Shift Work and the Risk of Coronary Artery Disease: A Cardiac Computed Tomography Angiography Study

Abstract

Aims: Shift work disrupts the normal circadian rhythm and is associated with risk factors for coronary artery disease (CAD) and a higher incidence of CAD morbidity and mortality. Cardiac computed tomography angiography (CCTA) is a robust noninvasive modality for assessing the presence, extent, and severity of CAD. We sought to investigate whether shift workers are prone to a higher burden of CAD compared to non-shift workers. Methods: We conducted a historically prospective study in consecutive patients who underwent CCTA and answered a telephonic questionnaire. Due to significant differences in age and gender, we compared 89 well-matched pairs of shift workers and non-shift workers with the use of propensity scores. Results: Our cohort consisted of 349 participants, of whom 94 (26.9%) were shift workers. The mean age was 50.7 years, and 62.5% were males. After pairing, we showed that shift workers had a higher prevalence of CAD than non-shift workers (74.2 vs. 53.9%, respectively, p = 0.01), and a lower prevalence of coronary calcium scores of zero (46.8 vs. 63.4%, respectively, p = 0.034). Stenosis >50% was more prevalent in shift workers than in non-shift workers (20.2 vs. 11.2%, respectively, p = 0.006), and the extent of CAD (defined as the presence of ≥1-vessel disease) tended to be higher in shift workers than in non-shift workers (25.8 vs. 13.5%, respectively, p = 0.06). Conclusions: In this CCTA study, we showed in a well-matched cohort of consecutive patients that shift workers had a higher prevalence and extent of CAD than non-shift workers.

24-h Activity Rhythms and Health in Older Adults

“…A longitudinal population-based study reported that a lower robustness of the rhythm and a lower amplitude were associated with an increased risk of overall cardiovascular disease, and that a lower mesor was associated with an increased risk of coronary heart disease [70•]. It has also been repeatedly shown that shift work is a risk factor for cardiometabolic disease, such as type 2 diabetes, obesity, and coronary artery disease [50,71,72]; the 24-h activity rhythm has however not been assessed in these studies. Most of these findings have been based on observational studies, making it difficult to determine the underlying mechanisms.…”

Circadian Rhythms: Will It Revolutionise the Management of Diseases?

“…Experimental studies have been carried out on animals that show that prolonged CR misalignment between the body and the external environment is a risk factor for heart disease, as the heart is no longer protected from injury [18]. In the morning, fibrinolysis decreases and heart rate, blood pressure, platelet reactivity, vasoconstriction and intra-arterial pressures increase, after the night-time dip.…”

The influence of shift work on health behaviors and self-reported health status of nurses

“…A rotating day/night shift work system puts strain on the body and disturbs the functioning of defense mechanisms. Exposure to negative factors may contribute to a higher incidence of health problems [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

“…System, w którym występują naprzemiennie zmiany nocne oraz dzienne trwające dwanaście godzin jest podstawową formą zatrudnienia personelu pielęgniarskiego [2]. W literaturze przedmiotu przedstawiane są liczne doniesienia wskazujące na niekorzystny wpływ pracy zmianowej na organizm ludzki, który zwiększa ryzyko wystąpienia schorzeń układu krążenia, układu pokarmowego, zaburzeń snu, zaburzeń neuropsychiatrycznych oraz dolegliwości bólowych [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Negatywne czynniki środowiskowe i zmianowy system pracy mogą również znacząco wpływać na stan zdrowia personelu pielęgniarskiego.…”

“…Zatrudnienie w systemie zmianowym, który obejmuje również pracę w godzinach nocnych wpływa obciążająco na organizm powodując zaburzenia jego mechanizmów obronnych. Narażenie osłabionego organizmu na działanie negatywnych czynników może przyczynić się do częstszego występowania dolegliwości zdrowotnych [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”