Circadian Variation in the Onset of Myocardial Infarction
Abstract
There are conflicting reports regarding circadian variation in the onset of acute myocardial infarction (MI) among patients with diabetes. We therefore, studied the circadian pattern of the incidence of acute MI in patients (n = 3,882) who were enrolled in the Onset Study stratified by the presence, type, and duration of diabetes. The Onset Study was conducted at 64 U.S. medical centers between August 1989 and September 1996. We used harmonic regression model to evaluate the circadian variation of MI symptom onset in patients with and without diabetes. Subgroup analysis was performed according to the presence, type, and duration of diabetes by the χ2 test (dividing the day into four 6-h intervals). Patients without diabetes exhibited a prominent morning peak in the incidence of acute MI symptom onset (P < 0.001). In contrast, patients with type 1 diabetes and type 2 diabetes ≥5 years had a marked attenuation of the morning peak. Patients who had type 2 diabetes diagnosed within the previous 5 years had a pattern of onset of acute MI similar to patients without diabetes. Patients with type 1 diabetes and those with type 2 diabetes ≥5 years have an attenuation of the morning peak in acute MI. Inconsistency in observation of such an effect in patients with diabetes in the past may well have been due to difference in the duration of diabetes and thus the variable extent of underlying autonomic dysfunction.
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In patients with long-term (≥5 years) type I or II diabetes, the morning peak in myocardial infarction is significantly blunted.
“in patients with long-term (≥5 years) type I or II diabetes, the morning peak in myocardial infarction is significantly blunted (184).”
From Role of the circadian system in cardiovascular disease (2018) · cites this paper as [184]
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Chokroverty, S. (2011) · Elsevier eBooks · doi:10.1016/b978-84-8086-733-7.00033-4 · Cited by 1 · see citing works
Nattel, S., & Comtois, P. (2006) · Heart Rhythm · doi:10.1016/j.hrthm.2006.12.024 · Cited by 1 · see citing works
Interventions in diabetic patients after myocardial infarction
Miličević, Z., & Raz, I. (2003) · Acta Diabetologica · doi:10.1007/s00592-003-0118-7 · Cited by 1 · see citing works
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Diabetic Autonomic Neuropathy and Circadian Misalignment in Type 1 Diabetes
Matteucci, E., & Giampietro, O. (2013) · InTech eBooks · doi:10.5772/52033
Canino, B., Hopps, E., Calandrino, V., Presti, R. L., Montana, M., & Caimi, G. (2014) · European Respiratory Journal · doi:10.1183/13993003/erj.44.suppl_58.p1533
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(2003) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.350
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- Authors
- Rana, J. S., Mukamal, K. J., Morgan, J. P., Muller, J. E., & Mittleman, M. A.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Harvard University (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2003-06-01
- Volume
- 52
- Issue
- 6
- Pages
- 1464-1468
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2119321943
- Cited by
- 58
- References
- 48
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2018: 1 · 2017: 5 · 2016: 3 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 4
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5t32hl007374-41)
- National Heart, Lung, and Blood Institute (HL41016, T32-HL07374-22, R01HL041016)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- circadian variation, acute myocardial infarction, diabetes mellitus, type 1 diabetes, type 2 diabetes, diabetes duration, morning peak, autonomic dysfunction, symptom onset
- MeSH terms
- Angina Pectoris, Circadian Rhythm, Diabetes Mellitus, Diabetic Angiopathies, Female, Humans, Male, Middle Aged, Myocardial Infarction, Obesity, Retrospective Studies, Risk Factors, Smoking, Time Factors, United States, Incidence, Age of Onset
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