Once after a full moon: acute type A aortic dissection and lunar phases.

• Published in: Interactive CardioVascular and Thoracic Surgery
• Main Authors: Bjursten, Henrik, Oudin Åström, Daniel, Nozohoor, Shahab, Ahmad, Khalil, Tang, Mariann, Bjurbom, Markus, Hansson, Emma C, Jeppsson, Anders, Joost Holdflod Møller, Christian, 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
• Other Authors: 1Department of Cardiothoracic Surgery, Lund University, Skåne University Hospital, Lund, Sweden. 2Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden. 3Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 4Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark. 5Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden. 6Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 7Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 8Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 9Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. 10Research Unit of Surgery, Anesthesia, and Critical Care, University of Oulu, Oulu, Finland. 11Heart Centre, Tampere University Hospital and University of Tampere, Tampere, Finland. 12Department of Cardiothoracic Surgery, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. 13Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland. 14Turku University Hospital, Turku, Finland. 15Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital and Faculty of Medicine and Health, Orebro University, Orebro, Sweden. 16Section of Cardiac Surgery, Yale University School of Medicine, New Haven, CT, USA. 17Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press 2022
• Subjects: Dissection of the aorta; Moon; Æðagúll; Tunglið; Aneurysm; Dissecting; Alf; Iceland
• Online Access: http://hdl.handle.net/2336/622103; https://doi.org/10.1093/icvts/ivab220

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Download 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. Keywords: Dissection of the aorta; Moon. Skane Regional Research Fund ALF-funds (Government Compensation to County Councils for Costs Arising from Research and Education) University of Iceland Research Fund Landspitali Research Fund Mats Kleberg ...