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Panminerva Medica 2001 March;43(1):7-10

lingua: Inglese

Chronobiology of non fatal pulmonary thromboembolism

Bilora F., Manfredini R. *, Petrobelli F., Vettore G., Boccioletti V., Pomerri F. **

From the Institute of Medicine II, Department of Medical and Surgical Sciences, University of Padua
*Department of Internal Medicine I Azienda Ospedaliera, Ferrara
**Department of Radiology, University of Padua


Background. It as ­been dem­on­strated ­that ­acute myo­car­dial infarc­tion, ­sudden car­diac ­death, ­stroke, and ­fatal pul­mo­nary embo­lism ­show an ­increased ­onset ­rate ­during cer­tain ­periods of the day, ­week, or ­year. According to ­some ­authors, the ­highest ­risk ­appears to ­occur in the ­morning, on week­ends and ­during ­winter. This ­paper, there­fore, ­intends to ­examine ­whether a cir­ca­dian, ­weekly, or ­annual ­rhythm in the inci­dence ­rate of ­deep ­vein throm­bosis (DVT) and non-­fatal pul­mo­nary embo­lism (PE) in ­ageing ­patients ­does ­exists.
Methods. A ­survey was con­ducted ­into 212 ­patients ­affected by DVT and PE, ­admitted to the Second Medicine Institute of Padua, Italy, ­over a ­period of two ­solar ­years. Thromboses ­were diag­nosed via ­echo-Doppler exam­ina­tion of the ­legs and pul­mo­nary embo­lism via per­fu­sive and ven­til­a­tory scin­ti­phot­o­graphs.
Results. In the ­overall ­sample, a cir­ca­dian vari­a­tion was ­found, ­both for ­deep ­vein throm­bosis (­peak at 12:26 hrs, p=0.001), and pul­mo­nary embo­lism (­peak at 10:26 hrs, p=0.001). A ­weekly, ­rhythmic recur­rence was ­also ­found for the two com­plaints, ­with a ­peak on Saturdays, ­while no sig­nif­i­cant ­annual ­rhythmic recur­rence was ­found. There was, how­ever, a ten­dency ­towards an ­increase ­during the ­winter and ­summer ­months.
Conclusions. The ­results may ­have impor­tant clin­ical appli­ca­tions, ­both in pre­ven­tion and in the ''­timing'' of ­drug ­dosage.

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