Or rather, a rise in myocardial infarctions have been observed across all U.S. states during the darker winter months.363 Moreover, long-term night shift work linked to increased myocardial infarct size in patients with myocardial infarction.364 The exact mechanism by which the entrainment signal related to central clock reaches peripheral organs remains uncertain, but it could involve neuro-hormonal factors or autonomic innervation.307 However, specific phototherapy treatments can actually provide protective effects in simulating cardiac hypoxia/ischemia preconditioning as mentioned above. This evidence concerns the gene CLOCK and myocardial infarction.