Rymer Jennifer A, Li Shuang, Chiswell Karen, Kansal Aman, Nanna Michael G, Gutierrez Jorge Antonio, Feldman Dmitriy N, Rao Sunil V, Swaminathan Rajesh V
Division of Cardiology, Duke University Hospital, Durham, North Carolina.
Duke Clinical Research Institute, Durham, North Carolina.
JAMA Netw Open. 2025 Sep 2;8(9):e2530442. doi: 10.1001/jamanetworkopen.2025.30442.
Previous data suggest that the time changes associated with daylight savings time (DST) may be associated with an increased incidence of acute myocardial infarction (AMI).
To determine whether the incidence of patients presenting with AMI is greater during the weeks during or after DST and compare the in-hospital clinical events between the week before DST and after DST.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study examined patients enrolled in the Chest Pain MI Registry from 2013 to 2022. The study included patients who presented 1 week before DST, during the week of DST, or 1 week after DST (spring or fall) and assessed incidence of AMI, in-hospital mortality, stroke, and clinical outcomes during those times and compared the DST weeks with the week before or after. Data were analyzed from March 2024 to May 2025.
The main outcome was in-hospital mortality rate. The incidence ratio (IR) of AMI cases was calculated using the observed number of patients with AMI in the DST week divided by the number of patients with AMI who arrived 1 week before or after DST.
The final cohort included 168 870 patients (median [IQR] age, 65 [56-75] years, 57 023 females [33.8%]; 111 847 males [66.2%]) at 1124 hospitals during the study period. There were 28 678 patients (17.0%) with AMI treated during spring DST, 28 596 (16.9%) the week before, and 28 169 (16.7%) the week after. There were 27 942 patients (16.5%) with AMI treated during fall DST, 27 365 (16.2%) the week before, and 28 120 (16.7%) the week after. Patient characteristics were similar for the spring and fall DST analyses (spring and fall DST median [IQR] age across groups: 65 [56-74] years and 65 [56-75] years, respectively), and there were 28 725 females (33.6%) in the spring and 28 298 females (33.9%) in the fall. There was no significant difference in the incidence of AMI for the following time periods: spring DST week vs 1 week prior, spring DST week vs 1 week after, fall DST week vs 1 week prior, and fall DST week vs 1 week after. There were no significant differences in adjusted in-hospital outcomes for the 1 week before or after fall or spring DST.
This study found no significant difference in the incidence rates of AMI in DST weeks compared with the week before or after. Additionally, there were no differences in in-hospital clinical outcomes.
先前的数据表明,与夏令时(DST)相关的时间变化可能与急性心肌梗死(AMI)发病率增加有关。
确定在夏令时期间或之后的几周内,出现急性心肌梗死的患者发病率是否更高,并比较夏令时前一周和夏令时后一周的院内临床事件。
设计、设置和参与者:这项横断面研究对2013年至2022年纳入胸痛心肌梗死登记处的患者进行了检查。该研究纳入了在夏令时前1周、夏令时当周或夏令时后1周(春季或秋季)就诊的患者,并评估了这些时间段内急性心肌梗死的发病率、院内死亡率、中风及临床结局,并将夏令时周与之前或之后的一周进行比较。数据于2024年3月至2025年5月进行分析。
主要结局是院内死亡率。急性心肌梗死病例的发病率比值(IR)通过将夏令时周观察到的急性心肌梗死患者数量除以夏令时前或后1周到达的急性心肌梗死患者数量来计算。
在研究期间,最终队列包括1124家医院的168870名患者(年龄中位数[四分位间距]为65[56 - 75]岁,女性57023名[33.8%];男性111847名[66.2%])。春季夏令时期间有28678名(17.0%)急性心肌梗死患者接受治疗,前一周有28596名(16.9%),后一周有28169名(16.7%)。秋季夏令时期间有27942名(16.5%)急性心肌梗死患者接受治疗,前一周有27365名(16.2%),后一周有28120名(16.7%)。春季和秋季夏令时分析的患者特征相似(各组春季和秋季夏令时年龄中位数[四分位间距]分别为65[56 - 74]岁和65[56 - 75]岁),春季有28725名女性(33.6%),秋季有28298名女性(33.9%)。在以下时间段内,急性心肌梗死的发病率没有显著差异:春季夏令时周与前1周、春季夏令时周与后1周、秋季夏令时周与前1周、秋季夏令时周与后1周。秋季或春季夏令时前或后的1周内,调整后的院内结局没有显著差异。
本研究发现,与夏令时前或后的一周相比,夏令时周的急性心肌梗死发病率没有显著差异。此外,院内临床结局也没有差异。