%0 Journal Article
%T Circadian Rhythm and ST
%A Abduljabar G. Alghamdi
%A Alawi A. Alsheikh-Ali
%A Amar M. Salam
%A Anhar Ullah
%A Fahad A. Al Subaie
%A Hanan B. Albackr
%A Hussam Alfaleh
%A Jassim Al Suwaidi
%A Khalid F. AlHabib
%A Mostafa Q. AlShamiri
%A Tarek Kashour
%A Wael Almahmeed
%J Angiology
%@ 1940-1574
%D 2019
%R 10.1177/0003319718797470
%X Circadian rhythms have been identified in multiple physiological processes that may affect cardiovascular diseases, yet little is known about the impact of circadian rhythm on acute ST-segment elevation myocardial infarction (STEMI) onset and outcomes in the Middle East. The relationship between time of symptom onset during the 24-hour circadian cycle and prehospital delays and in-hospital death was assessed in 2909 patients with STEMI presenting in 6 Arabian Gulf countries. A sinusoidal smoothing function was used to show the average circadian trends. There was a significant association between time of symptom onset and the circadian cycle. The STEMIs were more frequent during the late morning and early afternoon hours (P < .001). Patients with pain onset from 0.00 to 5:59 had median prehospital delays of 150 minutes versus 90 minutes from 6:00 to 11:59 and 12:00 to 17:59, respectively (P < .001). Although there was no significant difference in mortality between the 4 groups (P = .230), there was a significant association between time of symptom onset as sinusoidal function and in-hospital mortality (P = .032). Patients with STEMI in the Middle East have significant circadian patterns in symptoms onset, prehospital delay, and timeliness of reperfusion. A circadian rhythm of in-hospital mortality was found over the 24-hour clock of symptom onset time
%K myocardial infarction
%K circadian rhythm
%K Arabian gulf
%K reperfusion
%U https://journals.sagepub.com/doi/full/10.1177/0003319718797470