05/20/2002 By Veronica Rose
Older, sicker patients appear to be more vulnerable to acute myocardial infarction during sleep, say American researchers.
They suggest that these patients are likely to have a less active life style, and are consequently less vulnerable to established trigger factors such as vigorous physical exercise. There is a circadian pattern in the onset of AMI with a peak typically at mid-morning, ascribed to the catecholamine surge that accompanies awakening and assuming the upright position, they note.
Yet for an estimated 27 percent of patients, onset occurs during sleep without apparent precipitating factors. To assess the factors involved in this phenomenon, researchers used a data base from a large multicentre clinical trial, and grouped 3.309 patients according to whether the onset of AMI symptoms awoke them from sleep or not.
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