Relationship between off-hour onset and infarct size of young patients with acute myocardial infarction

Abstract

Abstract: Objective To determine the impact of time of symptom onset during off-hour on infarct size in young patients（≤45 years old） with ST-segment elevation myocardial infarction（STEMI）. Methods A total of 217 young patients with STEMI who admitted in Tianjin Chest Hospital from January 2015 to December 2019 were continuously included. The on-hour group included patient with symptom onset time between 08：00-16：59 on weekdays,the rest were catalogued as off-hour group. The patients were further divided into four groups based on 6-hour intervals（00：00-05：59,06：00-11：59,12：00-17：59 and 18：00-23：59）. The non-linear regression model was used to assess the dependence of infarct size（peak creatine kinase,peak CK） on 24-hour time of symptom onset. The multivariate linear regression model was used to analyze the association between time of symptom onset and infarct size. Results The ejection fraction of the patients in off-hour group was lower than that in on-hour group,and the peak CK was higher than that in on-hour group（P<0.05）. The median peak CK of the 00：00-05：59 onset group tended to be higher than those of other groups. The periodic sinusoidal regression analysis showed circadian rhythm in infarct size with 24-hour onset time,and the maximum infarct size occurred at 2：00 am. The multivariate linear regression model showed that after adjusting for confounders,there was an average increase in peak CK of 708.07 U/L in patients with off-hour onset compared with patients with on-hour onset,while there was an average increase in peak CK of 864.08 U/L in patients with onset time between 00：00 and 05：59 compared with patients with onset time between 06：00 and 23：59. Conclusion This study reports that the myocardial infarct size after STEMI have a circadian dependence on time of symptom onset in Chinese young patients,and the young patientswith STEMI onset during off-hour and 00：00-05：59 may have a greater myocardial injury.

Key words: Young people, Acute myocardial infarction, Off-hour, Time of symptom onset, Infarction size

CLC Number:

R181.3

MA Jing, CUI Yan, ZOU Zhonghe, XIAO Jianyong, LIU Yin, GAO Jing. Relationship between off-hour onset and infarct size of young patients with acute myocardial infarction. [J]OCCUPATION AND HEALTH, 2023, 39(21): 2911-2916.

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