Daylight Saving Time Does Not Increase Heart Attack Risk, Study Shows

Researchers study that springing guardant aliases falling backmost does not lead to spikes successful bosom attacks, easing concerns for patients and wellness systems alike.

Study: Daylight Savings Time and Acute Myocardial Infarction. Image Credit: Stokkete / Shutterstock

In a caller study published successful the JAMA Network Open, researchers successful nan United States examined whether daylight redeeming clip (DST) transitions impact nan incidence of acute myocardial infarction (AMI) and in-hospital outcomes by comparing nan weeks before, during, and aft outpouring and autumn timepiece changes, and estimated adjusted effects utilizing a nationalist registry.

Background

Each outpouring and fall, millions misplace an hour, and wonderment if hearts salary nan price. DST tin disturb slumber and circadian rhythm, which are imaginable triggers for AMI. Early studies suggested little spikes successful AMI aft nan “spring forward,” prompting headlines and bills to extremity timepiece changes. Yet cardiovascular attraction and activity patterns person evolved. Knowing whether today’s transitions matter tin style diligent advice, staffing, and nationalist policy. The reply affects slumber habits, displacement work, and worry astir clip changes. The authors statement that earlier affirmative signals whitethorn bespeak underpowered designs and pre-pandemic believe patterns. Further investigation is needed to explain real-world risks crossed seasons, regions, systems, and divers populations.

About nan study

This cross-sectional study utilized nan American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) Chest Pain-Myocardial Infarction (MI) Registry to comparison patterns 1 week before, during, and 1 week aft DST successful outpouring and autumn crossed nan United States (US) from 2013 to 2022. Unique consecutive patients pinch ST-elevation myocardial infarction (STEMI) aliases non-ST-elevation myocardial infarction (NSTEMI) were included; non-AMI encounters and residents of states without DST were excluded. The superior result was in-hospital mortality. Secondary outcomes were in-hospital stroke, reperfusion for STEMI, and revascularization for NSTEMI via percutaneous coronary involution (PCI) aliases coronary artery bypass grafting (CABG). Incidence ratio (IR) compared DST weeks pinch adjacent weeks, adjusting for nan 23-hour “spring forward” and 25-hour “fall back” days.

Generalized estimating equations (GEE) logistic models generated adjusted likelihood ratios (aORs), accounting for infirmary clustering and covariates for illustration demographics, presentation, comorbidities, and laboratory, including assemblage wide scale (BMI), near ventricular ejection fraction (LVEF), and troponin comparative to nan precocious limit of normal (ULN). Analyses were conducted successful accordance pinch nan Strengthening nan Reporting of Observational Studies successful Epidemiology (STROBE) guidelines. Sensitivity analyses compared DST weeks pinch 3 weeks earlier aliases aft and examined Arizona and Hawaii.

Study results

The last cohort included 168,870 patients treated astatine 1124 hospitals (median age, 65 years; 57,023 women (33.8%); 111,847 men (66.2%)). In spring, 28,596 patients presented nan week earlier DST, 28,678 during DST week, and 28,169 nan week after. In fall, 27,365 presented nan week before, 27,942 during DST week, and 28,120 nan week after. Baseline demographics, comorbidities, position type, and procedural attraction were intimately matched crossed weeks successful some seasons. STEMI comprised 37.4–37.9% successful each week examined, pinch balanced distributions by region and infirmary type. Door-to-balloon times remained accordant astatine 57–58 minutes, coronary angiography usage exceeded 91%, superior PCI for STEMI was utilized successful much than 90% of eligible cases successful outpouring and astir 81% successful fall, and revascularization for NSTEMI was unchangeable astatine 61–63% crossed each weeks.

Across nan full period, incidence ratios (IRs) showed nary important quality successful AMI during outpouring DST week compared pinch 1 week anterior aliases 1 week after, and nary quality for autumn DST week versus its adjacent weeks. Year-by-year land were level astir unity, pinch 1 notable exception: successful 2020, nan outpouring DST week showed a 21% higher IR compared to nan pursuing week and a 6% little IR compared to nan anterior week, patterns that overlapped pinch nan onset of coronavirus illness 2019 (COVID-19). Daily analyses during DST weeks mirrored nan wide null findings.

In-hospital outcomes were likewise stable. Mortality rates were 4.5% before, 4.6% during, and 4.4% aft outpouring DST; and 4.8% before, 4.9% during, and 4.7% aft autumn DST. aORs for decease comparing DST week pinch nan anterior aliases consequent week hovered astatine 1.00–1.02, and adjusted estimates for immoderate changeable were likewise nonsignificant. Subgroup analyses by STEMI and NSTEMI yielded nary meaningful differences successful aORs crossed seasons aliases weeks.

Sensitivity checks supported accuracy: successful a abstracted sensitivity study of Arizona and Hawaii, which were excluded from nan superior cohort because they do not observe DST, IRs crossed nan corresponding almanac windows were similar; three-week windows were null overall, pinch an objection successful 2020 wherever IRs were higher successful nan 3 weeks aft outpouring DST; and excluding 2020-2021 did not alteration conclusions. Overall, successful modern practice, timepiece changes were not associated pinch surges successful AMI presentations aliases worse in-hospital course.

Conclusions

In this extensive, modern registry, DST transitions did not raise AMI incidence aliases worsen in-hospital outcomes. These findings are accordant crossed STEMI and NSTEMI strata and adjusted for demographic, clinical, and laboratory covariates utilizing GEE models. For patients, families, and wellness systems, nan connection is reassuring: nan mislaid aliases gained hr is improbable to trigger bosom attacks aliases complicate infirmary care.

Public statement astir clip standards should measurement different endpoints, specified arsenic out-of-hospital cardiac arrest, postulation risk, and slumber health, alternatively than AMI alone. The authors besides statement that different conditions, specified arsenic ischemic changeable and vehicular crashes, whitethorn still show temporal associations pinch DST changes.