Daylight saving time transitions and acute myocardial infarction

Abstract

Most recently, the possible impact of transitions to and from daylight saving time (DST) on the increased incidence of acute myocardial infarction (AMI) has been suggested. The goal of this report was to analyze independent influence of DST transitions on the incidence of AMI with simultaneous control for the confounding presence of situational triggers such as physical exertion, emotional stress, heavy meals, and sexual intercourse, as well as for other clinical factors. Detailed information was obtained from 2412 patients and included baseline characteristics, working status, exact time of AMI, possible external triggers, cardiovascular risk factors, and prehospital medication. AMI incidence on days after the DST was compared with incidence during control periods and patient characteristics, cardiovascular medication, and circumstances of AMI were evaluated to identify potential risk modifiers. Relative risks of AMI and differences in patient characteristics were expressed through incidence ratios and odds ratios, respectively, with 95% confidence intervals (CIs). Multivariate analysis was performed by using a stepwise multiple regression to assess the independent predictive significance of the characteristics of patients for the AMI occurring in the posttransitional period. The incidence ratio for AMI for the first four workdays after the spring DST transition was 1.29 (95% CI: 1.09-1.49) and the excess was particularly prominent on Monday. In autumn, the incidence ratio for AMI for this 4-d period was 1.44 (95% CI: 1.19-1.69), with peaks on Tuesday and Thursday. The independent predictors for AMI during this period in spring were male sex (p = 0.03) and nonengagement in physical activity (p = 0.02) and there was a trend for the lower risk of incident among those taking calcium antagonists (p = 0.07). In autumn, the predictors were female sex (p = 0.04), current employment (p = 0.006), not taking β-blocker (p = 0.03), and nonengagement in physical activity (p = 0.02). The present report supports the possibility that DST transitions represent additional chronobiological feature of AMI, and that risk of an onset varies according to sex, employment status, and the taking of cardiovascular medication.

Are daylight saving time transitions associated with changes in myocardial infarction incidence? Results from the German MONICA/KORA Myocardial Infarction Registry

“…In contrast to Janszky et al [ 6 , 7 ] but in line with Culic [ 8 ] we found men to be more prone to the spring shift. This may be explained by the fact that men are more likely to be later chronotypes than women also in later adulthood [ 21 , 23 ].…”

“…A recent study from Croatia on 2,412 hospitalized AMI survivors confirmed the significant increase of AMI incidence for the first 4 workdays after spring transition with a particular excess on Monday [ 8 ]. In contrast to the Swedish results, the authors reported a significant increase after the autumn transition for the first four workdays with a peak on Tuesday and Thursday.…”

Daylight Saving Time and Acute Myocardial Infarction: A Meta-Analysis

“…Among the 2633 retrieved papers, we identified seven studies (including >115,000 subjects) that met the selection criteria and were included in the analyses [17,18,19,20,21,22,23] (Figure 1). All were cohort studies, which retrospectively analysed data from national- or county-level disease registries [17,19,23], health insurance databases [21] or hospital discharge abstracts [18,20,22] (Table 1).…”

“…Among the 2633 retrieved papers, we identified seven studies (including >115,000 subjects) that met the selection criteria and were included in the analyses [17,18,19,20,21,22,23] (Figure 1). All were cohort studies, which retrospectively analysed data from national- or county-level disease registries [17,19,23], health insurance databases [21] or hospital discharge abstracts [18,20,22] (Table 1). All studies were published from 2008 onwards (five after 2012 [17,18,20,21,22]); five were based in a European country (Sweden, Finland, Germany and Croatia) [17,18,19,20,23] and two in USA [21,22].…”

Transition into and out of daylight saving time and spontaneous delivery: a population-based study

“…Nevertheless, other studies, the majority investigating risk of injuries or accidents following DST transitions, found no effects 23 28 31–33 or no difference in effects between shifts. 21 25 34 …”