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Background <p>Circadian variation in STEMI onset is well established; however, the relationship between symptom onset time and thrombus burden remains unclear.</p> Methods <p>We retrospectively analyzed 1068 STEMI patients treated with primary PCI between January 2018 and September 2021. Patients were categorized into four groups according to symptom onset time. Thrombus burden was assessed using the TIMI thrombus grading system. Multivariable logistic regression analysis was performed to identify independent predictors of large thrombus burden.</p> Results <p>STEMI onset showed a clear circadian pattern, with a morning peak between 06:00 and 11:59 (<i>p</i> &lt; 0.001). Patients with nighttime symptom onset (00:00–05:59) had a significantly higher rate of large thrombus burden (<i>p</i> &lt; 0.001). In univariate analysis, hypertension and nighttime symptom onset were associated with large thrombus burden; however, these associations did not remain independently significant after multivariable adjustment.</p> Conclusion <p>STEMI incidence follows a circadian pattern, with a morning peak; however, although thrombus burden appears higher during nighttime hours, this association was not independent after adjustment.</p> Graphical Abstract <p></p>

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Circadian patterns of angiographic thrombus burden in STEMI

  • 期刊论文

  • 发表日期：

    2026年7月8日

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  • Hatice Taşkan,
  • Ayse Saatci Yasar,
  • Farıd Baghırov,
  • Selen Eşki,
  • Ender Murat,
  • Serdar Fırtına,
  • Salim Yaşar,
  • Suat Görmel,
  • Serkan Asil,
  • Erkan Yıldırım,
  • Murat Çelik,
  • Uygar Çagdas Yüksel,
  • Hasan Kutsi Kabul,
  • Cem Barçın

摘要

Background

Circadian variation in STEMI onset is well established; however, the relationship between symptom onset time and thrombus burden remains unclear.

Methods

We retrospectively analyzed 1068 STEMI patients treated with primary PCI between January 2018 and September 2021. Patients were categorized into four groups according to symptom onset time. Thrombus burden was assessed using the TIMI thrombus grading system. Multivariable logistic regression analysis was performed to identify independent predictors of large thrombus burden.

Results

STEMI onset showed a clear circadian pattern, with a morning peak between 06:00 and 11:59 (p < 0.001). Patients with nighttime symptom onset (00:00–05:59) had a significantly higher rate of large thrombus burden (p < 0.001). In univariate analysis, hypertension and nighttime symptom onset were associated with large thrombus burden; however, these associations did not remain independently significant after multivariable adjustment.

Conclusion

STEMI incidence follows a circadian pattern, with a morning peak; however, although thrombus burden appears higher during nighttime hours, this association was not independent after adjustment.

Graphical Abstract