Abstract

ARROYO UCAR, E.; DOMINGUEZ-RODRIGUEZ, A.  and  ABREU-GONZALEZ, P.. Influence of diurnal variation in the size of acute myocardial infarction. Med. Intensiva [online]. 2012, vol.36, n.1, pp.11-14. ISSN 0210-5691.

Objective: To evaluate whether the size of acute myocardial infarction (AMI) shows circadian variability. Design: An observational, prospective study. Setting: A 12-bed coronary care unit. Patients: Consecutive patients diagnosed with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Interventions: The patients were divided into two groups according to the time of onset of AMI symptoms (Group A: 0-12hours, Group B: 12-24 hours). Main variables of interest: Age, sex, cardiovascular risk factors, coronary anatomy, left ventricular ejection fraction, infarct location, time from onset of symptoms to reperfusion, presence of heart failure upon admission, and peak troponin I value. Results: A total of 108 patients with a diagnosis of STEMI were included. Patients in group A showed a higher troponin I concentration compared to group B (troponin I: 70.85±16.38 versus 60.90±22.92ng / ml, p=0.003). In the multivariate analysis the onset of AMI between 0-12 hours was identified as an independent predictor of infarct size (OR: 1.133, 95%CI 1.012-1.267, p=0.01). Conclusions: An onset of AMI between 0-12 hours results in a significantly larger final size of necrosis compared with any other time of presentation.

Keywords : Acute myocardial infarction; Circadian rhythm; Infarct size.

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