Back to Search
Start Over
Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2020 Jul 07; Vol. 9 (13), pp. e015579. Date of Electronic Publication: 2020 Jul 02. - Publication Year :
- 2020
-
Abstract
- Background Seasonal variations in acute coronary syndromes (ACS) have been reported, with incidence and mortality peaking in the winter. However, the underlying pathophysiology for these variations remain speculative. Methods and Results Patients with ACS who underwent optical coherence tomography were recruited from 6 countries. The prevalence of the 3 most common pathologies (plaque rupture, plaque erosion, and calcified plaque) were compared between the 4 seasons. In 1113 patients with ACS (885 male; mean age, 65.8±11.6 years), the rates of plaque rupture, plaque erosion, and calcified plaque were 50%, 39%, and 11% in spring; 44%, 43%, and 13% in summer; 49%, 39%, and 12% in autumn; and 57%, 30%, and 13% in winter ( P =0.039). After adjusting for age, sex, and other coronary risk factors, winter was significantly associated with increased risk of plaque rupture (odds ratio [OR], 1.652; 95% CI, 1.157-2.359; P =0.006) and decreased risk of plaque erosion (OR, 0.623; 95% CI, 0.429-0.905; P =0.013), compared with summer as a reference. Among patients with rupture, the prevalence of hypertension was significantly higher in winter ( P =0.010), whereas no significant difference was observed in the other 2 groups. Conclusions Seasonal variations in the incidence of ACS reflect differences in the underlying pathobiology. The proportion of plaque rupture is highest in winter, whereas that of plaque erosion is highest in summer. A different approach may be needed for the prevention and treatment of ACS depending on the season of its occurrence. Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT03479723.
- Subjects :
- Acute Coronary Syndrome diagnostic imaging
Aged
Coronary Artery Disease diagnostic imaging
Europe epidemiology
Female
Heart Disease Risk Factors
Humans
Incidence
Japan epidemiology
Male
Middle Aged
Plaque, Atherosclerotic
Prevalence
Registries
Rupture, Spontaneous
Time Factors
Tomography, Optical Coherence
United States epidemiology
Vascular Calcification diagnostic imaging
Acute Coronary Syndrome epidemiology
Coronary Artery Disease epidemiology
Seasons
Vascular Calcification epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 9
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 32611221
- Full Text :
- https://doi.org/10.1161/JAHA.119.015579