On May 24, the team of Bu Jun, a professor of Cardiology at Renji Hospital Affiliated to the Medical College of Shanghai Jiao Tong University, published a paper in the Journal of the American College of Cardiology, pointing out that the circadian rhythm disorders such as staying up late or working at night aggravate the myocardial injury after emergency reperfusion in patients with acute myocardial infarction and lead to poor long-term clinical prognosis** In the same period, the journal issued editorial comments, saying that this discovery provides new strategies and ideas for myocardial protection in patients with acute myocardial infarction.
Circadian rhythm disorder leads to poor prognosis in patients with myocardial infarction
The phenomenon of staying up late or working night shift is not uncommon in today's society, which leads to biological rhythm disorder and many health problems. Acute myocardial infarction is a major disease that affects the life and health of Chinese people. At present, it has become a consensus that acute cardiovascular events have the characteristics of circadian rhythm, but the risk of cardiovascular injury caused by circadian rhythm disorder is still unknown.
Through a prospective, multicenter clinical study, the researchers continuously included patients with acute ST segment elevation myocardial infarction who received emergency reperfusion surgery within 12 hours after onset. The primary clinical end point was myocardial infarction size after reperfusion, and the secondary clinical end point was major adverse cardiovascular events including death, myocardial infarction, heart failure and stroke.
The study found that night shift work significantly increased the risk of myocardial reperfusion injury and microcirculation disturbance in patients with acute myocardial infarction.
"During the 5-year median follow-up period, the risk of adverse cardiovascular events in night shift workers nearly tripled." "This is closely related to the increased risk of heart failure after myocardial infarction," Bu Jun explained
On this basis, the researchers verified the above clinical phenomena by using the preclinical large animal model, and found a new nuclear receptor regulatory signal pathway of myocardial biological clock.
This study suggests that maintaining rhythmic homeostasis is a potential myocardial protection strategy, which provides a new idea for improving the prognosis of patients with myocardial infarction.
Relevant paper information: https://doi Org/10.1016/j.jacc 2022.03.370
Author: zhangshuanghu, Huang Xin source: China Science Daily