Health

Don’t Use at Night – Common Sedative Can Increase the Risk of Heart Damage

Prescription Drug Concept

The drug, midazolam, is often used before surgery to make a patient feel more relaxed. According to a new study, it is associated with an increased risk of heart damage when surgeries are performed at night.

More evidence has been discovered by CU Anschutz researchers to back up the idea that timing is important when giving drugs.

According to a study conducted by researchers at the University of Colorado Anschutz Medical Campus, a popular drug that makes patients sleepy and less anxious before surgery is associated with an increased risk of heart damage when surgeries are performed at night.

The results provide further proof that a drug’s effectiveness might vary depending on the time it is administered.

“We performed a large dataset analysis and demonstrated that administering midazolam is associated with an increased risk of myocardial injury in non-cardiac surgery when surgeries occurred at night and in healthier patients,” said the study’s senior author Tobias Eckle, MD, Ph.D., professor of anesthesiology at the University of Colorado School of Medicine. “This is significant because these findings could have tremendous implications for patient mortality.”

The findings were recently published in the journal Frontiers of Cardiovascular Medicine.

Eckle is one of a select group of experts in chronotherapy, the practice of giving drugs at specific times of day to better align with circadian rhythms. Previous research conducted by him has shown that intense light can aid in the healing of damaged hearts and that certain proteins that are favorable to health are expressed more strongly at certain times of the day.

In this study, researchers used the vast Multicenter Perioperative Outcomes Group to evaluate 1,773,118 instances in which the sedative midazolam was given to 951,345 patients.

16,404 of the patients satisfied the criteria for myocardial injury (MINS). Although there was no connection between giving the drug and the risk of heart damage in the overall study population, researchers determined that the time the drug was administered was significant.

“We found a strong association between midazolam administration and risk of MINS when surgery occurred at night or with healthier patients,” said Eckle.

The reasons are unclear but may lie within the PER2 gene, a light-regulated protein that Eckle said helps protect the heart from injury. In mouse studies, investigators found a link between midazolam, circadian protein expression, and heart ischemia.

“That suggests midazolam interferes with the circadian system in humans,” Eckle said.

The drug increases the neurotransmitter GABA which inhibits certain brain signals to produce a calming effect. That in turn can lessen the expression of higher nighttime levels of PER2. As the levels decrease, the heart may become more susceptible to injury when the midazolam is given at night rather than during the day.

“This is the major focus of chronotherapy. Drugs can have different effects depending on when they are given,” Eckle said. “If you separate day and night there is a huge effect. For example, maybe we should not give anyone midazolam at night if it increases the risks of myocardial infarcts.”

Eckle said the entire field of chronotherapy is understudied and may hold clues to more effective use of routine therapies. He believes new drugs should be tested for the best time of day to be used. Blood pressure drugs, for example, tend to work best at night.

“Drugs are often administered according to what’s most efficient,” he said. “But what is most efficient, may in the end cause damage.”

Reference: “Time-of-day dependent effects of midazolam administration on myocardial injury in non-cardiac surgery” by Meghan Prin, Jack Pattee, David J. Douin, Benjamin K. Scott, Adit A. Ginde and Tobias Eckle, 28 October 2022, Frontiers in Cardiovascular Medicine.
DOI: 10.3389/fcvm.2022.982209

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  • You know what's really causing a lot of heart damage to people? The vaccine. The vaccine that after 2 years big pharma still will not stand behind and continue to run on an emergency use authorization.

    News today is that American musician rod Stewart's 11-year-old son has had a heart attack...when have you heard of kid's having heart attacks playing sports and whatnot?

    The scary thing is the medical industry and doctors just don't seem to want to know.

    • Although rare, there are several possible causes of a heart attack in childhood, such as:

      Congenital heart disease, or congenital heart defects, is an umbrella term for birth-related heart conditions. It affects around 1%Trusted Source of live births. Children with a history of certain congenital heart defects are at higher risk than others for having a heart attack from the blockage of a coronary artery.

      Anomalous origin of the left coronary artery An example of congenital heart disease is the anomalous origin of the left coronary artery. This occurs when the heart and blood vessels are forming. The left coronary artery connects to the pulmonary artery instead of the aorta in the heart. When the heart does not get enough blood from the coronary arteries, it begins to fail, similar to what occurs during a myocardial infarction or heart attack.

      However, this is also a rare occurrence, comprising less than 1% of all congenital heart defects in children.

      Acquired heart disease Acquired heart conditions develop after birth. Below are some examples of conditions a child may develop.

      Rheumatic heart disease This is the most common type of acquired heart disease in children, affecting 33.4 million peopleTrusted Source in 2015.Rheumatic fever can be a consequence of untreated strep pharyngitis or strep throat. However, it is uncommon in places where doctors readily treat strep throat with antibiotics. If doctors do not treat rheumatic fever promptly, long-term heart damage, or rheumatic heart disease, may occur. Rheumatic heart disease weakensTrusted Source the valves between the chambers of the heart.

