Circadian and seasonal distribution of cardioembolic strokes due to atrial fibrillation

Konstantinos Spengos, Georgios Tsivgoulis, Efstathios Manios, Athanassios Tsivgoulis, Nikolaos Zakopoulos, Konstantinos N. Vemmos

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: A seasonal and circadian distribution of the incidence of stroke has been described in many countries, with peaks during the winter period and the morning hours. In Greece, a cardioembolic aetiology accounts for the most important stroke subgroup, while atrial fibrillation (AF) is the commonest cause. Methods: In 2 groups of 335 and 360 patients with cardioembolic stroke (CES) due to AF we studied the time distribution of the onset of symptoms over 24 hours and one year, respectively. The X2 test ("goodness of fit" model) was then used to compare the incidence of CES per two-hour interval over 24 hours, per month and per season over the course of the year, with the expected values in each case. Results: There was a statistically significant difference (p<0.001) between the actual findings and a uniform 24-hour distribution. The daily distribution was unusual, with 2 peaks between 08:00-10:00 and 16:00-18:00. There was a similar difference (p<0.001) in the comparison over the year, with an increased incidence being apparent during the winter months. The differences between the seasons were also significant, with the largest number of CES during the winter and the smallest during the summer. Conclusions: The well-established increase in stroke in the morning, just a few hours after awakening, is probably related to corresponding changes in various biological parameters. The appearance of a second peak late in the afternoon may similarly be related to awakening from siesta. Further population studies are needed to confirm the increased incidence of CES during the winter months.

Original languageEnglish (US)
Pages (from-to)234-241
Number of pages8
JournalHellenic Journal of Cardiology
Volume45
Issue number4
StatePublished - Jul 2004
Externally publishedYes

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Atrial Fibrillation
Stroke
Incidence
Greece
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Spengos, K., Tsivgoulis, G., Manios, E., Tsivgoulis, A., Zakopoulos, N., & Vemmos, K. N. (2004). Circadian and seasonal distribution of cardioembolic strokes due to atrial fibrillation. Hellenic Journal of Cardiology, 45(4), 234-241.

Circadian and seasonal distribution of cardioembolic strokes due to atrial fibrillation. / Spengos, Konstantinos; Tsivgoulis, Georgios; Manios, Efstathios; Tsivgoulis, Athanassios; Zakopoulos, Nikolaos; Vemmos, Konstantinos N.

In: Hellenic Journal of Cardiology, Vol. 45, No. 4, 07.2004, p. 234-241.

Research output: Contribution to journalArticle

Spengos, K, Tsivgoulis, G, Manios, E, Tsivgoulis, A, Zakopoulos, N & Vemmos, KN 2004, 'Circadian and seasonal distribution of cardioembolic strokes due to atrial fibrillation', Hellenic Journal of Cardiology, vol. 45, no. 4, pp. 234-241.
Spengos, Konstantinos ; Tsivgoulis, Georgios ; Manios, Efstathios ; Tsivgoulis, Athanassios ; Zakopoulos, Nikolaos ; Vemmos, Konstantinos N. / Circadian and seasonal distribution of cardioembolic strokes due to atrial fibrillation. In: Hellenic Journal of Cardiology. 2004 ; Vol. 45, No. 4. pp. 234-241.
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