{"title":"A Systematic Review and Meta-Analysis of 35,409 Patients Undergoing PCI versus CABG for Unprotected Left Main Coronary Artery Diseases","authors":"Hao Liu, Dongdong Li, Chuncheng Gao, Huimiao Dai, Lin Kang, Mingming Zhang, Chen Yun, Wangang Guo","doi":"10.31083/j.rcm2508282","DOIUrl":"https://doi.org/10.31083/j.rcm2508282","url":null,"abstract":"","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Girdauskas, S. Stock, Elisa Favot, Blerim Luani, Tatiana Sequeira-Gross, C. Dumps, M. V. Stumm, T. Owais, Wolfgang von Scheidt
{"title":"Papillary Muscle Maneuvers: Pathophysiology-based Approach in Secondary Mitral Regurgitation","authors":"E. Girdauskas, S. Stock, Elisa Favot, Blerim Luani, Tatiana Sequeira-Gross, C. Dumps, M. V. Stumm, T. Owais, Wolfgang von Scheidt","doi":"10.31083/j.rcm2508283","DOIUrl":"https://doi.org/10.31083/j.rcm2508283","url":null,"abstract":"","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nilian Wu, Xueyan Lang, Yanxiu Zhang, Bing Zhao, Yao Zhang
{"title":"Predictors and Prognostic Factors of Heart Failure with Improved Ejection Fraction","authors":"Nilian Wu, Xueyan Lang, Yanxiu Zhang, Bing Zhao, Yao Zhang","doi":"10.31083/j.rcm2508280","DOIUrl":"https://doi.org/10.31083/j.rcm2508280","url":null,"abstract":"","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristian Galanti, Mario Di Marino, Davide Mansour, Sabrina Testa, Davide Rossi, Claudio Scollo, Roberta Magnano, Laura Pezzi, A. D’Alleva, D. Forlani, Piergiusto Vitulli, Leonardo Paloscia, Fabrizio Ricci, Giulia Renda, Sabina Gallina, Massimo Di Marco
{"title":"Current Antithrombotic Treatments for Cardiovascular Diseases: A Comprehensive Review","authors":"Kristian Galanti, Mario Di Marino, Davide Mansour, Sabrina Testa, Davide Rossi, Claudio Scollo, Roberta Magnano, Laura Pezzi, A. D’Alleva, D. Forlani, Piergiusto Vitulli, Leonardo Paloscia, Fabrizio Ricci, Giulia Renda, Sabina Gallina, Massimo Di Marco","doi":"10.31083/j.rcm2508281","DOIUrl":"https://doi.org/10.31083/j.rcm2508281","url":null,"abstract":"","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Physical inactivity and poor cardiorespiratory fitness (CRF) are strongly associated with type 2 diabetes (DM2) and all-cause and cardiovascular morbidity and mortality. Incorporating physical activity promotion in the management of DM2 has been a pivotal approach modulating the underlying pathophysiology of DM2 of increased insulin resistance, endothelial dysfunction, and abnormal mitochondrial function. Although CRF is considered a modifiable risk factor, certain immutable aspects such as age, race, and gender impact CRF status and is the focus of this review. Results show that diabetes has often been considered a disease of premature aging manifested by early onset of macro and microvascular deterioration with underlying negative impact on CRF and influencing next generation. Certain races such as Native Americans and African Americans show reduced baseline CRF and decreased gain in CRF in randomized trials. Moreover, multiple biological gender differences translate to lower baseline CRF and muted responsivity to exercise in women with increased morbidity and mortality. Although factors such as age, race, and sex may not have major impacts on CRF their influence should be considered with the aim of optimizing precision medicine.
