli; Edward O McFalls; Selcuk Adabag Journal: BMC Cardiovasc Disord Date: 2011-10-20 Impact factor: 2.298
Authors: David Becker; Pal Soos; Balazs Berta; Andrea Nagy; Gabor Fulop; Gyorgy Szabo; Gyorgy Barczi; Eva Belicza; Istvan Martai; Béla Merkely Journal: Croat Med J Date: 2009-10 Impact factor: 1.351