Abstract 9810: Relationship Between Time of Day and Periprocedural Myocardial Infarction After Elective Angioplasty
Introduction: Recent studies have suggested an influence of circadian rhythms on myocardial infarction size and mortality among patients with ST-elevation myocardial infarction. The aim of the study is to investigate whether periprocedural myocardial infarction (PMI) is influenced by the time of day in elective patients undergoing percutaneous coronary intervention (PCI).
Hypothesis: The time of day influences the occurrence of type 4A myocardial infarction in elective patients undergoing PCI.
Methods: All consecutive patients undergoing elective PCI between 2007 and 2011 at our institutions with known post-interventional troponin were retrospectively included.Patients (n=1,021) were divided into 2 groups according to the starting time of the PCI: the morning group (n=651) between 07:00 and 11:59, and the afternoon group (n=370) between 12:00 and 18:59. Baseline and procedural characteristics as well as clinical outcome defined as the occurrence of PMI were compared between groups. In order to limit selection bias, all analyses were equally performed in 308 pairs using propensity score matching.
Results: In the overall population, the rate of PMI was statistically lower in the morning group compared to the afternoon group (20% vs. 30%, p<0.001). This difference remained statistically significant after PS-matching (21% vs. 29%, p=0.03). Multivariate analysis shows that being treated in the afternoon independently increases the risk for PMI with an odds ratio of 2.0 (95%CI: 1.1-3.4; p=0.02).
Conclusions: This observational propensity score-matched study suggests that the timing of an elective PCI influences the rate of periprocedural myocardial infarction.
- © 2013 by American Heart Association, Inc.