"Summer Shift" A Potential Effect of Sunshine on the Time Onset of ST-Elevation Acute Myocardial Infarction

Carlo Vittorio Cannistraci, Tuomo Nieminen, Masahiro Nishi, Levon M Khachigian, Juho Viikilä, Mika Laine, Domenico Cianflone, Attilio Maseri, Khung Keong Yeo, Ravinay Bhindi, Enrico Ammirati

Research output: Contribution to journalArticle

Abstract

BACKGROUND: ST-elevation acute myocardial infarction (STEMI) represents one of the leading causes of death. The time of STEMI onset has a circadian rhythm with a peak during diurnal hours, and the occurrence of STEMI follows a seasonal pattern with a salient peak of cases in the winter months and a marked reduction of cases in the summer months. Scholars investigated the reason behind the winter peak, suggesting that environmental and climatic factors concur in STEMI pathogenesis, but no studies have investigated whether the circadian rhythm is modified with the seasonal pattern, in particular during the summer reduction in STEMI occurrence.

METHODS AND RESULTS: Here, we provide a multiethnic and multination epidemiological study (from both hemispheres at different latitudes, n=2270 cases) that investigates whether the circadian variation of STEMI onset is altered in the summer season. The main finding is that the difference between numbers of diurnal (6:00 to 18:00) and nocturnal (18:00 to 6:00) STEMI is markedly decreased in the summer season, and this is a prodrome of a complex mechanism according to which the circadian rhythm of STEMI time onset seems season dependent.

CONCLUSIONS: The "summer shift" of STEMI to the nocturnal interval is consistent across different populations, and the sunshine duration (a measure related to cloudiness and solar irradiance) underpins this season-dependent circadian perturbation. Vitamin D, which in our results seems correlated with this summer shift, is also primarily regulated by the sunshine duration, and future studies should investigate their joint role in the mechanisms of STEMI etiogenesis.

Original languageEnglish
JournalJournal of the American Heart Association
Volume7
Issue number8
DOIs
Publication statusPublished - Apr 6 2018

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Sunlight
Circadian Rhythm
ST Elevation Myocardial Infarction
Vitamin D
Epidemiologic Studies
Cause of Death
Joints

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"Summer Shift" A Potential Effect of Sunshine on the Time Onset of ST-Elevation Acute Myocardial Infarction. / Cannistraci, Carlo Vittorio; Nieminen, Tuomo; Nishi, Masahiro; Khachigian, Levon M; Viikilä, Juho; Laine, Mika; Cianflone, Domenico; Maseri, Attilio; Yeo, Khung Keong; Bhindi, Ravinay; Ammirati, Enrico.

In: Journal of the American Heart Association, Vol. 7, No. 8, 06.04.2018.

Research output: Contribution to journalArticle

Cannistraci, Carlo Vittorio ; Nieminen, Tuomo ; Nishi, Masahiro ; Khachigian, Levon M ; Viikilä, Juho ; Laine, Mika ; Cianflone, Domenico ; Maseri, Attilio ; Yeo, Khung Keong ; Bhindi, Ravinay ; Ammirati, Enrico. / "Summer Shift" A Potential Effect of Sunshine on the Time Onset of ST-Elevation Acute Myocardial Infarction. In: Journal of the American Heart Association. 2018 ; Vol. 7, No. 8.
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abstract = "BACKGROUND: ST-elevation acute myocardial infarction (STEMI) represents one of the leading causes of death. The time of STEMI onset has a circadian rhythm with a peak during diurnal hours, and the occurrence of STEMI follows a seasonal pattern with a salient peak of cases in the winter months and a marked reduction of cases in the summer months. Scholars investigated the reason behind the winter peak, suggesting that environmental and climatic factors concur in STEMI pathogenesis, but no studies have investigated whether the circadian rhythm is modified with the seasonal pattern, in particular during the summer reduction in STEMI occurrence.METHODS AND RESULTS: Here, we provide a multiethnic and multination epidemiological study (from both hemispheres at different latitudes, n=2270 cases) that investigates whether the circadian variation of STEMI onset is altered in the summer season. The main finding is that the difference between numbers of diurnal (6:00 to 18:00) and nocturnal (18:00 to 6:00) STEMI is markedly decreased in the summer season, and this is a prodrome of a complex mechanism according to which the circadian rhythm of STEMI time onset seems season dependent.CONCLUSIONS: The {"}summer shift{"} of STEMI to the nocturnal interval is consistent across different populations, and the sunshine duration (a measure related to cloudiness and solar irradiance) underpins this season-dependent circadian perturbation. Vitamin D, which in our results seems correlated with this summer shift, is also primarily regulated by the sunshine duration, and future studies should investigate their joint role in the mechanisms of STEMI etiogenesis.",
author = "Cannistraci, {Carlo Vittorio} and Tuomo Nieminen and Masahiro Nishi and Khachigian, {Levon M} and Juho Viikil{\"a} and Mika Laine and Domenico Cianflone and Attilio Maseri and Yeo, {Khung Keong} and Ravinay Bhindi and Enrico Ammirati",
note = "{\circledC} 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.",
year = "2018",
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doi = "10.1161/JAHA.117.006878",
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T1 - "Summer Shift" A Potential Effect of Sunshine on the Time Onset of ST-Elevation Acute Myocardial Infarction

