Once after a full moon : acute type A aortic dissection and lunar phases
Bjursten, Henrik; Oudin Åström, Daniel; Nozohoor, Shahab; Ahmad, Khalil; Tang, Mariann; Bjurbom, Markus; Hansson, Emma C; Jeppsson, Anders; Møller, Christian Joost Holdflod; Jormalainen, Miko; Juvonen, Tatu; Mennander, Ari; Olsen, Peter S; Olsson, Christian; Ahlsson, Anders; Oudin, Anna; Pan, Emily; Raivio, Peter; Wickbom, Anders; Sjögren, Johan; Geirsson, Arnar; Gudbjartsson, Tomas; Zindovic, Igor (2021-08-27)
Henrik Bjursten, Daniel Oudin Åström, Shahab Nozohoor, Khalil Ahmad, Mariann Tang, Markus Bjurbom, Emma C Hansson, Anders Jeppsson, Christian Joost Holdflod Møller, Miko Jormalainen, Tatu Juvonen, Ari Mennander, Peter S Olsen, Christian Olsson, Anders Ahlsson, Anna Oudin, Emily Pan, Peter Raivio, Anders Wickbom, Johan Sjögren, Arnar Geirsson, Tomas Gudbjartsson, Igor Zindovic, Once after a full moon: acute type A aortic dissection and lunar phases, Interactive CardioVascular and Thoracic Surgery, Volume 34, Issue 1, January 2022, Pages 105–110, https://doi.org/10.1093/icvts/ivab220
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
https://creativecommons.org/licenses/by/4.0/
https://urn.fi/URN:NBN:fi-fe2022053039278
Tiivistelmä
Abstract
Objectives: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.
Methods: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).
Results: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00–1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01–1.23, P = 0.027). The peak incidence came 4–6 days after the moon was fully illuminated.
Conclusions: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.
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