Abstract
Background
Previous studies show that myocardial infarctions (MIs) occur most frequently in the
morning.
Objectives
We hypothesized that there no longer is a morning predominance of MI, and that the
timing of ST-elevation myocardial infarction (STEMI) vs. non-ST-elevation myocardial
infarction (NSTEMI) presentation differs.
Methods
We reviewed MI, STEMI, and NSTEMI patients (2013–2017) from a multiple-hospital system,
identified by diagnostic codes. Daily emergency department arrival times were categorized
into variable time intervals for count and proportional analysis, then examined for
differences.
Results
There were 18,663 MI patients from 12 hospitals included in the analysis. Most MIs
occurred between 12:00 pm and 5:59 pm (35.7%), and least between 12:00 am–5:59 am (16.3%). After subdividing all MIs into STEMIs and NSTEMIs, both groups continued
to have the greatest presentation between 12:00 pm and 5:59 pm (33.1% and 36.0%, respectively). STEMIs (17.2%) and NSTEMIs (16.2%) were least frequent
between 12:00 am and 5:59 am. We found the second most common presentation time for MIs was in the 6 pm–11:59 pm time period, which held true for both subtypes (MI 26.7%, STEMI 26.4%, NSTEMI 26.7%).
Conclusions
These data suggest a potential shift in the circadian pattern of MI, revealing an
afternoon predominance for both STEMI and NSTEMI subtypes.
Keywords
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Article info
Publication history
Published online: March 27, 2020
Accepted:
January 9,
2020
Received in revised form:
December 27,
2019
Received:
September 20,
2018
Identification
Copyright
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