Morning and Monday: Critical periods for the onset of acute myocardial infarction - The GISSI 2 study experience

T. Ginecchi-Ruscone, E. Piccaluga, S. Guzzetti, M. Contini, N. Montano, E. Nicolis

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

The onset of acute myocardial infarction (AMI) is unevenly distributed over the 24 h and the week. While presence of a morning peak is generally agreed upon contrasting results had been obtained regarding other periods of the day probably due to differences of origin, size and composition of the populations. The 24 h and weekly distributions were studied within 6 h from the beginning of the symptoms in a population following a Latin life-style who were enrolled in the GISSI 2 Study (n = 11472). Subgroups (smokers, the elderly (> 65 years), diabetics, hypertensives) were also considered. Six hour periods starting at midnight were tested for uniformity. Circadian non-uniformity was found. Events increased in the morning hours and reduced during the night regardless of the day of the week. The night and day difference was attenuated in smokers and diabetics. Non-uniformity of the events was also found among the days of the week. AMI significantly increased in non-smokers on Monday. We suggest that there is a night-day gradient (characterized by the short time interval between the two frequency extremes) in the time of onset of AMI. The different distribution in smokers stresses the possible unfavourable and masking effect of a heightened sympathetic tone during the day while the general protective role of the night hours is preserved. Moreover, the increased incidence of events on Monday may suggest the importance of the shift from a period of non-scheduled to scheduled activity.

Original languageEnglish
Pages (from-to)882-887
Number of pages6
JournalEuropean Heart Journal
Volume15
Issue number7
Publication statusPublished - 1994

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Myocardial Infarction
Population Density
Life Style
Incidence
Population
Critical Period (Psychology)

Keywords

  • Acute myocardial infarction
  • Circadian variation
  • Diabetes
  • Smokers
  • Week distribution

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Morning and Monday : Critical periods for the onset of acute myocardial infarction - The GISSI 2 study experience. / Ginecchi-Ruscone, T.; Piccaluga, E.; Guzzetti, S.; Contini, M.; Montano, N.; Nicolis, E.

In: European Heart Journal, Vol. 15, No. 7, 1994, p. 882-887.

Research output: Contribution to journalArticle

Ginecchi-Ruscone, T. ; Piccaluga, E. ; Guzzetti, S. ; Contini, M. ; Montano, N. ; Nicolis, E. / Morning and Monday : Critical periods for the onset of acute myocardial infarction - The GISSI 2 study experience. In: European Heart Journal. 1994 ; Vol. 15, No. 7. pp. 882-887.
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