Monday preference in onset of takotsubo cardiomyopathy

Am J Emerg Med. 2010 Jul;28(6):715-9. doi: 10.1016/j.ajem.2009.04.023. Epub 2010 Feb 25.


Objective: Acute cardiovascular events show definite temporal patterns of occurrence. Takotsubo cardiomyopathy (TTC) has been recently shown to exhibit a seasonal (summer) and circadian (morning) temporal distribution. The aim of this study, based on the database of a multicenter Italian network, was to investigate the possible existence of a weekly pattern of onset of TTC.

Methods: The study included all cases of TTC admitted to the coronary care unit of 8 referral cardiac centers in Italy (five in Southern Italy and three in Northern Italy, respectively), belonging to the Takotsubo Italian Network (January 2002-December 2008). Day of admission was categorized into seven 1-day intervals according by week, and chronobiological analysis was performed by partial Fourier series.

Results: The database included 112 patients with TTC (92.9% females). The weekly distribution identified the highest number of cases on Monday and the lowest on Saturday. Chronobiologic analysis yielded a rhythmic pattern with a significant peak on Monday (P = .036).

Conclusions: This study confirms a Monday preference for TTC occurrence on Monday, similar to that reported for acute myocardial infarction. Stress of starting weekly day life activities, could play a triggering role.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Coronary Care Units
  • Emergency Service, Hospital
  • Female
  • Hospitalization
  • Humans
  • Incidence
  • Italy
  • Male
  • Middle Aged
  • Periodicity*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Takotsubo Cardiomyopathy / complications
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / epidemiology*