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

• Published in: Interactive cardiovascular and thoracic surgery Vol. 34; no. 1; pp. 105 - 110
• 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
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.01.2022
• Subjects: Aneurysm, Dissecting - diagnostic imaging; Aneurysm, Dissecting - epidemiology; Aneurysm, Dissecting - surgery; Cardiac and Cardiovascular Systems; Clinical Medicine; Cross-Over Studies; Dissection of the aorta; Humans; Incidence; Kardiologi; Kirurgi; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Moon; Retrospective Studies; Risk; Surgery; Moon; Dissection of the aorta
• ISSN: 1569-9285; 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivab220

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. The impact our nearest celestial body has on our ecosystem, society and humans has been studied and debated for at least 20 000 years [1] when humans first started to record the lunar cycle.