Workday-rescheduling effects on ST-segment elevation myocardial infarction: a registry study analysis
Qize Li1, Ru Jiang1, Duoer Wang1
1Medical Research and Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Journal of Epidemiology and Community Health
|July 29, 2026
Summary
China's workday rescheduling policy increases mortality risk for ST-segment elevation myocardial infarction (STEMI) patients in high-exposure occupations. Abnormal work cycles are linked to worse short-term and long-term outcomes for these patients.
Area of Science:
- Cardiology
- Public Health
- Occupational Health
Background:
- Workday rescheduling policies aim to optimize economic activity but may disrupt established routines.
- The impact of such policies on vulnerable patient groups, like those with ST-segment elevation myocardial infarction (STEMI), is not well understood.
- Occupational groups may experience varying degrees of exposure to these policy-induced schedule changes.
Purpose of the Study:
- To assess the association between China's workday-rescheduling policy and short-term/long-term outcomes in STEMI patients.
- To investigate if occupational groups more likely to be affected by rescheduling face different outcomes.
- To analyze the relationship between abnormal work cycles and adverse events in STEMI patients.
Main Methods:
- A prospective cohort study utilized data from the China Acute Myocardial Infarction registry (January 2013-September 2014).
- 15,854 STEMI patients were included, with occupational category used as a proxy for rescheduling exposure.
- In-hospital mortality, major adverse cardiovascular and cerebrovascular events (MACCE), and 2-year mortality were analyzed using multivariable logistic and Cox regression models.
Main Results:
- Patients in rescheduling-likely occupations showed significantly higher in-hospital mortality (7.8% vs 3.44%) and 2-year mortality (adjusted HR=1.99) during abnormal workdays.
- No significant mortality differences were observed in rescheduling-unlikely occupational groups.
- Baseline characteristics and care quality were comparable across temporal groups within the rescheduling-likely cohort.
Conclusions:
- Workday-rescheduling-induced abnormal work cycles are associated with increased in-hospital and 2-year adverse events in STEMI patients.
- The findings suggest heterogeneity in mortality risk based on occupational likelihood of rescheduling exposure.
- The study highlights potential health implications of work schedule disruptions for STEMI patients in specific occupations.
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