Background Generally AMI occur less in summer and more frequently in 06-12 am. But there is few data about this circadian and seasonal pattern of AMI in Korea.
Method We reviewed our coronary database of 245 AMI patients (206 STEMI, 39 NSTEMI)who admitted our hospital from 2005~2007. Chest pain onset was plotted hourly and seasonally. Clinical variables and in-hospital and 6 Mo MACE were evaluated.
Results STEMI occur 2 peaks manner in 9:00~12:59 (A group; 26.8%) and 19:00~19:59 (6.9%) and less frequently in fall (20.4%) season (Fig.) Between A and other time, male sex (79.6 vs 71.7%), age (59짹12 vs 61짹13yrs), BMI (23.7짹5.1 vs 24.0짹3.2), metabolic syndrome (40.4 vs 44.4%), SxtoDoor time (340.7짹412 vs 386짹609min.), Killip Class were similar (p>0.05). But, A group showed more severe lesion (3VD+left main disease, 55.6vs34.9%,p=0.012), totally occluded vessel (84.3 vs 67.4%,p=0.049), culprit of RCA (55.6 vs 34.2%,p=0.01), in-hospital/6 Mo MACE were comparable in 2 groups. In the fall, previously mentioned variables were comparable except Sxtodoor time was prolonged (696짹1069 vs 320짹464min,p=0.03), higher Cr (1.35짹0.7 vs 1.10짹0.3mg/dL,p=0.04) and uric acid (5.9짹2.2 vs 4.8짹1.6mg/dL,p=0.001).
Conclusion Different to previous data, STEMI occurrence showed 2 peaks on a day and low incidence in fall. STEMI on peak time showed more severe coronary disease, total and RCA occlusion. Analysis of National registry of AMI will be necessary to improve treatment strategy.