Clinical studyCircadian variation and possible external triggers of onset of myocardial infarction
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2017, American Journal of CardiologyCitation Excerpt :Patients who reported anxiety in the 2 hours before MI in the onset study were more likely to have died at 10-year follow-up than those not reporting anxiety (adjusted hazard ratio 1.4, 95% CI 1.1 to 1.9).26 Although the frequency of ACS was greatest between 6 a.m. and noon, as previously reported,14–17,27 the proportion of triggered ACS was greatest between noon and 6 p.m., for triggers overall and specifically for physical exertion and emotional stress. Strike also found that the noon to 6 p.m. interval was the peak time for exertion-triggered ACS.4
Circadian pattern of symptoms onset in patients ≤ 35 years presenting with ST-segment elevation acute myocardial infarction
2015, European Journal of Internal MedicineCitation Excerpt :Finally, none of our patients had a history of prior myocardial infarction which is known to abolish the circadian variation of subsequent coronary events [22]. Numerous studies have demonstrated a circadian pattern in AMI onset with a higher incidence in the morning, during sleep to wake transition [3–10]. In addition, Cohen et al. [23] performed a meta-analysis of the time-of-day distribution of AMI and found a consistently increased incidence of AMI in the dark to light transition period (06:00 to noon), representing 32% of the entire population.
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From the Neufeld Cardiac Research Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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See Appendix.