Circulation, Vol 82, 897-902, Copyright © 1990 by American Heart Association
PM Ridker, JE Manson, JE Buring, JE Muller and CH Hennekens
Increased platelet aggregation in the morning and upon assuming an upright
posture may account at least in part for the observed circadian variation
in onset of acute myocardial infarction. The Physicians' Health Study, a
randomized, double-blind, placebo-controlled trial of alternate-day aspirin
intake (325 mg) among 22,071 US male physicians, afforded the opportunity
to assess this circadian pattern and examine whether it is altered by
aspirin therapy. During a 5-year period of follow-up, 342 cases of nonfatal
myocardial infarction were confirmed, of which the time of onset was
available in 211 (62%). The placebo group showed a bimodal circadian
variation in onset of myocardial infarction with a primary peak between
4:00 AM and 10:00 AM (p less than 0.001). In the aspirin group, however,
this circadian variation was minimal (p = 0.16), due primarily to a marked
reduction in the morning peak of infarction. Specifically, aspirin was
associated with a 59.3% reduction in the incidence of infarction during the
morning waking hours, compared with a 34.1% reduction for the remaining
hours of the day. The greater reduction was observed during the 3-hour
interval immediately after awakening, a period with a risk of infarction
twice that of any other comparable time interval (p less than 0.001).
Aspirin intake was associated with a mean reduction in the incidence of
infarction of 44.8% over the entire 24-hour cycle. These data support the
hypothesis that increased platelet aggregability in the morning and upon
arising contributes to the occurrence of myocardial infarction and that
aspirin reduces the risk of infarction by inhibiting platelet aggregation
during these critical periods.
ARTICLES
Circadian variation of acute myocardial infarction and the effect of low-dose aspirin in a randomized trial of physicians
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02146.
This article has been cited by other articles:
 |
|
 |
|
  M. Woollard, P. C Elwood, and G. Morgan Life saving early and immediate aspirin: too little too late Postgrad. Med. J., July 1, 2008; 84(993): 337 - 338. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Duez and B. Staels The nuclear receptors Rev-erbs and RORs integrate circadian rhythms and metabolism Diabetes and Vascular Disease Research, June 1, 2008; 5(2): 82 - 88. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Ch. Ivanov, K. Hu, M. F. Hilton, S. A. Shea, and H. E. Stanley Endogenous circadian rhythm in human motor activity uncoupled from circadian influences on cardiac dynamics PNAS, December 26, 2007; 104(52): 20702 - 20707. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. F. Reilly, E. J. Westgate, and G. A. FitzGerald Peripheral Circadian Clocks in the Vasculature Arterioscler Thromb Vasc Biol, August 1, 2007; 27(8): 1694 - 1705. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Amasyali, K. Aytemir, S. Kose, A. Kilic, G. Abali, A. Iyisoy, H. Kursaklioglu, M. Turan, N. Bingol, E. Isik, et al. Admission Plasma Leptin Level Strongly Correlates With the Success of Thrombolytic Therapy in Patients With Acute Myocardial Infarction Angiology, January 1, 2007; 57(6): 671 - 680. [Abstract] [PDF]
|
|
|
|
 |
|
 G. H. Tofler and J. E. Muller Triggering of Acute Cardiovascular Disease and Potential Preventive Strategies Circulation, October 24, 2006; 114(17): 1863 - 1872. [Full Text] [PDF]
|
|
|
|
 |
|
 H.-J. Priebe Perioperative myocardial infarction--aetiology and prevention Br. J. Anaesth., July 1, 2005; 95(1): 3 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Hu, P. Ch. Ivanov, M. F. Hilton, Z. Chen, R. T. Ayers, H. E. Stanley, and S. A. Shea Endogenous circadian rhythm in an index of cardiac vulnerability independent of changes in behavior PNAS, December 28, 2004; 101(52): 18223 - 18227. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-J. Priebe Triggers of perioperative myocardial ischaemia and infarction Br. J. Anaesth., July 1, 2004; 93(1): 9 - 20. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. A. Spencer and R. C. Becker Circadian variations in acute myocardial infarction: Patients or health care delivery? J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2143 - 2146. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Casetta, E. Granieri, E. Fallica, O. la Cecilia, E. Paolino, and R. Manfredini Patient Demographic and Clinical Features and Circadian Variation in Onset of Ischemic Stroke Arch Neurol, January 1, 2002; 59(1): 48 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R Witte, M. L Bots, A. W Hoes, and D. E Grobbee Cardiovascular mortality in Dutch men during 1996 European football championship: longitudinal population study BMJ, December 23, 2000; 321(7276): 1552 - 1554. [Abstract] [Full Text]
|
|
|
|
|
|
