Periodic Variation and Its Effect on Management and Prognosis of Korean Patients With Acute Myocardial Infarction

Title
Periodic Variation and Its Effect on Management and Prognosis of Korean Patients With Acute Myocardial Infarction
Author(s)
김영조박효은[박효은]구본권[구본권]이원재[이원재]조영진[조영진]박진식[박진식]최지영[최지영]정명호[정명호]김종현[김종현]채성철[채성철]남창욱[남창욱]이재환[이재환]최동훈[최동훈]홍택종[홍택종]채재근[채재근]류재영[류재영]
Keywords
PERCUTANEOUS CORONARY INTERVENTION; TO-BALLOON TIME; CIRCADIAN VARIATION; SEASONAL-VARIATIONS; ENVIRONMENTAL-TEMPERATURE; AUTONOMIC NEUROPATHY; PRIMARY ANGIOPLASTY; NATIONAL REGISTRY; MORTALITY; ONSET
Issue Date
201001
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.74, no.5, pp.970 - 976
Abstract
Background: The characteristics of the periodic variation in acute myocardial infarction (AMI) and the subsequent 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. (Circ J 2010; 74: 970-976)
URI
http://hdl.handle.net/YU.REPOSITORY/23028http://dx.doi.org/10.1253/circj.CJ-09-0344
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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