TY - JOUR
T1 - Circadian variation in the onset of unstable angina and non-Q-wave acute myocardial infarction (the TIMI III registry and TIMI IIIB)
AU - Cannon, Christopher P.
AU - McCabe, Carolyn H.
AU - Stone, Peter H.
AU - Schactman, Mark
AU - Thompson, Bruce
AU - Theroux, Pierre
AU - Gibson, Robert S.
AU - Feldman, Ted
AU - Kleiman, Neal
AU - Tofler, Geoffrey H.
AU - Muller, James E.
AU - Chaitman, Bernard R.
AU - Braunwald, Eugene
N1 - Funding Information:
The TIMI III Registry and TIMI IIIB clinical centers are supported by the National Heart, Lung, and Blood Institute Grant R01-HL-42311, the Core Laboratories Grant R01-HL-42419, and the Data Coordinating Center Grant R01-HL-42428, Bethesda, Maryland.
PY - 1997/2/1
Y1 - 1997/2/1
N2 - Circadian variation has been demonstrated in several types of acute cardiovascular disease, including acute myocardial infarction (AMI), sudden cardiac death, silent ambulatory ischemia, and thrombotic stroke. In contrast, no diurnal variation was observed in 1 study of non-Q-wave AMI, and limited data are available for unstable angina. To assess whether circadian variation is present in unstable angina and non-Q-wave AMI, we examined the time of onset of ischemic pain in 7,731 patients who were prospectively identified in the Thrombolysis in Myocardial Ischemia (TIMI) III Registry, 3,318 of whom were enrolled in the prospective study, and in 1,473 patients enrolled in the TIMI IIIB trial. A circadian variation in the onset of pain was observed, with an increase in the number of patients experiencing the onset of pain in the morning hours between 6 A.M. and 12 noon (p < 0.001). This circadian variation was observed both in patients with unstable angina and in those with evolving non-Q-wave AMI. A similar circadian pattern was observed in all subgroups tested. These findings were confirmed in the TIMI IIIB trial and complement previous studies suggesting that circadian variation exists in the onset of the full spectrum of myocardial ischemic syndromes.
AB - Circadian variation has been demonstrated in several types of acute cardiovascular disease, including acute myocardial infarction (AMI), sudden cardiac death, silent ambulatory ischemia, and thrombotic stroke. In contrast, no diurnal variation was observed in 1 study of non-Q-wave AMI, and limited data are available for unstable angina. To assess whether circadian variation is present in unstable angina and non-Q-wave AMI, we examined the time of onset of ischemic pain in 7,731 patients who were prospectively identified in the Thrombolysis in Myocardial Ischemia (TIMI) III Registry, 3,318 of whom were enrolled in the prospective study, and in 1,473 patients enrolled in the TIMI IIIB trial. A circadian variation in the onset of pain was observed, with an increase in the number of patients experiencing the onset of pain in the morning hours between 6 A.M. and 12 noon (p < 0.001). This circadian variation was observed both in patients with unstable angina and in those with evolving non-Q-wave AMI. A similar circadian pattern was observed in all subgroups tested. These findings were confirmed in the TIMI IIIB trial and complement previous studies suggesting that circadian variation exists in the onset of the full spectrum of myocardial ischemic syndromes.
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U2 - 10.1016/S0002-9149(97)00743-1
DO - 10.1016/S0002-9149(97)00743-1
M3 - Article
C2 - 9036740
AN - SCOPUS:0031053517
SN - 0002-9149
VL - 79
SP - 253
EP - 258
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 3
ER -