Heart surgery risks double when operation is performed in the morning

Heart surgery? Slate it for the afternoon study says

To get an idea of how that stress is linked to time, the team looked at how complications - including heart attacks, heart failure, or death after surgery - changed from morning to afternoon to night.

PARIS-The risk of serious heart problems after open heart surgery almost doubles when the operation is performed in the morning rather than the afternoon, researchers said Friday.

He said the researchers had gone to great lengths to rule out differences in individual surgeons skills that might impact the outcomes of the surgeries studied, and said the differences were also not due to some surgeons simply not being "morning people".

In comparison, just 28 out of the 298 afternoon patients (9%) experienced adverse events.

The risk of having serious complications after open-heart surgery nearly doubles when the operation is performed in the morning rather than the afternoon, according to new research.

"The study also suggests that modifying the genes responsible for this phenomenon could lead to the development of new drugs to protect the heart from damage during open heart surgery". This could equate to one major event being avoided for every 11 patients who have afternoon surgery.

They tracked 596 patients who had heart valve replacement surgery. There were no deaths in either group and the average time in hospital was 12 days. "The circadian clock may affect outcomes from heart surgery, but understanding why-and how to leverage this information-requires more research".

Study author Professor David Montaigne, University of Lille, France, said: "Our study found that post-surgery heart damage is more common among people who have heart surgery in the morning, compared to the afternoon".

Thousands of people now have open heart surgery in the United Kingdom, procedures which can take many hours and come with a number of risks.

Not only did tissue from the afternoon group show less damage, it also regained the ability to contract more quickly in lab tests that mimicked the heart refilling with blood.

"If this finding can be replicated in other hospitals this could be helpful to surgeons planning their operating list, for non-urgent heart surgery". Genetic analysis showed that circadian rhythms 287 genes in heart tissues of the patients operated on in the afternoon, was more active.

Those who had their ops before noon had a one in five chance of a heart attack or heart failure in the following 500 days.

Dr Mike Knapton, associate medical director of the British Heart Foundation, said: "Thousands of people now have open heart surgery in the UK". They identified the Rev-Erbα gene "as a master switch in cardiomyocyte ischemia-reperfusion tolerance"-meaning by blocking or turning off its signaling pathway, the mice were able to recover from surgery after short sleep-to-wake transitions with fewer side effects".

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