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Heart surgery in afternoon less risky due to body clock

Patients who have open heart surgery in the afternoon could be at less risk of adverse effects than those who have morning operations, due to the body's internal clock, researchers say.

Patients who have open heart surgery in the afternoon could be at less risk of adverse effects than those who have morning operations, due to the body's internal clock, researchers say.


Open heart surgery. Picture: Getty Images

The body clock, or circadian rhythm, regulates when people feel the need to eat, sleep or wake up.

A study in The Lancet found nearly 300 genes linking the body clock to heart damage.

Major cardiac events

It also identified a link between a person’s body clock, their risk of heart damage and major events such as heart attacks after heart surgery.

Researchers looked at the medical records of 596 people who had heart valve replacement surgery, half in the morning and half in the afternoon.

They checked for any major cardiac events such as a heart attack, heart failure or death from heart disease in the study, which took place between 2009 and 2015.

They found that 28 of 298 afternoon patients had adverse events while 54 of 298 morning patients experienced such events.

Tissue damage

The team also tracked 88 patients randomly scheduled for heart valve replacement surgery in the morning or afternoon between January 2016 and February 2017.

Those who had afternoon surgery had lower levels of heart tissue damage after surgery.

Tests on heart tissue samples from 30 of the patients showed afternoon surgery samples more quickly regained their ability to contract when put in conditions similar to the heart refilling with blood.

Genetic analysis of these samples also showed that 287 genes linked to the circadian clock were more active in the afternoon surgery sample.


Montaigne D et al (2017) Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbα antagonism: a single-centre propensity-matched cohort study and a randomised study. The Lancet. doi:org/10.1016/S0140-6736(17)32132-3

 

 

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