CIRCADIAN VARIATION IN ACUTE CORONARY SYNDROMES AMONG PATIENTS PRESENTING IN A TERTIARY CARE HOSPITAL IN LAHORE

Abstract

Abstract

Background:  One of the most important cause of death is Acute Coronary Syndrome (ACS) throughout the world. Its incidence is also increasing in Pakistan. The phenomenon of circadian rhythm is well known among the patients presenting with ACS. This study has been designed to find out the occurrence of this phenomenon in local population. Most of the ACS patients present in early morning hours making management a challenging task at that period of time if no proper logistics are available. The rationale of this study is to emphasize the importance of logistical preparation for management of ACS patients in light of presentation at off hours due to circadian variations.

Objective:  To determine the frequency of patients with ACS who fall in various categories of timings of day.

Methodology:  300 subjects those fulfilling the inclus-ion and exclusion criteria were studied at the department of Cardiology, Jinnah Hospital Lahore, after obtaining the informed consent, data was collected through the proposed performa by researcher himself. We divided the patients into three groups who presented in 24 hours based on the timing of most recent worst symptoms onset that made the patient come to emergency department i.e., 12 am – 08 am, 08 am – 04 pm and 04 pm – 12 am. Data was entered and analyzed in SPSS ver: 17.0. Frequency tablulation and percentages were calculated for circadian rhythm.

Results:  When mean age of the patients was calcula-ted it was 54.66 ± 12.45 years that included 30.33% females and 69.67% male patients. Most of the pati-ents 44% (n = 132) were in the time interval group of 12 am – 08 am. There were 25% (n = 75) of patients in the time interval group of 08 am – 04 pm, and 31%(n = 93) patients were presented in the time interval group of 04 pm – 12 am.

Conclusions:  This study has shown that circadian variation in Acute Coronary Syndrome also exists in our local population, as most of the patients presented in the time interval of 12 am – 08 am.