Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes
Background Seasonal variations in acute coronary syndromes (ACS) have been reported, with incidence and mortality peaking in the winter. However, the underlying pathophysiology for these variations remain speculative. Methods and Results Patients with ACS who underwent optical coherence tomography w...
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015579 |
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| author | Osamu Kurihara Masamichi Takano Erika Yamamoto Taishi Yonetsu Tsunekazu Kakuta Tsunenari Soeda Bryan P. Yan Filippo Crea Takumi Higuma Shigeki Kimura Yoshiyasu Minami Tom Adriaenssens Niklas F. Boeder Holger M. Nef Chong Jin Kim Vikas Thondapu Hyung Oh Kim Michele Russo Tomoyo Sugiyama Francesco Fracassi Hang Lee Kyoichi Mizuno Ik‐Kyung Jang |
| author_facet | Osamu Kurihara Masamichi Takano Erika Yamamoto Taishi Yonetsu Tsunekazu Kakuta Tsunenari Soeda Bryan P. Yan Filippo Crea Takumi Higuma Shigeki Kimura Yoshiyasu Minami Tom Adriaenssens Niklas F. Boeder Holger M. Nef Chong Jin Kim Vikas Thondapu Hyung Oh Kim Michele Russo Tomoyo Sugiyama Francesco Fracassi Hang Lee Kyoichi Mizuno Ik‐Kyung Jang |
| author_sort | Osamu Kurihara |
| collection | DOAJ |
| description | Background Seasonal variations in acute coronary syndromes (ACS) have been reported, with incidence and mortality peaking in the winter. However, the underlying pathophysiology for these variations remain speculative. Methods and Results Patients with ACS who underwent optical coherence tomography were recruited from 6 countries. The prevalence of the 3 most common pathologies (plaque rupture, plaque erosion, and calcified plaque) were compared between the 4 seasons. In 1113 patients with ACS (885 male; mean age, 65.8±11.6 years), the rates of plaque rupture, plaque erosion, and calcified plaque were 50%, 39%, and 11% in spring; 44%, 43%, and 13% in summer; 49%, 39%, and 12% in autumn; and 57%, 30%, and 13% in winter (P=0.039). After adjusting for age, sex, and other coronary risk factors, winter was significantly associated with increased risk of plaque rupture (odds ratio [OR], 1.652; 95% CI, 1.157–2.359; P=0.006) and decreased risk of plaque erosion (OR, 0.623; 95% CI, 0.429–0.905; P=0.013), compared with summer as a reference. Among patients with rupture, the prevalence of hypertension was significantly higher in winter (P=0.010), whereas no significant difference was observed in the other 2 groups. Conclusions Seasonal variations in the incidence of ACS reflect differences in the underlying pathobiology. The proportion of plaque rupture is highest in winter, whereas that of plaque erosion is highest in summer. A different approach may be needed for the prevention and treatment of ACS depending on the season of its occurrence. Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT03479723. |
| first_indexed | 2024-04-13T17:01:23Z |
| format | Article |
| id | doaj.art-70dcdc28a86a4986951cb6b6fe75a26e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T17:01:23Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-70dcdc28a86a4986951cb6b6fe75a26e2022-12-22T02:38:38ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-07-0191310.1161/JAHA.119.015579Seasonal Variations in the Pathogenesis of Acute Coronary SyndromesOsamu Kurihara0Masamichi Takano1Erika Yamamoto2Taishi Yonetsu3Tsunekazu Kakuta4Tsunenari Soeda5Bryan P. Yan6Filippo Crea7Takumi Higuma8Shigeki Kimura9Yoshiyasu Minami10Tom Adriaenssens11Niklas F. Boeder12Holger M. Nef13Chong Jin Kim14Vikas Thondapu15Hyung Oh Kim16Michele Russo17Tomoyo Sugiyama18Francesco Fracassi19Hang Lee20Kyoichi Mizuno21Ik‐Kyung Jang22Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiovascular Center Nippon Medical School Chiba Hokusoh Hospital Inzai, Chiba JapanCardiology Division Massachusetts General Hospital Harvard Medical School Boston MADepartment of Interventional Cardiology Tokyo Medical and Dental University Tokyo JapanDivision of Cardiovascular