Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-07-10

AUTHORS

Makoto Araki, Taishi Yonetsu, Osamu Kurihara, Akihiro Nakajima, Hang Lee, Tsunenari Soeda, Yoshiyasu Minami, Takumi Higuma, Shigeki Kimura, Masamichi Takano, Bryan P. Yan, Tom Adriaenssens, Niklas F. Boeder, Holger M. Nef, Chong Jin Kim, Filippo Crea, Tsunekazu Kakuta, Ik-Kyung Jang

ABSTRACT

Previous studies have reported a circadian variation in the onset of ST-segment elevation myocardial infarction (STEMI). However, underlying mechanisms for the circadian variation have not been fully elucidated. We investigated the relationship between onset of STEMI and the underlying pathology using optical coherence tomography (OCT). Patients with a diagnosis of STEMI were selected from a multicenter OCT registry. Patients were divided into 4 groups based on the estimated time of onset (00:00–05:59, 06:00–11:59, 12:00–17:59, or 18:00–23:59). Underlying pathologies of MI (plaque rupture, plaque erosion, and calcified plaque) were compared among the 4 groups. Among 648 patients, plaque rupture was diagnosed in 386 patients (59.6%), plaque erosion in 197 patients (30.4%), and calcified plaque in 65 patients (10.0%). A marked circadian variation was detected in the incidence of plaque rupture with a peak at 09:00, whereas it was not evident in plaque erosion or calcified plaque. The probability of plaque rupture significantly increased in the periods of 06:00–11:59 [odds ratio (OR) 2.13, 95% confidence interval (CI) 1.30–3.49, p = 0.002] and 12:00–17:59 (OR 2.10, 95% CI 1.23–3.58, p = 0.005), compared to the period of 00:00–05:59. This circadian pattern was observed only during weekdays (p = 0.010) and it was not evident during the weekend (p = 0.742). Plaque rupture occurred most frequently in the morning and this circadian variation was evident only during weekdays. Acute MI caused by plaque rupture may be related to catecholamine surge. More... »

PAGES

379-387

Journal

TITLE

Journal of Thrombosis and Thrombolysis

ISSUE

2

VOLUME

51

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11239-020-02220-6

DOI

http://dx.doi.org/10.1007/s11239-020-02220-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1129146431

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32651890


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17 schema:description Previous studies have reported a circadian variation in the onset of ST-segment elevation myocardial infarction (STEMI). However, underlying mechanisms for the circadian variation have not been fully elucidated. We investigated the relationship between onset of STEMI and the underlying pathology using optical coherence tomography (OCT). Patients with a diagnosis of STEMI were selected from a multicenter OCT registry. Patients were divided into 4 groups based on the estimated time of onset (00:00–05:59, 06:00–11:59, 12:00–17:59, or 18:00–23:59). Underlying pathologies of MI (plaque rupture, plaque erosion, and calcified plaque) were compared among the 4 groups. Among 648 patients, plaque rupture was diagnosed in 386 patients (59.6%), plaque erosion in 197 patients (30.4%), and calcified plaque in 65 patients (10.0%). A marked circadian variation was detected in the incidence of plaque rupture with a peak at 09:00, whereas it was not evident in plaque erosion or calcified plaque. The probability of plaque rupture significantly increased in the periods of 06:00–11:59 [odds ratio (OR) 2.13, 95% confidence interval (CI) 1.30–3.49, p = 0.002] and 12:00–17:59 (OR 2.10, 95% CI 1.23–3.58, p = 0.005), compared to the period of 00:00–05:59. This circadian pattern was observed only during weekdays (p = 0.010) and it was not evident during the weekend (p = 0.742). Plaque rupture occurred most frequently in the morning and this circadian variation was evident only during weekdays. Acute MI caused by plaque rupture may be related to catecholamine surge.
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24 ST-segment elevation myocardial infarction
25 acute MI
26 catecholamine surge
27 circadian pattern
28 circadian variation
29 coherence tomography
30 diagnosis
31 diagnosis of STEMI
32 elevation myocardial infarction
33 erosion
34 group
35 incidence
36 infarction
37 marked circadian variation
38 mechanism
39 morning
40 myocardial infarction
41 onset
42 onset of STEMI
43 optical coherence tomography
44 optical coherence tomography study
45 pathogenesis
46 pathology
47 patients
48 patterns
49 peak
50 period
51 plaque erosion
52 plaque rupture
53 plaques
54 previous studies
55 probability
56 registry
57 relationship
58 rupture
59 study
60 surge
61 time
62 time of onset
63 tomography
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