Periodic Variation and Its Effect on Management and Prognosis of Korean Patients With Acute Myocardial Infarction
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概要
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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 patients and the medical facilitys 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.
著者
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Park Hyo
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National Univers
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Koo Bon-Kwon
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National Univers
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Lee Wonjae
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National Univers
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Cho Youngjin
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National Univers
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Park Jin
Department of Internal Medicine, Sejong General Hospital
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Choi Ji-Yong
Division of Cardiology, Department of Internal Medicine, College of Medicine, Daegu Catholic Univers
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Jeong Myung-Ho
Division of Cardiology, Department of Internal Medicine, College of Medicine, Chonnam National Unive
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Kim Jong
Busan Hanseo Hospital
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Chae Shung
Division of Cardiology, Kyungpook National University Hospital
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Kim Young
Division of Cardiology, Yeungnam University Medical Center
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Nam Chang-Wook
Division of Cardiology, Keimyung University Dongsan Medical Center
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Lee Jae-Hwan
Division of Cardiology, Chungnam National University Hospital
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Choi Dong
Division of Cardiology, Yonsei University Severans Hospital
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Hong Taek
Division of Cardiology, Pusan National University Hospital
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Chae Jei
Division of Cardiology, Chonbuk National University Hospital
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Rhew Jae
Jeonju Presbyterian Medical Center
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Kim Kee
Division of Cardiology, Department of Internal Medicine, College of Medicine, Daegu Catholic Univers
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Kim Hyo-Soo
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National Univers
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Oh Byung-Hee
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National Univers
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Park Young
Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National Univers
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