The non-uniform occurrence of myocardial ischaemia, with a trough at night and a peak in the morning, is at the base of the concept of a circadian distribution of coronary events. Cardiovascular variables known to influence the occurrence of ischaemia have similar rhythms, and a likely culprit could be hidden among them. Nevertheless, in many cases an identifiable trigger is lacking and the prediction of ischaemia is still elusive.
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