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Abstract
Background Previous studies have shown a circadian association with the incidence of myocardial infarction, with a higher incidence on a Monday. We sought to establish whether there was any association between rates of ST-segment elevation myocardial infarction (STEMI) and day of the week in an Irish population
Methods All STEMIs recorded in the Republic of Ireland national ACS database, and from both centres providing primary PCI in Northern Ireland, from January 2013 through March 2018 were included in the analysis. Dates of admission were grouped by day of the week. Chi-Square goodness-of-fit test was performed across the entire data set. Odds ratios and Chi-Square independence tests were calculated for each day versus the mean of the other 6 days of the week.
Results 10,528 patients were included in the analysis (7,112 in the Republic of Ireland, 3,416 in Northern Ireland). Chi-Square goodness-of-fit test showed a significant deviation from an even distribution across the week (p<0.000). The total number of STEMI vs mean by day of week are reported in Figure 1 below. The incidence of STEMI was significantly higher on Mondays: OR 1.13 (p=0.015). Relative odds ratios and p values are reported in Figure 2 below.
Summary We found an association between the incidence of STEMI and the start of the working week. There is a significantly higher incidence of STEMI on Mondays.
Incidence of STEMI by day of the week. (NB truncated y-axis)
Relative odds ratio of STEMI by day of the week. P values from Chi-square vs other 6 days
Conflict of Interest None