European Journal of Epidemiology

, Volume 20, Issue 5, pp 401–406 | Cite as

A Meta-analysis of excess cardiac mortality on Monday

Article

Abstract

Background: Available evidence suggests a peak in the incidence of cardiovascular events on Mondays compared to other days of the week. The exact magnitude of the excess risk and the role of age and gender, however, remain unclear. Objective: To quantify the excess risk associated with the Monday peak in cardiovascular mortality and to explore the role of age and gender. Methods: A meta-analysis of available published studies reporting on weekly patterns in incidence of myocardial infarction and sudden cardiac death was performed. Results: Reports based on routinely collected data from population statistics (n ¼ 5) generally reported a lower odds ratio (OR) of an event on Monday than studies with a confirmed diagnosis (n ¼ 16). The pooled OR estimate based on population statistics was 1.04 (95%CI: 1.03; 1.05), whereas the pooled OR estimate based on confirmed diagnoses was 1.19 (95%CI: 1.17; 1.21). Subgroup analysis yielded an OR of 1.19 (95%CI: 1.07; 1.31) for men and 1.15 (95%CI: 0.99; 1.32) for women. Odds ratios for patients younger than 65 years of age and 65 or older were 1.22 (95%CI: 1.09; 1.36) and 1.16 (95%CI: 1.07; 1.27), respectively. The differences between subgroup odds ratios were not statistically significant. Conclusion: The incidence of sudden cardiac death is markedly increased on Monday, similar for men and women, and for subjects below and above 65 years of age.

