A Meta-analysis of excess cardiac mortality on Monday

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Abstract
Background: Available evidence suggests a peak in the incidence of cardiovascular events on Mondays compared to other days of the week. The exact magnitude of the excess risk and the role of age and gender, however, remain unclear. Objective: To quantify the excess risk associated with the Monday peak in cardiovascular mortality and to explore the role of age and gender. Methods: A meta-analysis of available published studies reporting on weekly patterns in incidence of myocardial infarction and sudden cardiac death was performed. Results: Reports based on routinely collected data from population statistics (n ¼ 5) generally reported a lower odds ratio (OR) of an event on Monday than studies with a confirmed diagnosis (n ¼ 16). The pooled OR estimate based on population statistics was 1.04 (95%CI: 1.03; 1.05), whereas the pooled OR estimate based on confirmed diagnoses was 1.19 (95%CI: 1.17; 1.21). Subgroup analysis yielded an OR of 1.19 (95%CI: 1.07; 1.31) for men and 1.15 (95%CI: 0.99; 1.32) for women. Odds ratios for patients younger than 65 years of age and 65 or older were 1.22 (95%CI: 1.09; 1.36) and 1.16 (95%CI: 1.07; 1.27), respectively. The differences between subgroup odds ratios were not statistically significant. Conclusion: The incidence of sudden cardiac death is markedly increased on Monday, similar for men and women, and for subjects below and above 65 years of age.