Afternoon surgery has lower risk of complications

Heart attacks and heart failure less common in patients having heart operations in the afternoon as opposed to the morning.


New research has shown that patients who underwent heart surgery during the afternoon tend to have a lower risk of potentially fatal complications. It also highlights another approach to reducing complications.

The study is associated with the ability of the heart tissue to recover after being starved of blood supply during surgery.

Professor David Montaigne, the first author of the research, said, “The study suggests patients might fare better if they undergo afternoon surgery.”

“We have to find a drug that can alter the circadian clock to induce jet lag. Noting that it could also help to improve patient outcomes for heart attacks and organ transplantation.”

Scientists analyzed the data from 596 patients. Half of the patients had valve surgery in the morning and the remaining half in the afternoon. Patents who had morning surgery reported a major cardiac event, such as a heart attack or heart failure in the following 500 days. On the other hand, only 9% of patients who had afternoon surgery experienced such events.

Scientists later assigned 88 valve surgery patients and determined them by monitoring protein levels in their blood linked to heart tissue damage. They found that afternoon surgery patients had lower levels of protein after their operation. The patients had  20% fewer chances of heart damage.

For a detailed study, scientists took biopsies from 14-morning surgery patients and 16 afternoon surgery patients. The tissues from the latter recovered better after being deprived of oxygen.

With a period of-day impact likewise found in the recuperation of mouse heart tissue, the group investigated the effect of tinkering with the movement connected to one of the body clock qualities, both utilizing drugs and by taking a gander at mice without the quality. Both methodologies enhanced the recuperation of the heart tissue at the season of the day when it was regularly more terrible.

Dr. John O’Neill, an expert in circadian rhythms from the MRC Laboratory, said, “The research backed up previous work in mice and fruit flies that had explored the genes involved in the body clock, work which scooped a trio of scientists the Nobel prize for medicine earlier this month.”

“The biological clock, the circadian rhythm, is in every single cell of the body, therefore, it affects the biological activity of each cell type, commensurate with the function of those cells. In healthy humans, the heart is known to follow a daily pattern of activity and is not at its optimum performance in the morning.”

“But since systems including that of inflammation are also influenced by circadian rhythms, they too might play a role in the different outcomes for morning and afternoon surgeries.”

“What’s more, the study did not consider whether the surgeons performed the operation better in the afternoon, adding that more work needs to explore whether the findings would hold for patients at other hospitals or for other types of surgery.”

Professor Bryan Williams, chair of medicine at University College London, said, “The study builds on the fact that cardiovascular events, such as heart attacks, are more common in the morning. What this research suggests is that an intrinsic body clock within cells of the heart may render these cells more susceptible to injury during cardiac surgery in the morning versus the afternoon.”

“It was too soon to consider rescheduling heart surgeries to the afternoon, and that large-scale, robust clinical trials would be needed to probe the effect further. So you can see why we need to ask for your help. The Guardian’s independent investigative journalism takes a lot of time, money, and hard work to produce. But we do it because we believe our perspective matters – because it might well be your perspective.”

Scientists published the study in the journal The Lancet.


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