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Seasonal and circadian patterns of myocardial infarction by coronary artery disease status and sex in the ACTION Registry-GWTG.

Publication ,  Journal Article
Mahajan, AM; Gandhi, H; Smilowitz, NR; Roe, MT; Hellkamp, AS; Chiswell, K; Gulati, M; Reynolds, HR
Published in: Int J Cardiol
January 1, 2019

BACKGROUND: Myocardial infarction (MI) presentations are more common during winter months and morning hours. However, it is unknown whether MI with obstructive coronary artery disease (MI-CAD) and non-obstructive CAD (MINOCA) display similar patterns. METHODS: We evaluated seasonal and circadian patterns of MI presentation by coronary artery disease (CAD) status and sex in patients with MI from 2007 to 2014 in the National Cardiovascular Data Registry (NCDR) Acute Coronary Treatment Intervention Outcomes Network (ACTION) Registry-Get With the Guidelines. Adult patients who underwent coronary angiography for MI were included. Patients with missing age, sex, or angiographic data, cocaine use, thrombolytic therapy prior to catheterization, or prior revascularization were excluded. Baseline demographics and characteristics of symptom onset, including season and time of day of presentation, were compared by CAD status and sex. RESULTS: Among 322,523 patients, 112,547 were female (35%); 18,918 had MINOCA (5.9%). There was no seasonal pattern of MI overall. However, both men and women with MINOCA presented more often in the summer and fall while MI-CAD presentations were equally distributed across seasons. The most common time of presentation was 8 am-2 pm regardless of CAD status or sex. A secondary peak in women with MINOCA during late afternoon hours was also identified. CONCLUSIONS: Seasonal variation of MI differed between MINOCA and MI-CAD, with a small increase in MINOCA incidence in the summer and fall. MINOCA and MI-CAD most commonly occurred in the morning, with a secondary peak in late afternoon in women with MINOCA. These differences in presentation may relate to underlying MI pathophysiology.

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Published In

Int J Cardiol

DOI

EISSN

1874-1754

Publication Date

January 1, 2019

Volume

274

Start / End Page

16 / 20

Location

Netherlands

Related Subject Headings

  • United States
  • Time Factors
  • Sex Factors
  • Seasons
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Myocardial Infarction
  • Middle Aged
  • Male
 

Citation

APA
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ICMJE
MLA
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Mahajan, A. M., Gandhi, H., Smilowitz, N. R., Roe, M. T., Hellkamp, A. S., Chiswell, K., … Reynolds, H. R. (2019). Seasonal and circadian patterns of myocardial infarction by coronary artery disease status and sex in the ACTION Registry-GWTG. Int J Cardiol, 274, 16–20. https://doi.org/10.1016/j.ijcard.2018.08.103
Mahajan, Asha M., Himali Gandhi, Nathaniel R. Smilowitz, Matthew T. Roe, Anne S. Hellkamp, Karen Chiswell, Martha Gulati, and Harmony R. Reynolds. “Seasonal and circadian patterns of myocardial infarction by coronary artery disease status and sex in the ACTION Registry-GWTG.Int J Cardiol 274 (January 1, 2019): 16–20. https://doi.org/10.1016/j.ijcard.2018.08.103.
Mahajan AM, Gandhi H, Smilowitz NR, Roe MT, Hellkamp AS, Chiswell K, et al. Seasonal and circadian patterns of myocardial infarction by coronary artery disease status and sex in the ACTION Registry-GWTG. Int J Cardiol. 2019 Jan 1;274:16–20.
Mahajan, Asha M., et al. “Seasonal and circadian patterns of myocardial infarction by coronary artery disease status and sex in the ACTION Registry-GWTG.Int J Cardiol, vol. 274, Jan. 2019, pp. 16–20. Pubmed, doi:10.1016/j.ijcard.2018.08.103.
Mahajan AM, Gandhi H, Smilowitz NR, Roe MT, Hellkamp AS, Chiswell K, Gulati M, Reynolds HR. Seasonal and circadian patterns of myocardial infarction by coronary artery disease status and sex in the ACTION Registry-GWTG. Int J Cardiol. 2019 Jan 1;274:16–20.
Journal cover image

Published In

Int J Cardiol

DOI

EISSN

1874-1754

Publication Date

January 1, 2019

Volume

274

Start / End Page

16 / 20

Location

Netherlands

Related Subject Headings

  • United States
  • Time Factors
  • Sex Factors
  • Seasons
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Myocardial Infarction
  • Middle Aged
  • Male