Atherosclerosis Cardiovascular disease Circaseptan variation Review Sudden cardiac death 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Arntz, HR, Muller-Nordhorn, J, Willich, SN 2001Cold Monday mornings prove dangerous: Epidemiology of sudden cardiac deathCurr Opin Crit Care7139144PubMedGoogle Scholar
  2. 2.
    Cohen, MC, Rohtla, KM, Lavery, CE, Muller, JE, Mittleman, MA 1997Meta-analysis of the morning excess of acute myocardial infarction and sudden cardiac deathAm J Cardiol7915121516PubMedGoogle Scholar
  3. 3.
    Oberg, AL, Ferguson, JA, McIntyre, LM, Horner, RD 2000Incidence of stroke and season of the year: Evidence of an associationAm J Epidemiol152558564PubMedGoogle Scholar
  4. 4.
    Rabkin, SW, Mathewson, FA, Tate, RB 1980Chronobiology of cardiac sudden death in menJAMA24413571358PubMedGoogle Scholar
  5. 5.
    Willich, SN, Maclure, M, Mittleman, M, Arntz, HR, Muller, JE 1993Sudden cardiac deathSupport for a role of triggering in causation. Circulation8714421450Google Scholar
  6. 6.
    Muller, JE, Abela, GS, Nesto, RW, Tofler, GH 1994Triggers, acute risk factors and vulnerable plaques: The lexicon of a new frontierJ Am Coll Cardiol23809813PubMedGoogle Scholar
  7. 7.
    Tofler, GH, Stone, PH, Maclure, M,  et al. 1990Analysis of possible triggers of acute myocardial infarction (the MILIS study)Am J Cardiol662227PubMedGoogle Scholar
  8. 8.
    Kauhanen, J, Kaplan, GA, Goldberg, DE, Salonen, JT 1997Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population based studyBMJ315846851PubMedGoogle Scholar
  9. 9.
    Witte, DR, Bots, ML, Hoes, AW, Grobbee, DE 2000Cardiovascular mortality in Dutch men during 1996 European football championship: Longitudinal population studyBMJ32115521554PubMedGoogle Scholar
  10. 10.
    Hoes, AW, Grobbee, DE, Lubsen, J, Manin’t Veld, AJ, der, DE, Hofman, A 1995Diuretics, beta-blockers, and the risk for sudden cardiac death in hypertensive patientsAnn Intern Med123481487PubMedGoogle Scholar
  11. 11.
    Thompson, DR, Pohl, JE, Sutton, TW 1992Acute myocardial infarction and day of the weekAm J Cardiol69266267PubMedGoogle Scholar
  12. 12.
    Gnecchi-Ruscone, T, Piccaluga, E, Guzzetti, S, Contini, M, Montano, N, Nicolis, E 1994Morning and Monday: Critical periods for the onset of acute myocardial infarction. The GISSI 2 Study experienceEur Heart J15882887PubMedGoogle Scholar
  13. 13.
    Maron, BJ, Kogan, J, Proschan, MA, Hecht, GM, Roberts, WC 1994Circadian variability in the occurrence of sudden cardiac death in patients with hypertrophic cardiomyopathyJ Am Coll Cardiol2314051409PubMedGoogle Scholar
  14. 14.
    Willich, SN, Lowel, H, Lewis, M, Hormann, A, Arntz, HR, Keil, U 1994Weekly variation of acute myocardial infarction. Increased Monday risk in the working populationCirculation908793PubMedGoogle Scholar
  15. 15.
    der, PJ, Doggen, CJ, Beaglehole, R 1995Variation in the time and day of onset of myocardial infarction and sudden deathN Z Med J108332324PubMedGoogle Scholar
  16. 16.
    Spielberg, C, Falkenhahn, D, Willich, SN, Wegscheider, K, Voller, H 1996Circadian, day-of-week, and seasonal variability in myocardial infarction: Comparison between working and retired patientsAm Heart J132579585PubMedGoogle Scholar
  17. 17.
    Peters, RW, Brooks, MM, Zoble, RG, Liebson, PR, Seals, AA 1996Chronobiology of acute myocardial infarction: Cardiac arrhythmia suppression trial (CAST) experienceAm J Cardiol7811981201PubMedGoogle Scholar
  18. 18.
    Sayer, JW, Wilkinson, P, Ranjadayalan, K, Ray, S, Marchant, B, Timmis, AD 1997Attenuation or absence of circadian and seasonal rhythms of acute myocardial infarctionHeart77325329PubMedGoogle Scholar
  19. 19.
    Ku, CS, Yang, CY, Lee, WJ, Chiang, HT, Liu, CP, Lin, SL 1998Absence of a seasonal variation in myocardial infarction onset in a region without temperature extremesCardiology89277282PubMedGoogle Scholar
  20. 20.
    Zhou, RH, Xi, B, Gao, HQ,  et al. 1998Circadian and septadian variation in the occurrence of acute myocardial infarction in a Chinese populationJpn Circ J62190192PubMedGoogle Scholar
  21. 21.
    Chenet, L, Britton, A 2001Weekend binge drinking may be linked to Monday peaks in cardiovascular deathsBMJ322998Google Scholar
  22. 22.
    Bleyer, AJ, Russell, GB, Satko, SG 1999Sudden and cardiac death rates in haemodialysis patientsKidney Int5515531559PubMedGoogle Scholar
  23. 23.
    Vehvilainen, AT, Kumpusalo, EA, Takala, JK 1999They call it stormy Monday – Reasons for referral from primary to secondary care according to the days of the weekBr J Gen Pract49909911PubMedGoogle Scholar
  24. 24.
    Arntz, HR, Willich, SN, Schreiber, C, Bruggemann, T, Stern, R, Schultheiss, HP 2000Diurnal, weekly and seasonal variation of sudden death. Population-based analysis of 24,061 consecutive casesEur. Heart J21315320PubMedGoogle Scholar
  25. 25.
    Massing, W, Angermeyer, MC 1985Myocardial infarction on various days of the weekPsychol Med15851857PubMedGoogle Scholar
  26. 26.