AU - Cannistraci, Carlo Vittorio

AU - Nieminen, Tuomo

AU - Nishi, Masahiro

AU - Khachigian, Levon M

AU - Viikilä, Juho

AU - Laine, Mika

AU - Cianflone, Domenico

AU - Maseri, Attilio

AU - Yeo, Khung Keong

AU - Bhindi, Ravinay

AU - Ammirati, Enrico

N1 - © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

PY - 2018/4/6

Y1 - 2018/4/6

N2 - BACKGROUND: ST-elevation acute myocardial infarction (STEMI) represents one of the leading causes of death. The time of STEMI onset has a circadian rhythm with a peak during diurnal hours, and the occurrence of STEMI follows a seasonal pattern with a salient peak of cases in the winter months and a marked reduction of cases in the summer months. Scholars investigated the reason behind the winter peak, suggesting that environmental and climatic factors concur in STEMI pathogenesis, but no studies have investigated whether the circadian rhythm is modified with the seasonal pattern, in particular during the summer reduction in STEMI occurrence.METHODS AND RESULTS: Here, we provide a multiethnic and multination epidemiological study (from both hemispheres at different latitudes, n=2270 cases) that investigates whether the circadian variation of STEMI onset is altered in the summer season. The main finding is that the difference between numbers of diurnal (6:00 to 18:00) and nocturnal (18:00 to 6:00) STEMI is markedly decreased in the summer season, and this is a prodrome of a complex mechanism according to which the circadian rhythm of STEMI time onset seems season dependent.CONCLUSIONS: The "summer shift" of STEMI to the nocturnal interval is consistent across different populations, and the sunshine duration (a measure related to cloudiness and solar irradiance) underpins this season-dependent circadian perturbation. Vitamin D, which in our results seems correlated with this summer shift, is also primarily regulated by the sunshine duration, and future studies should investigate their joint role in the mechanisms of STEMI etiogenesis.

AB - BACKGROUND: ST-elevation acute myocardial infarction (STEMI) represents one of the leading causes of death. The time of STEMI onset has a circadian rhythm with a peak during diurnal hours, and the occurrence of STEMI follows a seasonal pattern with a salient peak of cases in the winter months and a marked reduction of cases in the summer months. Scholars investigated the reason behind the winter peak, suggesting that environmental and climatic factors concur in STEMI pathogenesis, but no studies have investigated whether the circadian rhythm is modified with the seasonal pattern, in particular during the summer reduction in STEMI occurrence.METHODS AND RESULTS: Here, we provide a multiethnic and multination epidemiological study (from both hemispheres at different latitudes, n=2270 cases) that investigates whether the circadian variation of STEMI onset is altered in the summer season. The main finding is that the difference between numbers of diurnal (6:00 to 18:00) and nocturnal (18:00 to 6:00) STEMI is markedly decreased in the summer season, and this is a prodrome of a complex mechanism according to which the circadian rhythm of STEMI time onset seems season dependent.CONCLUSIONS: The "summer shift" of STEMI to the nocturnal interval is consistent across different populations, and the sunshine duration (a measure related to cloudiness and solar irradiance) underpins this season-dependent circadian perturbation. Vitamin D, which in our results seems correlated with this summer shift, is also primarily regulated by the sunshine duration, and future studies should investigate their joint role in the mechanisms of STEMI etiogenesis.

U2 - 10.1161/JAHA.117.006878

DO - 10.1161/JAHA.117.006878

M3 - Article

VL - 7

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 8

ER -