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Daylight Saving Time and Acute Myocardial Infarction: A Meta-Analysis

Faculty of Medicine, Surgery and Prevention, University of Ferrara, via Ludovico Ariosto 35, 44121 Ferrara, Italy
Azienda Ospedaliero-Universitaria ‘S. Anna’, Via Aldo Moro 8, 44123 Ferrara, Italy
Regional Healthcare Agency of Abruzzo, via Attilio Monti 9, 65127 Pescara, Italy
Center of Clinical Epidemiology, University of Ferrara, via Fossato di Mortara 64B, 44121 Ferrara, Italy
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(3), 404;
Received: 21 February 2019 / Revised: 12 March 2019 / Accepted: 20 March 2019 / Published: 23 March 2019
(This article belongs to the Special Issue Therapies for Myocardial Injury and Infarction)
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Background: The available evidence on the effects of daylight saving time (DST) transitions on major cardiovascular diseases is limited and conflicting. We carried out the first meta-analysis aimed at evaluating the risk of acute myocardial infarction (AMI) following DST transitions. Methods: We searched cohort or case-control studies evaluating the incidence of AMI, among adults (≥18 y), during the weeks following spring and/or autumn DST shifts, versus control periods. The search was made in MedLine and Scopus, up to 31 December 2018, with no language restriction. A summary odds ratio of AMI was computed after: (1) spring, (2) autumn or (3) both transitions considered together. Meta-analyses were also stratified by gender and age. Data were combined using a generic inverse-variance approach. Results: Seven studies (>115,000 subjects) were included in the analyses. A significantly higher risk of AMI (Odds Ratio: 1.03; 95% CI: 1.01–1.06) was observed during the two weeks following spring or autumn DST transitions. However, although AMI risk increased significantly after the spring shift (OR: 1.05; 1.02–1.07), the incidence of AMI during the week after winter DST transition was comparable with control periods (OR 1.01; 0.98–1.04). No substantial differences were observed when the analyses were stratified by age or gender. Conclusion: The risk of AMI increases modestly but significantly after DST transitions, supporting the proposal of DST shifts discontinuation. Additional studies that fully adjust for potential confounders are required to confirm the present findings. View Full-Text
Keywords: daylight saving time; circadian rhythm; chronobiology; acute myocardial infarction; meta-analysis daylight saving time; circadian rhythm; chronobiology; acute myocardial infarction; meta-analysis

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Manfredini, R.; Fabbian, F.; Cappadona, R.; De Giorgi, A.; Bravi, F.; Carradori, T.; Flacco, M.E.; Manzoli, L. Daylight Saving Time and Acute Myocardial Infarction: A Meta-Analysis. J. Clin. Med. 2019, 8, 404.

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