Medicine Tsuchiura Kyodo General Hospital Ibaraki JapanDepartment of Cardiovascular Medicine Nara Medical University Nara JapanDivision of Cardiology Department of Medicine and Therapeutics Prince of Wales Hospital Chinese University of Hong Kong Hong Kong SAR ChinaFondazione Policlinico Universitario A Gemelli IRCCS Roma ItalyDivision of Cardiology Department of Internal Medicine St. Marianna University School of Medicine Kawasaki Kanagawa JapanDivision of Cardiology Kameda Medical Center Chiba JapanDepartment of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara JapanDepartment of Cardiovascular Medicine University Hospitals Leuven Leuven BelgiumDepartment of Cardiology University of Giessen GermanyDepartment of Cardiology University of Giessen GermanyDepartment of Cardiology Kyung Hee University Hospital Seoul KoreaCardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MABiostatistics Center Massachusetts General Hospital Harvard Medical School Boston MAMitsukoshi Health and Welfare Foundation Tokyo JapanCardiology Division Massachusetts General Hospital Harvard Medical School Boston MABackground Seasonal variations in acute coronary syndromes (ACS) have been reported, with incidence and mortality peaking in the winter. However, the underlying pathophysiology for these variations remain speculative. Methods and Results Patients with ACS who underwent optical coherence tomography were recruited from 6 countries. The prevalence of the 3 most common pathologies (plaque rupture, plaque erosion, and calcified plaque) were compared between the 4 seasons. In 1113 patients with ACS (885 male; mean age, 65.8±11.6 years), the rates of plaque rupture, plaque erosion, and calcified plaque were 50%, 39%, and 11% in spring; 44%, 43%, and 13% in summer; 49%, 39%, and 12% in autumn; and 57%, 30%, and 13% in winter (P=0.039). After adjusting for age, sex, and other coronary risk factors, winter was significantly associated with increased risk of plaque rupture (odds ratio [OR], 1.652; 95% CI, 1.157–2.359; P=0.006) and decreased risk of plaque erosion (OR, 0.623; 95% CI, 0.429–0.905; P=0.013), compared with summer as a reference. Among patients with rupture, the prevalence of hypertension was significantly higher in winter (P=0.010), whereas no significant difference was observed in the other 2 groups. Conclusions Seasonal variations in the incidence of ACS reflect differences in the underlying pathobiology. The proportion of plaque rupture is highest in winter, whereas that of plaque erosion is highest in summer. A different approach may be needed for the prevention and treatment of ACS depending on the season of its occurrence. Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT03479723.https://www.ahajournals.org/doi/10.1161/JAHA.119.015579optical coherence tomographyplaque erosionplaque ruptureseason |
| spellingShingle | Osamu Kurihara Masamichi Takano Erika Yamamoto Taishi Yonetsu Tsunekazu Kakuta Tsunenari Soeda Bryan P. Yan Filippo Crea Takumi Higuma Shigeki Kimura Yoshiyasu Minami Tom Adriaenssens Niklas F. Boeder Holger M. Nef Chong Jin Kim Vikas Thondapu Hyung Oh Kim Michele Russo Tomoyo Sugiyama Francesco Fracassi Hang Lee Kyoichi Mizuno Ik‐Kyung Jang Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease optical coherence tomography plaque erosion plaque rupture season |
| title | Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes |
| title_full | Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes |
| title_fullStr | Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes |
| title_full_unstemmed | Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes |
| title_short | Seasonal Variations in the Pathogenesis of Acute Coronary Syndromes |
| title_sort | seasonal variations in the pathogenesis of acute coronary syndromes |
| topic | optical coherence tomography plaque erosion plaque rupture season |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015579 |
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