{"title":"Age, Race, Sex and Cardiorespiratory Fitness: Implications for Prevention and Management of Cardiometabolic Disease in Individuals with Diabetes Mellitus","authors":"Eric Nylén","doi":"10.31083/j.rcm2507263","DOIUrl":"https://doi.org/10.31083/j.rcm2507263","url":null,"abstract":"Physical inactivity and poor cardiorespiratory fitness (CRF) are strongly associated with type 2 diabetes (DM2) and all-cause and cardiovascular morbidity and mortality. Incorporating physical activity promotion in the management of DM2 has been a pivotal approach modulating the underlying pathophysiology of DM2 of increased insulin resistance, endothelial dysfunction, and abnormal mitochondrial function. Although CRF is considered a modifiable risk factor, certain immutable aspects such as age, race, and gender impact CRF status and is the focus of this review. Results show that diabetes has often been considered a disease of premature aging manifested by early onset of macro and microvascular deterioration with underlying negative impact on CRF and influencing next generation. Certain races such as Native Americans and African Americans show reduced baseline CRF and decreased gain in CRF in randomized trials. Moreover, multiple biological gender differences translate to lower baseline CRF and muted responsivity to exercise in women with increased morbidity and mortality. Although factors such as age, race, and sex may not have major impacts on CRF their influence should be considered with the aim of optimizing precision medicine.","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evan Czulada, Samir A. Shah, Apostolos Tsimploulis
The expanding field of cardiorespiratory fitness (CRF) in individuals with and without atrial fibrillation (AF) presents a complex landscape, demanding careful interpretation of the existing research. AF, characterized by significant mortality and morbidity, prompts the exploration of strategies to mitigate its impact. Increasing physical activity (PA) levels emerges as a promising avenue to address AF risk factors, such as obesity, hypertension, and diabetes mellitus, through mechanisms of reduced vasoconstriction, endothelin-1 modulation, and improved insulin sensitivity. However, caution is warranted, as recent investigations suggest a heightened incidence of AF, particularly in athletes engaged in high-intensity exercise, due to the formation of ectopic foci and changes in cardiac anatomy. Accordingly, patients should adhere to guideline-recommended amounts of low-to-moderate PA to balance benefits and minimize adverse effects. When looking closer at the current evidence, gender-specific differences have been observed and challenged conventional understanding, with women demonstrating decreased AF risk even at extreme exercise levels. This phenomenon may be rooted in divergent hemodynamic and structural responses to exercise between men and women. Existing research is predominantly observational and limited to racially homogenous populations, which underscores the need for comprehensive studies encompassing diverse, non-White ethnic groups in athlete and non-athlete populations. These individuals exhibit a disproportionately high burden of AF risk factors that could be addressed through improved CRF. Despite the limitations, randomized control trials offer promising evidence for the efficacy of CRF interventions in patients with preexisting AF, showcasing improvements in clinically significant AF outcomes and patient quality of life. The potential of CRF as a countermeasure to the consequences of AF remains an area of great promise, urging future research to delve deeper to explore its role within specific racial and gender contexts. This comprehensive understanding will contribute to the development of tailored strategies for optimizing cardiovascular health and AF prevention in all those who are affected.
心房颤动（AF）患者和非心房颤动患者的心肺功能（CRF）领域不断扩大，呈现出复杂的局面，需要对现有研究进行仔细解读。心房颤动的特点是死亡率和发病率高，这促使人们探索减轻其影响的策略。通过减少血管收缩、调节内皮素-1 和改善胰岛素敏感性等机制，增加体力活动（PA）水平成为解决心房颤动风险因素（如肥胖、高血压和糖尿病）的一个有希望的途径。然而，需要谨慎的是，最近的研究表明，由于异位灶的形成和心脏解剖结构的改变，房颤的发生率会升高，尤其是从事高强度运动的运动员。因此，患者应遵守指南推荐的低度至中度 PA 量，以平衡益处并尽量减少不良影响。仔细观察当前的证据，我们发现了性别差异并对传统认识提出了挑战，即使在极限运动水平下，女性的房颤风险也会降低。这一现象可能源于男女对运动的血液动力学和结构反应不同。现有的研究主要是观察性的，而且仅限于种族相同的人群，这就强调了对运动员和非运动员人群中不同的非白人种族群体进行全面研究的必要性。这些人的房颤风险因素负担过重，可以通过改善 CRF 来解决。尽管存在这些局限性，但随机对照试验为 CRF 干预对原有心房颤动患者的疗效提供了有希望的证据，展示了临床上显著的心房颤动结果和患者生活质量的改善。CRF作为心房颤动后果对策的潜力仍是一个大有可为的领域，这促使未来的研究更深入地探讨其在特定种族和性别背景下的作用。这种全面的认识将有助于制定有针对性的策略，优化所有受影响人群的心血管健康和心房颤动预防。