N. Aleksic, H. Juneja, A. R. Folsom, C. Ahn, E. Boerwinkle, L. E. Chambless, and K. K. Wu Platelet PlA2 Allele and Incidence of Coronary Heart Disease : Results From the Atherosclerosis Risk In Communities (ARIC) Study Circulation, October 17, 2000; 102(16): 1901 - 1905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Carson, C. M. O'Connor, A. B. Miller, S. Anderson, R. Belkin, G. W. Neuberg, J. H. Wertheimer, D. Frid, A. Cropp, and M. Packer Circadian rhythm and sudden death in heart failure: Results from prospective randomized amlodipine survival trial J. Am. Coll. Cardiol., August 1, 2000; 36(2): 541 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Passero, F. Reale, G. Ciacci, and E. Zei Differing Temporal Patterns of Onset in Subgroups of Patients With Intracerebral Hemorrhage Stroke, July 1, 2000; 31(7): 1538 - 1544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kawasaki, Y. Ozeki, T. Igawa, and J.-i. Kambayashi Increased Platelet Sensitivity to Collagen in Individuals Resistant to Low-Dose Aspirin Stroke, March 1, 2000; 31(3): 591 - 595. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E Goldhammer, L Kharash, and E G Abinader Circadian fluctuations in the efficacy of thrombolysis with streptokinase Postgrad. Med. J., November 1, 1999; 75(889): 667 - 671. [Abstract] [Full Text]
|
|
|
|
 |
|
 S. N Willich Circadian variation and triggering of cardiovascular events Vascular Medicine, February 1, 1999; 4(1): 41 - 49. [Abstract] [PDF]
|
|
|
|
|
|
J. D. Folts, A. I. Schafer, J. Loscalzo, J. T. Willerson, and J. E. Muller A perspective on the potential problems with aspirin as an antithrombotic agent: a comparison of studies in an animal model with clinical trials J. Am. Coll. Cardiol., February 1, 1999; 33(2): 295 - 303. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. J. Brown, M. A. Agirbasli, G. H. Williams, W. R. Litchfield, and D. E. Vaughan Effect of Activation and Inhibition of the Renin-Angiotensin System on Plasma PAI-1 Hypertension, December 1, 1998; 32(6): 965 - 971. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Peckova, C. E. Fahrenbruch, L. A. Cobb, and A. P. Hallstrom Circadian Variations in the Occurrence of Cardiac Arrests : Initial and Repeat Episodes Circulation, July 7, 1998; 98(1): 31 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Muller, P. G. Kaufmann, R. V. Luepker, M. L. Weisfeldt, P. C. Deedwania, and J. T. Willerson Mechanisms Precipitating Acute Cardiac Events : Review and Recommendations of an NHLBI Workshop Circulation, November 4, 1997; 96(9): 3233 - 3239. [Full Text]
|
|
|
|
 |
|
 A. G. Bostom, L. A. Cupples, J. L. Jenner, J. M. Ordovas, L. J. Seman, P. W. F. Wilson, E. J. Schaefer, and W. P. Castelli Elevated Plasma Lipoprotein(a) and Coronary Heart Disease in Men Aged 55 Years and Younger: A Prospective Study JAMA, August 21, 1996; 276(7): 544 - 548. [Abstract] [PDF]
|
|
|
|
 |
|
 E. J. Weiss, P. F. Bray, M. Tayback, S. P. Schulman, T. S. Kickler, L. C. Becker, J. L. Weiss, G. Gerstenblith, and P. J. Goldschmidt-Clermont A Polymorphism of a Platelet Glycoprotein Receptor as an Inherited Risk Factor for Coronary Thrombosis N. Engl. J. Med., April 25, 1996; 334(17): 1090 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Leor, W. K. Poole, and R. A. Kloner Sudden Cardiac Death Triggered by an Earthquake N. Engl. J. Med., February 15, 1996; 334(7): 413 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Q. Kong Jr, J. J. Goldberger, M. Parker, T. Wang, and A. H. Kadish Circadian Variation in Human Ventricular Refractoriness Circulation, September 15, 1995; 92(6): 1507 - 1516. [Abstract] [Full Text]
|
|
|
|
|
|
E. Falk, P. K. Shah, and V. Fuster Coronary Plaque Disruption Circulation, August 1, 1995; 92(3): 657 - 671. [Full Text]
|
|
|
|
 |
|
 N. F. Col, J. Yarzebski, J. M. Gore, J. S. Alpert, and R. J. Goldberg Does Aspirin Consumption Affect the Presentation or Severity of Acute Myocardial Infarction? Arch Intern Med, July 10, 1995; 155(13): 1386 - 1389. [Abstract] [PDF]
|
|
|
|
|
|
P. B. Kurnik Circadian Variation in the Efficacy of Tissue-Type Plasminogen Activator Circulation, March 1, 1995; 91(5): 1341 - 1346. [Abstract] [Full Text]
|
|
|
|
|
|
E. Braunwald Morning Resistance to Thrombolytic Therapy Circulation, March 1, 1995; 91(5): 1604 - 1606. [Full Text]
|
|
|
|
|
|
S. N. Willich, M. Lewis, H. Lowel, H.-R. Arntz, F. Schubert, R. Schroder, and The Triggers and Mechanisms of Myocardial Infarcti Physical Exertion as a Trigger of Acute Myocardial Infarction N. Engl. J. Med., December 2, 1993; 329(23): 1684 - 1690. [Abstract] [Full Text]
|
|
|
|
|
|
J. E. Muller and G. H. Tofler Morning vs Afternoon Exertion: Both Are Safe, but Which Is Safer? Arch Intern Med, April 12, 1993; 153(7): 803 - 804. [Abstract] [PDF]
|
|
|
|
|
|
P. M. Murray, D. M. Herrington, C. W. Pettus, H. S. Miller, J. D. Cantwell, and W. C. Little Should Patients With Heart Disease Exercise in the Morning or Afternoon? Arch Intern Med, April 12, 1993; 153(7): 833 - 836. [Abstract] [PDF]
|
|
|
|
|
|
D. D. Buff, J. M. Fleisher, J. A. Roca, M. Jaffri, and P. M. Wyrwinski Circadian Distribution of In-Hospital Cardiopulmonary Arrests on the General Medical Ward Arch Intern Med, June 1, 1992; 152(6): 1282 - 1288. [Abstract] [PDF]
|
|
|
|
 |
|
 P. M. Ridker, J. E. Manson, J. M. Gaziano, J. E. Buring, and C. H. Hennekens Low-Dose Aspirin Therapy for Chronic Stable Angina: A Randomized, Placebo-Controlled Clinical Trial Ann Intern Med, May 15, 1991; 114(10): 835 - 839. [Abstract] [PDF]
|
|