{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:59:51Z","timestamp":1785347991737,"version":"3.55.0"},"reference-count":23,"publisher":"BMJ","funder":[{"name":"National Science and Technology Innovation 2030 Fund","award":["2023ZD0505606"],"award-info":[{"award-number":["2023ZD0505606"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2026,7,13]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study assessed whether China\u2019s workday-rescheduling policy is associated with short-term and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI), particularly in occupational groups more likely to be affected by rescheduling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted using data from the China Acute Myocardial Infarction registry between January 2013 and September 2014. A total of 15\u2009854 STEMI patients were included. Since individual adherence to workday rescheduling is not directly measured in the registry, occupational category was used as a proxy to define groups more likely versus less likely to be affected by the workday-rescheduling policy. The primary outcome was in-hospital all-cause mortality. Secondary outcomes included in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) and 2\u2009year all-cause mortality. Multivariable logistic and Cox regression models were used for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Using occupational category as a proxy for the likelihood of exposure to workday rescheduling, we stratified patients into a rescheduling-likely group (n=3141) and a rescheduling-unlikely group (n=12\u2009713). Among patients in the rescheduling-likely occupational group, in-hospital mortality was significantly higher during abnormal workdays than conventional weekdays (7.8% vs 3.44%; adjusted OR=3.01; 95%\u2009CI 1.40 to 6.45). Two-year mortality was also higher (adjusted HR=1.99; 95%\u2009CI 1.20 to 3.30). Among 12\u2009713 patients in the rescheduling-unlikely occupational group, no significant mortality differences were observed across temporal groups. Within the rescheduling-likely group, baseline characteristics and care quality indicators were generally comparable across the four temporal groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Workday-rescheduling-induced abnormal work cycles are associated with higher in-hospital and 2\u2009year adverse events in affected ST-segment elevation myocardial infarction patients. These findings should be interpreted as heterogeneity in the association between abnormal workdays and mortality by occupational likelihood of rescheduling exposure rather than as a direct individual-level causal effect of rescheduling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2025-225757","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:20:22Z","timestamp":1785345622000},"page":"jech-2025-225757","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Workday-rescheduling effects on ST-segment elevation myocardial infarction: a registry study analysis"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct01874691","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3062-8735","authenticated-orcid":false,"given":"Qize","family":"Li","sequence":"first","affiliation":[{"name":"Medical 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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ru","family":"Jiang","sequence":"additional","affiliation":[{"name":"Medical 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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duoer","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical 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, 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feilong","family":"Chen","sequence":"additional","affiliation":[{"name":"Medical 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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Li","sequence":"additional","affiliation":[{"name":"Medical 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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Medical 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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingang","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuejin","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojin","family":"Gao","sequence":"additional","affiliation":[{"name":"Coronary Heart 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