On May 24, the team of Bu Jun, a professor of cardiology at Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, published a paper in the Journal of the American College of Cardiology, pointing out that circadian rhythm disorders such as staying up late or working at night aggravated myocardial injury after emergency reperfusion in patients with acute myocardial infarction, and led to long-term poor clinical prognosis. The journal also distributed editorial comments at the same time, believing that this finding provides a new strategy and idea for myocardial protection in patients with acute myocardial infarction.
Poor prognosis for patients with myocardial infarction caused by circadian rhythm disturbances Provided by the respondent
Staying up late or working in shift shifts is not uncommon in today’s society, which leads to many health problems caused by biorhythm disturbances. Acute myocardial infarction is a major disease affecting the life and health of our people, and it has become a consensus that acute cardiovascular events have circadian rhythm characteristics, but the risk of cardiovascular damage caused by circadian rhythm disorders remains unknown.
Through a prospective, multicenter clinical study, the investigators continuously included patients with acute ST-segment elevation myocardial infarction who underwent emergency reperfusion surgery within 12 hours of onset. The primary clinical endpoint was the area of myocardial infarction after reperfusion, and the secondary clinical endpoint was the primary adverse cardiovascular event including death, myocardial infarction, heart failure, and stroke.
Studies have found that night shift work significantly increases the risk of myocardial reperfusion injury and microcirculation disorders in patients with acute myocardial infarction.
“During the 5-year median follow-up period, night shift workers nearly tripled their risk of cardiovascular adverse events.” Bu Jun explained, “This is mainly related to the increased risk of heart failure after myocardial infarction. ”
On this basis, the researchers verified the above clinical phenomena using preclinical large animal models and discovered a new myocardial clock nucleus receptor regulatory signaling pathway.
This study suggests that maintaining rhythm homeostasis is a potential myocardial protection strategy and provides new ideas for improving the prognosis of patients with myocardial infarction. (Source: China Science Daily, Zhang Shuanghu, Huang Xin)
Related paper information:https://doi.org/10.1016/j.jacc.2022.03.370