Is there any effect of chronobiological changes on coronary angioplasty?
OBJECTIVE
We hypothesized that If there is a chronobiologic variation in the development of acute ischaemic events which is mainly attributed to the tendency for thrombus formation in the morning hours, same time dependent variations must also be seen in the development of ischaemic events after percutaneous transluminal coronary angioplasty (PTCA) and PTCA with stent implantation.


METHODS
Enrolled in this study were 349 consecutive patients with single vessel disease and undergoing elective single vessel angioplasty. Patients had been observed for the development of immediate postprocedural ischaemic events. Working hours of our laboratory were divided into 2-hourly intervals in order to define the ending time of procedure. Analysis of acute complications was carried out according to the ending time of procedure.


RESULTS
There was no difference with regard to clinical presentation, but patients who had complications had higher blood cholesterol level (P < 0.05). Patients with stent implantation had more adverse events than the PTCA group, but this difference did not reach the statistical significance (P = 0.07). The time interval between 10:30 a.m.-12:30 p.m. was found to be an independent risk factor for the negative outcomes (P = 0.043, Relative Risk 4838).


CONCLUSIONS
The results of our study have demonstrated that postprocedural complications after angioplasty is related to the procedure time These patients may be observed more closely for the development of immediate postprocedural ischaemic events.
Department of Cardiology, Numune Education and Research Hospital, and Ankara-Turkey. temizhan@usa.net
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Temizhan
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Dinçer
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Pamir
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Alpman
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Oral
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D012306:Risk; D015607:Stents