      Kasawki disease Kawasaki disease is another acquired condition that affects 9–20 in every 100,000Trusted Source children under five years in the United States. Kawasaki disease affects the coronary arteries due to acuteTrusted Source inflammation and the formation of coronary artery aneurysms, which may cause a myocardial infarction.

    • The son did NOT have a heart attack, just a bad panic attack. You should read the details of an article, not just the headline before you use the information!

      Do you even know if his son was vaccinated? Over the last 20 yrs or so, way before the COVID vaccine, there have been news reports about athletes in their teens and early 20s collapsing with heart attacks due to a hidden heart defect.

      Please give us the source for your data that vaccinated teens and young adult athletes are having heart attacks due to the vaccination.

  • @Phenry

    I understand your concern, but unfortunately, your post is irrelevant to the article, nevermind misleading at best and wrong at worst.

    Covid-19 infection itself causes heart damage (and other organ damage) to a lot of people, and that damage is much more common and usually worse than any such damage caused by the vaccine. To be fair, it would be nice if the vaccine never caused such damage, and it's a legitimate complaint. I'll take my chances with the vaccine over an unvaccinated bout of covid any day though.

    The Orange County Register reported on a 13 year old boy who died from heart problems he experienced while playing soccer in 2017. Google searches provide plenty of other examples of young sports players suffering heart problems prior to 2020.

    The original (and still effective, though not perfect) covid-19 vaccines are not under emergency use authorization. However, some updated versions that have been optimized for newer covid variants may be for a while. Nothing to see there.

  • Keep your crazy anti-vaccine comments to yourself. Kirstie Alley most likely died because of these crazy anti-vaccine conspiracies. She was 71 and looked amazing had she believed in the vaccines she might be alive

  • Rod Stewart’s son did NOT have a heart attack. He had a panic attack.
    Get your facts straight.

  • Although i am not an Anti-vaxer, I do believe people should decide for themselves on this one, though. FORCING people to take medical treatment is illegal. Period. I have SCL-70 pos Systemic Sclerosis with PAH (pulmonary arterial Hypertension for all non professionals). I chose not to take the vaccine because there was not enough research on how it effected people with blood clotting disorders (like myself.) I get all kinds of bullsh*t from all kinds of people, including doctors, medical professionals, people that try to tell me that they know my body more than I do; how MY BODY responds to different medications and/or injections. Thats funny 😂Like when i tried to tell a doctor and a nurse i thought something was wrong after a heart cath. They laughed me off..... turns out my feloral ven was leaking and i almost died from a retroperitenal hemorrhage. Or possibly the time that I was in labor, and kept telling the anesthesiologist that I was feeling my contractions… He told me there was no way possible. When I went to have a C-section and the doctor was cutting me open, I kept screaming I could feel it. The anesthesiologist was arguing with me . I almost stroked out on the table. Come to find out the catheter slipped out, so no medication is actually going into my epidural space and the doctor was cutting me open and I actually could feel it.

    Getting back to my point .... doctors and medical professionals DONT ALWAYS KNOW WHAT IS BEST FOR YOU. I've already had blood clots, so why the f*** would I want to get a vaccine when I already have multiple autoimmune disorders and vaccines have already been proven to give people auto immune diseases when vaccines are scientifically PROVEN to cause autoimmune diseases in families where people are predisposition to get them? I have a sisters, cousins, father, and grandmother with Lupus, AntiphosphoLipid (sp) Antibodies, RA, MS and a host of other things.

    I do get vaccines... prevnar, tetnus, shingles.... stuff like that. I did get Covid twice. I did get sick, but not at all like i was expecting. Neither did any of the 10+ of my 20 scleroderma support group that chose to not vaccinate. The only two we lost were in chemo for additional cancer. I ONOW THAT IF I DIE GETTING COVID.... its just my time. It is a personal choice; as long as people are following the restrictions. I AM NOT A NO MASK NO VAX A**HOLE. I do not agree with that and those people are infantile and should be put In jail.

    Also, i let my kids make up their iwn minds and they chose to get it.

    • At no point in any time has anyone ever been forced to take any vaccine or face legal action. Your entire point is bunk based on that alone. If so, you'd be in jail right now for not taking it. And you're not. You're here, spewing junk science and misinformation when you more than likely barely passed high school chemistry. God bless the USA I guess.

      • Clever, but although no one faced legal action, plenty lost their jobs and livelihoods. And there were plenty of covid nazi politicians that would have liked to pass legislation that had legal consequences for not taking the shot. Where is the data that shows that a person who got the shot would have definitely died if they had got the shot before infection? Jabs don’t prevent infection.

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University of Colorado Anschutz Medical Campus

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