    Cornelissen, G, Breus, TK, Bingham, C,  et al. 1993Beyond circadian chronorisk: Worldwide circaseptan-circasemiseptan patterns of myocardial infarctions, other vascular events, and emergenciesChronobiologia2087115PubMedGoogle Scholar
  27. 27.
    Evans, C, Chalmers, J, Capewell, S,  et al. 2000I don’t like Mondays-day of the week of coronary heart disease deaths in Scotland: Study of routinely collected dataBMJ320218219PubMedGoogle Scholar
  28. 28.
    Marques-Vidal, P, Arveiler, D, Amouyel, P, Ducimetiere, P, Ferrieres, J 2001Myocardial infarction rates are higher on weekends than on weekdays in middle aged French menHeart86341342Google Scholar
  29. 29.
    Chenet, L, Britton, A, Kalediene, R, Petrauskiene, J 2001Daily variations in deaths in Lithuania: The possible contribution of binge drinkingInt J Epidemiol30743748PubMedGoogle Scholar
  30. 30.
    Peters, RW, McQuillan, S, Resnick, SK, Gold, MR 1996Increased Monday incidence of lifethreatening ventricular arrhythmias Experience with a third-generation implantable defibrillatorCirculation9413461349PubMedGoogle Scholar
  31. 31.
    Vermeer, SE, Rinkel, GJ, Algra, A 1997Circadian fluctuations in onset of subarachnoid hemorrhage. New data on aneurysmal and perimesencephalic hemorrhage and a systematic reviewStroke28805808PubMedGoogle Scholar
  32. 32.
    Peckova, M, Fahrenbruch, CE, Cobb, LA, Hallstrom, AP 1999Weekly and seasonal variation in the incidence of cardiac arrestsAm Heart J137512515PubMedGoogle Scholar
  33. 33.
    Manfredini, R, Casetta, I, Paolino, E,  et al. 2001Monday preference in onset of ischemic strokeAm J Med111401403PubMedGoogle Scholar
  34. 34.
    Feigin, VL, Anderson, CS, Anderson, NE, Broad, JB, Pledger, MJ, Bonita, R 2001Is there a temporal pattern in the occurrence of subarachnoid hemorrhage in the southern hemisphere? Pooled data from 3 large, population-based incidence studies in Australia, 1981 to 1997Stroke32613619PubMedGoogle Scholar
  35. 35.
    Makie, T, Harada, M, Kinukawa, N,  et al. 2002Association of meteorological and day-of-the-week factors with emergency hospital admissions in Fukuoka, JapanInt J Biometeorol463841PubMedGoogle Scholar
  36. 36.
    Sumiyoshi, M, Kojima, S, Arima, M,  et al. 2002Circadian, weekly, and seasonal variation at the onset of acute aortic dissectionAm J Cardiol89619623PubMedGoogle Scholar
  37. 37.
    Witte DR, Grobbee DE, Bots ML, Hoes AW. Excess cardiac mortality on Monday: The importance of gender, age and hospitalisation. Eur J Epidemiol 2005Google Scholar
  38. 38.
    Greenland, S 1987Quantitative methods in the review of epidemiologic literatureEpidemiol Rev9130PubMedGoogle Scholar
  39. 39.
    Ridker, PM, Manson, JE, Buring, JE, Muller, JE, Hennekens, CH 1990Circadian variation of acute myocardial infarction and the effect of low-dose aspirin in a randomized trial of physiciansCirculation82897902PubMedGoogle Scholar
  40. 40.
    Willich, SN, Linderer, T, Wegscheider, K, Leizorovicz, A, Alamercery, I, Schroder, R 1989Increased morning incidence of myocardial infarction in the ISAM Study: Absence with prior beta-adrenergic blockade. ISAM Study GroupCirculation80853858PubMedGoogle Scholar
  41. 41.
    Woods, KL, Fletcher, S, Jagger, C 1992Modification of the circadian rhythm of onset of acute myocardial infarction by long-term antianginal treatmentBr Heart J68458461PubMedGoogle Scholar
  42. 42.
    Yamasaki, F, Seo, H, Furuno, T,  et al. 2002Effect of age on chronological variation of acute myocardial infarction onset: Study in JapanClin Exp Hypertens2419PubMedGoogle Scholar
  43. 43.
    Mitler, MM, Hajdukovic, RM, Shafor, R, Hahn, PM, Kripke, DF 1987When people die. Cause of death versus time of deathAm J Med82266274Google Scholar
  44. 44.
    Morning peak in the incidence of myocardial infarction: Experience in the ISIS-2 trial. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Eur Heart J 1992; 13: 594–598Google Scholar
  45. 45.
    Servoss, SJ, Januzzi, JL, Muller, JE 2002Triggers of acute coronary syndromesProg Cardiovasc Dis44369380PubMedGoogle Scholar
  46. 46.
    Davies, MJ 1996Stability and instability: two faces of coronary atherosclerosis. The Paul Dudley White Lecture 1995Circulation9420132020PubMedGoogle Scholar
  47. 47.
    Wannamethee, G, Shaper, AG 1992Alcohol and sudden cardiac deathBr Heart J68443448PubMedGoogle Scholar
  48. 48.
    Ryan, JM, Howes, LG 2002Relations between alcohol consumption, heart rate, and heart rate variability in menHeart88641642PubMedGoogle Scholar
  49. 49.
    Djousse, L, Levy, D, Benjamin, EJ 2004Long-term alcohol consumption and the risk of atrial fibrillation in the Framingham StudyAm J Cardiol93710713PubMedGoogle Scholar
  50. 50.
    Ridker, PM, Willich, SN, Muller, JE, Hennekens, CH 1991Aspirin, platelet aggregation, and the circadian variation of acute thrombotic eventsChronobiol Int8327335PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • D.R. Witte
    • 1
  • D.E. Grobbee
    • 1
  • M.L. Bots
    • 1
  • A.W. Hoes
    • 1
  1. 1.Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands

Personalised recommendations