{"title":"Racial and Gender Differences in Cardiorespiratory Fitness and Atrial Fibrillation","authors":"Evan Czulada, Samir A. Shah, Apostolos Tsimploulis","doi":"10.31083/j.rcm2507261","DOIUrl":"https://doi.org/10.31083/j.rcm2507261","url":null,"abstract":"The expanding field of cardiorespiratory fitness (CRF) in individuals with and without atrial fibrillation (AF) presents a complex landscape, demanding careful interpretation of the existing research. AF, characterized by significant mortality and morbidity, prompts the exploration of strategies to mitigate its impact. Increasing physical activity (PA) levels emerges as a promising avenue to address AF risk factors, such as obesity, hypertension, and diabetes mellitus, through mechanisms of reduced vasoconstriction, endothelin-1 modulation, and improved insulin sensitivity. However, caution is warranted, as recent investigations suggest a heightened incidence of AF, particularly in athletes engaged in high-intensity exercise, due to the formation of ectopic foci and changes in cardiac anatomy. Accordingly, patients should adhere to guideline-recommended amounts of low-to-moderate PA to balance benefits and minimize adverse effects. When looking closer at the current evidence, gender-specific differences have been observed and challenged conventional understanding, with women demonstrating decreased AF risk even at extreme exercise levels. This phenomenon may be rooted in divergent hemodynamic and structural responses to exercise between men and women. Existing research is predominantly observational and limited to racially homogenous populations, which underscores the need for comprehensive studies encompassing diverse, non-White ethnic groups in athlete and non-athlete populations. These individuals exhibit a disproportionately high burden of AF risk factors that could be addressed through improved CRF. Despite the limitations, randomized control trials offer promising evidence for the efficacy of CRF interventions in patients with preexisting AF, showcasing improvements in clinically significant AF outcomes and patient quality of life. The potential of CRF as a countermeasure to the consequences of AF remains an area of great promise, urging future research to delve deeper to explore its role within specific racial and gender contexts. This comprehensive understanding will contribute to the development of tailored strategies for optimizing cardiovascular health and AF prevention in all those who are affected.","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141655503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yumeng Lei, Mao Jiang, Xu Liu, Shuaiyong Zhang, Mengyao Li, Yunfei Wang, Ming Chen, Nan Guo, Yongxing Liu, Xu-fen Cao, Liqiu Yan
Background : This study investigated factors influencing discrepancies between fractional flow reserve (FFR) and resting full-cycle ratio (RFR) in the functional assessment of coronary artery stenosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods : We included 320 diseased vessels from 253 consecutive patients with NSTE-ACS. Vessels were categorized into four groups based on FFR ≤ 0.80 and RFR ≤ 0.89 thresholds: group 1 concordant negative (RFR–/FFR–), group 2 positive RFR and negative FFR (RFR+/FFR–), group 3 negative RFR and positive FFR (RFR–/FFR+), and group 4 concordant positive (RFR+/FFR+). Univariate and multivariate logistic regression analyses were conducted to identify predictors of diagnostic discrepancy between FFR and RFR. Results : Of the 320 diseased vessels, 182 (56.9%) were in group 1 (RFR–/FFR–), 33 (10.3%) in group 2 (RFR+/FFR–), 31 (9.7%) in group 3 (RFR–/FFR+), and 74 (23.1%) in group 4 (RFR+/FFR+). The concordance between FFR and RFR was 80.0%. No-tably, left anterior descending artery (LAD) lesions exhibited significantly lower consistency compared to non-LAD lesions ( p = 0.001), with distinct differences in FFR and RFR values between these groups ( p < 0.001). The presence of a LAD lesion emerged as an independent predictor of diagnostic inconsistency between positive RFR and negative FFR measurements ( p = 0.001). Conclusions : LAD involvement independently predicts diagnostic discrepancies between FFR and RFR in evaluating functional coronary artery stenosis in NSTE-ACS patients.
