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Circadian Variation of the Efficacy of Thrombolytic Therapy in Acute Myocardial Infarction—Isn’t the Time Ripe for Cardiovascular Chronotherapy?

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel, leonardo{at}barzi.health.gov.il

Nadya Pancheva, MD

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Michael Berman, MD

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Vladimir Khalameizer, MD

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Jamal Jafary, MD

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Chaim Yosefy, MD

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Yosef Blaer, MSc

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Ilia Manevich, MD

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Ronit Peled, PhD

Epidemiology Research Institute, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

Shimon Scharf, MD, MPH

Cardiology Department, Barzilai Medical Center Campus, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel

This study was designed to assess the circadian variation of the efficacy of thrombolytic therapy (TT) in 163 patients with acute myocardial infarction. Statistical analysis of the results suggests the existence of circadian variation in the efficacy of thrombolytic therapy with marked early morning resistance and significantly better late daytime results. There is a strong relationship between the normal physiologic rhythms of biochemical, hemodynamic, and hematologic parameters, observed in patients with CAD and the circadian fluctuations of efficacy of TT. Obviously the efficacy of TT is influenced by more evident impact of chronorisk factors during the early morning hours.

Angiology, Vol. 55, No. 3, 257-263 (2004)
DOI: 10.1177/000331970405500304


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