title: [Circadian variation in the incidence of myocardial infarction. New perceptions about the mechanisms of acute coronary disease].
abstract: The time of acute myocardial infarction (MI) was determined from the onset of symptoms and an analysis made of the time-activity course of the plasma CK-MB isoenzyme in 1741 patients of the prospective multicentre ISAM study (much greater than Intravenous Streptokinase in Acute Myocardial Infarction much less than). The occurrence of MI had a circadian variation with a marked peak between 6 a.m. and 12 noon compared with other periods during the day (P less than 0.001). Between 8 and 9 a.m., the period of highest incidence, the number of MIs was about four times higher than between midnight and 1 am (the period of lowest incidence). There was a good correlation between the clinical and enzymatic criteria for onset of MI (r = 0.95; P less than 0.001). A similar circadian pattern was obtained independent of site of MI, age and sex of patients, as well as severity and extent of the coronary heart disease. The temporal relationship between increased incidence of acute coronary heart disease (MI, sudden cardiac death, symptomatic or silent myocardial ischaemia) in the morning and a rise in platelet aggregation in the morning may point to a causal relationship.
authors.affiliation: Abteilung für Kardiologie Pulmologie, Klinikum Steglitz, Freie Universität Berlin.
authors.forename: S N
authors.initials: SN
authors.lastname: Willich
authors.forename: T
authors.initials: T
authors.lastname: Linderer
authors.forename: K
authors.initials: K
authors.lastname: Wegscheider
authors.forename: R
authors.initials: R
authors.lastname: Schröder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002940:Circadian Rhythm; D004796:Clinical Enzyme Tests; D015331:Cohort Studies; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D010974:Platelet Aggregation; D011446:Prospective Studies
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase
vernacular_title: Zirkadiane Variation in der Inzidenz des Myokardinfarkts. Neue Erkenntnisse über die Mechanismen der akuten koronaren Herzkrankheit.