{"title":"Comparison of Fractional Flow Reserve and Resting Full-Cycle Ratio in the Functional Assessment of Coronary Artery Stenosis in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome","authors":"Yumeng Lei, Mao Jiang, Xu Liu, Shuaiyong Zhang, Mengyao Li, Yunfei Wang, Ming Chen, Nan Guo, Yongxing Liu, Xu-fen Cao, Liqiu Yan","doi":"10.31083/j.rcm2507260","DOIUrl":"https://doi.org/10.31083/j.rcm2507260","url":null,"abstract":"Background : This study investigated factors influencing discrepancies between fractional flow reserve (FFR) and resting full-cycle ratio (RFR) in the functional assessment of coronary artery stenosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods : We included 320 diseased vessels from 253 consecutive patients with NSTE-ACS. Vessels were categorized into four groups based on FFR ≤ 0.80 and RFR ≤ 0.89 thresholds: group 1 concordant negative (RFR–/FFR–), group 2 positive RFR and negative FFR (RFR+/FFR–), group 3 negative RFR and positive FFR (RFR–/FFR+), and group 4 concordant positive (RFR+/FFR+). Univariate and multivariate logistic regression analyses were conducted to identify predictors of diagnostic discrepancy between FFR and RFR. Results : Of the 320 diseased vessels, 182 (56.9%) were in group 1 (RFR–/FFR–), 33 (10.3%) in group 2 (RFR+/FFR–), 31 (9.7%) in group 3 (RFR–/FFR+), and 74 (23.1%) in group 4 (RFR+/FFR+). The concordance between FFR and RFR was 80.0%. No-tably, left anterior descending artery (LAD) lesions exhibited significantly lower consistency compared to non-LAD lesions ( p = 0.001), with distinct differences in FFR and RFR values between these groups ( p < 0.001). The presence of a LAD lesion emerged as an independent predictor of diagnostic inconsistency between positive RFR and negative FFR measurements ( p = 0.001). Conclusions : LAD involvement independently predicts diagnostic discrepancies between FFR and RFR in evaluating functional coronary artery stenosis in NSTE-ACS patients.","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular disease (CVD), a leading cause of death and disability worldwide, and is associated with a wide range of risk factors, and genetically associated conditions. While many CVDs are preventable and early detection alongside treatment can significantly mitigate complication risks, current prediction models for CVDs need enhancements for better accuracy. Mendelian randomization (MR) offers a novel approach for estimating the causal relationship between exposure and outcome by using genetic variation in quasi-experimental data. This method minimizes the impact of confounding variables by leveraging the random allocation of genes during gamete formation, thereby facilitating the integration of new predictors into risk prediction models to refine the accuracy of prediction. In this review, we delve into the theory behind MR, as well as the strengths, applications, and limitations behind this emerging technology. A particular focus will be placed on MR application to CVD, and integration into CVD prediction frameworks. We conclude by discussing the inclusion of various populations and by offering insights into potential areas for future research and refinement.
{"title":"The Application of Mendelian Randomization in Cardiovascular Disease Risk Prediction: Current Status and Future Prospects","authors":"Yishan Jin, Xing-Yuan Wu, Zhuo-Yu An","doi":"10.31083/j.rcm2507262","DOIUrl":"https://doi.org/10.31083/j.rcm2507262","url":null,"abstract":"Cardiovascular disease (CVD), a leading cause of death and disability worldwide, and is associated with a wide range of risk factors, and genetically associated conditions. While many CVDs are preventable and early detection alongside treatment can significantly mitigate complication risks, current prediction models for CVDs need enhancements for better accuracy. Mendelian randomization (MR) offers a novel approach for estimating the causal relationship between exposure and outcome by using genetic variation in quasi-experimental data. This method minimizes the impact of confounding variables by leveraging the random allocation of genes during gamete formation, thereby facilitating the integration of new predictors into risk prediction models to refine the accuracy of prediction. In this review, we delve into the theory behind MR, as well as the strengths, applications, and limitations behind this emerging technology. A particular focus will be placed on MR application to CVD, and integration into CVD prediction frameworks. We conclude by discussing the inclusion of various populations and by offering insights into potential areas for future research and refinement.","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan-Carlos Díaz-Polanco, Carlos Tejada-González, Amanda Leandro-Barros, Antonio Ruiz-Saavedra, Elvira García-de-Santiago, Joaquín Alonso-Martín, A. García-Lledó, M. Martínez-Sellés
