Incidence of Myocardial Infarction With Shifts to and From Daylight Savings Time

Published:December 10, 2012DOI:
      Modulators of normal bodily functions such as the duration and quality of sleep might transiently influence cardiovascular risk. The transition to daylight savings time (DST) has been associated with a short-term increased incidence ratio (IR) of acute myocardial infarction (AMI). The present retrospective study examined the IR of AMIs that presented to our hospitals the week after DST and after the autumn switch to standard time, October 2006 to April 2012, with specific reference to the AMI type. Our study population (n = 935 patients; 59% men, 41% women) was obtained from the electronic medical records of the Royal Oak and Troy campuses of the Beaumont Hospitals in Michigan. Overall, the frequency of AMI was similar in the spring and autumn, 463 (49.5%) and 472 (50.5%), respectively. The IR for the first week after the spring shift was 1.17 (95% confidence interval 1.00 to 1.36). After the transition from DST in the autumn, the IR for the same period was lower, but not significantly different, 0.99 (95% confidence interval 0.85 to 1.16). Nevertheless, the greatest increase in AMI occurred on the first day (Sunday) after the spring shift to DST (1.71, 95% confidence interval 1.09 to 2.02; p <0.05). Also, a significantly greater incidence was found of non–ST-segment myocardial infarction after the transition to DST in the study group compared with that in the control group (p = 0.022). In conclusion, these data suggest that shifts to and from DST might transiently affect the incidence and type of acute cardiac events, albeit modestly.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cohen M.C.
        • Rohtla K.M.
        • Lavery C.E.
        • Muller J.E.
        • Mittleman M.A.
        Meta-analysis of the morning excess of acute myocardial infarctions and sudden cardiac death.
        Am J Cardiol. 1997; 79: 1512-1516
        • Boari B.
        • Salmi R.
        • Gallerani M.
        • Malagoni A.M.
        • Manfredini F.
        • Manfredini R.
        Acute myocardial infarction: circadian, weekly and seasonal patterns of occurrence.
        Biol Rhythm Res. 2007; 38: 155-167
        • Spencer F.A.
        • Goldberg R.J.
        • Becker R.C.
        • Gore J.M.
        Seasonal distribution of acute myocardial infarction in the second National Registry of Myocardial Infarction.
        J Am Coll Cardiol. 1998; 3: 1226-1233
        • Janszky I.
        • Ljung R.
        Shifts to and from daylight savings time and incidence of myocardial infarction.
        N Engl J Med. 2008; 359: 1966-1968
        • Janszky I.
        • Ahnve S.
        • Ljung R.
        • Mukamal K.J.
        • Gautam S.
        • Wallentin L.
        • Stenestrand U.
        Daylight saving time shifts and incidence of acute myocardial infarction—Swedish Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA).
        Sleep Med. 2012; 13: 237-242
        • Sun T.
        • Ono Y.
        • Takeuchi Y.
        A simple method for calculating the exact confidence interval of the standardized mortality ratio with an SAS function.
        J Occup Health. 1996; 38: 196-197
        • Nagai M.
        • Hoshide S.
        • Kario K.
        Sleep duration as a risk factor for cardiovascular disease—a review of the recent literature.
        Curr Cardiol Rev. 2010; 6: 54-61
        • Schwartz B.G.
        • French W.J.
        • Mayeda G.S.
        • Burstein S.
        • Economides C.
        • Bhandari A.K.
        • Cannom D.S.
        • Kloner R.A.
        Emotional stressors trigger cardiovascular events.
        Int J Clin Pract. 2012; 66: 631-639
        • Lin L.Y.
        • Wu C.C.
        • Liu Y.B.
        • Ho Y.L.
        • Liau C.S.
        • Lee Y.T.
        Derangement of heart rate variability during a catastrophic earthquake: a possible mechanism for increased heart attacks.
        Pacing Clin Electrophysiol. 2001; 24: 1596-1601
        • Vgontzas A.N.
        • Zoumakis M.
        • Papanicolaou D.A.
        • Bixler E.O.
        • Prolo P.
        • Lin H-.M.
        • Vela-Bueno A.
        • Kales A.
        • Chrousos G.P.
        Chronic insomnia is associated with a shift of interleukin-6 and tumor necrosis factor secretion from nightime to daytime.
        Metabolism. 2002; 51: 887-892
        • Spiegel K.
        • Leproult R.
        • Van Cauter E.
        Impact of sleep debt on metabolic and endocrine function.
        Lancet. 1999; 354: 1435-1439
        • Patel S.R.
        • Zhu X.
        • Storfer-Isser A.
        • Mehra R.
        • Jenny N.S.
        • Tracy R.
        Sleep duration and biomarkers of inflammation.
        Sleep. 2009; 32: 200-204
        • Kamdar B.B.
        • Needham D.M.
        • Collop N.A.
        Sleep deprivation in critical illness: its role in physical and psychological recovery.
        J Intensive Care Med. 2012; 27: 97-111
        • Yusuf S.
        • Hawken S.
        • Ôunpuu S.
        • Dans T.
        • Avezum A.
        • Lanas F.
        • McQueen M.
        • Budaj A.
        • Pais P.
        • Varigos J.
        • Lisheng L.
        • INTERHEART Study Investigators
        Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study.
        Lancet. 2004; 364: 937-952
        • Kannel W.B.
        • Vasan R.S.
        Adverse consequences of the 50% misconception.
        Am J Cardiol. 2009; 103: 426-427
        • Wingard D.L.
        • Berkman L.F.
        Mortality risk associated with sleeping patterns among adults.
        Sleep. 1983; 6: 102-107
        • Chandola T.
        • Ferrie J.E.
        • Perski A.
        • Akbaraly T.
        • Marmot M.G.
        The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance: a prospective study from the Whitehall II cohort.
        Sleep. 2010; 33: 739-744