Ku C S, Yang C Y, Lee W J, Chiang H T, Liu C P, Lin S L
Department of Internal Medicine, 802 Army General Hospital, Kaohsiung City, Taiwan, ROC.
Cardiology. 1998 May;89(4):277-82. doi: 10.1159/000006800.
To evaluate whether the incidence of acute myocardial infarction (AMI) attack would have circadian, weekly and monthly variations in a subtropical area, 540 consecutive patients with AMI who were admitted to our coronary care units were analyzed. Six-hour intervals over 24 h, daily intervals in a week (7 days) and monthly intervals in a year (12 months) were studied, respectively. Results showed that there was a circadian variation in the onset of AMI with a morning (6 a.m. to noon) peak (34%, p < 0.01) but no secondary late evening (18-24 p.m.) peak. The incidence of AMI was significantly lower on Sundays (9%) than on the other weekdays (Monday through Saturday; p < 0.05). However, no monthly and seasonal variations in the incidence of AMI (no winter or summer peaks) were observed in this series. This study demonstrated a circadian variation in the onset of AMI attack with a predominant morning peak. The fewer AMI cases on Sundays compared to the other weekdays suggested that freedom from 'stress' or 'work-load' on Sundays might have an important impact on this low incidence of AMI. Unlike the large ranges in cold or hot weather found in temperate regions, the warm climate of a subtropical region does not affect the frequency of AMI.
为评估亚热带地区急性心肌梗死（AMI）发作的发生率是否存在昼夜、每周和每月的变化，我们分析了连续入住我院冠心病监护病房的540例AMI患者。分别研究了24小时内每6小时的间隔、一周内每天的间隔（7天）以及一年内每月的间隔（12个月）。结果显示，AMI发作存在昼夜变化，上午（上午6点至中午）达到高峰（34%，p<0.01），但没有傍晚晚期（下午6点至午夜）的第二个高峰。AMI的发生率在周日（9%）显著低于其他工作日（周一至周六；p<0.05）。然而，在本系列研究中未观察到AMI发生率的每月和季节性变化（没有冬季或夏季高峰）。本研究表明，AMI发作存在昼夜变化，以上午高峰为主。与其他工作日相比，周日的AMI病例较少，这表明周日摆脱“压力”或“工作量”可能对AMI的低发生率有重要影响。与温带地区寒冷或炎热天气的大幅变化不同，亚热带地区的温暖气候不会影响AMI的发生频率。
