Periodic variation and its effect on management and prognosis of Korean patients with acute myocardial infarction

Hyo Eun Park, Bon Kwon Koo, Wonjae Lee, Youngjin Cho, Jin Sik Park, Ji Yong Choi, Myung Ho Jeong, Jong Hyun Kim, Shung Chull Chae, Young Jo Kim, Chang Wook Nam, Jae Hwan Lee, Dong Hoon Choi, Taek Jong Hong, Jei Keon Chae, Jae Young Rhew, Kee Sik Kim, Hyo Soo Kim, Byung Hee Oh, Young Bae Park

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Abstract

Background: The characteristics of the periodic variation in acute myocardial infarction (AMI) and the sub-sequent effect on management and prognosis have not been fully investigated in a large number of Asian populations. Methods and Results: From a prospective, observational multicenter online registry, 4,573 patients diagnosed as AMI in Korea from January to December 2006 were included. The highest incidence of AMI was between 8 a.m. and noon. The number of cases was highest in the winter and lowest in the autumn (13.6 vs 11.4 patients per day, P<0.001). Patients with symptom onset during working hours had a shorter time to first medical contact (203±288 min) compared with out-of-hours onset (230±288 min, P=0.003). In patients who underwent primary angioplasty, out-of hours symptom onset was associated with a greater time delay in both the patient's and the medical facility's response (door-to-balloon time out-of hours vs working hours: 101±54 min vs 84±44 min, P<0.001). In patients with ST-segment elevation myocardial infarction, symptoms to first medical contact showed a significant relationship to in-hospital mortality (for every 10 min of symptoms to first medical contact, odds ratio 1.006, 95% confidence interval 1.001-1.012, P=0.018) Conclusions: Circadian and periodic variation in AMI exists in Korean patients, which resulted in different patient behavior, hospital management and outcomes.

Original languageEnglish
Pages (from-to)970-976
Number of pages7
JournalCirculation Journal
Volume74
Issue number5
DOIs
Publication statusPublished - 2010

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Park, H. E., Koo, B. K., Lee, W., Cho, Y., Park, J. S., Choi, J. Y., Jeong, M. H., Kim, J. H., Chae, S. C., Kim, Y. J., Nam, C. W., Lee, J. H., Choi, D. H., Hong, T. J., Chae, J. K., Rhew, J. Y., Kim, K. S., Kim, H. S., Oh, B. H., & Park, Y. B. (2010). Periodic variation and its effect on management and prognosis of Korean patients with acute myocardial infarction. Circulation Journal, 74(5), 970-976. https://doi.org/10.1253/circj.CJ-09-0344