Background : A circadian rhythm of myocardial infarction has been described but there is little data on its relation with seasons and months. Methods : From June 2013 to June 2018, we analyzed the alerts for acute ST-segment elevation myocardial infarction (STEMI) in a Spanish region with 6.64 million inhabitants, universal health coverage, and an organized STEMI reperfusion network. We selected those patients which an identifiable culprit plaque. Results : We recruited 6765 cases of STEMI due to type I acute myocardial infarction (type-I AMI), with mean age of 63.2 years (range 17–101, standard deviation [SD] 13.7), 5238 were males (77.4%) and 2801 (41.9%) were 65 years or older. The hourly distribution followed a fixed pattern in all months, with most of the events occurring between 6:00 AM and 4:00 PM, a peak at approximately 01:00 PM and a valley between 10:00 PM and 06:00 AM. No significant difference was found when comparing the mean time to first medical contact between July (the month with more daylight hours) and December (the month with shortest days). No significant differences were found between male and female patients, or between patients aged 65 years or older and younger patients. There was a close correlation between the number of events per month and the number of events occurring during the day (6 AM to 6 PM, r = 0.988, p = 0.001) and during the night (6 PM to 6 AM, r = 0.944, p < 0.001), with different slopes of the regression lines ( t -test, p < 0.001), so that the difference between day-night occurrences increased with the total incidence. Conclusions : There is a circadian pattern in the presentation of STEMI that is not influenced by sex and age. The different incidence of STEMI at different times of the year does not affect the circadian pattern in terms of the shape of the curve or the mean time of presentation, although diurnal events increase more than nocturnal events, suggesting that triggers are most likely to act during vulnerable periods as determined by a circadian-based rhythm.
{"title":"Seasonal Stability of the Circadian Rhythm in Patients with Type I Myocardial Infarction","authors":"Juan-Carlos Díaz-Polanco, Carlos Tejada-González, Amanda Leandro-Barros, Antonio Ruiz-Saavedra, Elvira García-de-Santiago, Joaquín Alonso-Martín, A. García-Lledó, M. Martínez-Sellés","doi":"10.31083/j.rcm2507259","DOIUrl":"https://doi.org/10.31083/j.rcm2507259","url":null,"abstract":"Background : A circadian rhythm of myocardial infarction has been described but there is little data on its relation with seasons and months. Methods : From June 2013 to June 2018, we analyzed the alerts for acute ST-segment elevation myocardial infarction (STEMI) in a Spanish region with 6.64 million inhabitants, universal health coverage, and an organized STEMI reperfusion network. We selected those patients which an identifiable culprit plaque. Results : We recruited 6765 cases of STEMI due to type I acute myocardial infarction (type-I AMI), with mean age of 63.2 years (range 17–101, standard deviation [SD] 13.7), 5238 were males (77.4%) and 2801 (41.9%) were 65 years or older. The hourly distribution followed a fixed pattern in all months, with most of the events occurring between 6:00 AM and 4:00 PM, a peak at approximately 01:00 PM and a valley between 10:00 PM and 06:00 AM. No significant difference was found when comparing the mean time to first medical contact between July (the month with more daylight hours) and December (the month with shortest days). No significant differences were found between male and female patients, or between patients aged 65 years or older and younger patients. There was a close correlation between the number of events per month and the number of events occurring during the day (6 AM to 6 PM, r = 0.988, p = 0.001) and during the night (6 PM to 6 AM, r = 0.944, p < 0.001), with different slopes of the regression lines ( t -test, p < 0.001), so that the difference between day-night occurrences increased with the total incidence. Conclusions : There is a circadian pattern in the presentation of STEMI that is not influenced by sex and age. The different incidence of STEMI at different times of the year does not affect the circadian pattern in terms of the shape of the curve or the mean time of presentation, although diurnal events increase more than nocturnal events, suggesting that triggers are most likely to act during vulnerable periods as determined by a circadian-based rhythm.","PeriodicalId":507771,"journal":{"name":"Reviews in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141662217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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