Pareek Manan, Johansen Niklas Dyrby, Christensen Sine Højlund, Dyrvig Kristensen Anna Meta, Afzal Majid, Christina Frary Johanna Maria, Vaduganathan Muthiah, Olsen Michael Hecht, Sivapalan Pradeesh, Stæhr Jensen Jens Ulrik, Bhatt Deepak L, Biering-Sørensen Tor
Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte Hospital and Rigshospitalet, Copenhagen, Denmark.
Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte Hospital and Rigshospitalet, Copenhagen, Denmark.
JACC Adv. 2025 Sep 15;4(10 Pt 2):102147. doi: 10.1016/j.jacadv.2025.102147.
The incidence of certain disease events such as myocardial infarction, stroke, aortic rupture, and sudden cardiac death is affected by the time of day. It is thus theorized that synchronization of medication timing with circadian rhythmicity (or at the minimum, clock time) may improve treatment efficacy and/or reduce the risk of serious adverse events. We launched the C (Cardiovascular Circadian Chronotherapy) trial concept to efficiently conduct randomized, controlled, clinical outcome trials of the timing of medication administration. This concept takes advantage of the Danish nationwide administrative health registries for participant identification and collection of baseline and follow-up data as well as the mandatory governmental electronic letter system. Although many of these interventions may only provide small effect sizes, any positive effects from simple changes in the timing of drug administration could potentially lead to large, worldwide prognostic improvements.
某些疾病事件，如心肌梗死、中风、主动脉破裂和心源性猝死的发生率受一天中时间的影响。因此，理论上认为药物给药时间与昼夜节律（或至少与时钟时间）同步可能会提高治疗效果和/或降低严重不良事件的风险。我们发起了C（心血管昼夜时间疗法）试验概念，以高效地开展药物给药时间的随机对照临床结局试验。这一概念利用丹麦全国性行政健康登记系统来识别参与者并收集基线数据和随访数据，以及利用政府强制的电子信件系统。尽管许多此类干预措施可能只产生较小的效应量，但药物给药时间的简单改变所带来的任何积极影响都可能在全球范围内带来巨大的预后改善。
