Chi-Hang Lee1, See-Meng Khoo2, Bee-Choo Tai3, Eric Y Chong4, Cindy Lau5, Yemon Than5, Dong-Xia Shi5, Li-Ching Lee4, Anand Kailasam4, Adrian F Low6, Swee-Guan Teo4, Huay-Cheem Tan6. 1. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; The Heart Institute, National University Hospital, Singapore. Electronic address: mdclchr@nus.edu.sg. 2. Department of Medicine, National University Hospital, Singapore. 3. Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 4. The Heart Institute, National University Hospital, Singapore. 5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 6. The Heart Institute, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Abstract
BACKGROUND: We investigated the prevalence and predictors of obstructive sleep apnea (OSA) in patients admitted to the hospital for acute myocardial infarction and whether OSA has any association with microvascular perfusion after primary percutaneous coronary intervention (PCI). METHODS: Recruited patients were scheduled to undergo an overnight sleep study between 2 and 5 days after primary PCI. An apnea-hypopnea index (AHI) of > or = 15 was considered diagnostic of OSA. Impaired microvascular perfusion after primary PCI was defined as an ST-segment resolution of < or = 70%, myocardial blush grade 0 or 1, or a corrected Thrombolysis in Myocardial Infarction (TIMI) [antegrade flow scale] frame count > 28. RESULTS: Sleep study was performed in 120 patients and completed in 105 patients (study cohort, mean age 53 +/- 10 years, male 98%) with uncomplicated myocardial infarction. An AHI was > or = 15 in 69 patients (OSA-positive), giving a prevalence of 65.7%. Diabetes mellitus was found to be a significant risk factor for OSA (odds ratio, 2.86; 95% confidence interval, 1.06 to 8.24; p = 0.033). There were no differences between OSA-positive and OSA-negative groups with regard to the percentage of patients with < or = 70% ST-segment resolution (73% vs 64%, respectively; p = 0.411), myocardial blush grade 0 or 1 (39.1% vs 38.9%, respectively; p = 1.000), or corrected TIMI frame count > 28 (21.7% vs 25.0%, respectively; p = 0.807). CONCLUSIONS: We found a high prevalence of previously undiagnosed OSA in patients admitted with acute myocardial infarction. Diabetes mellitus was independently associated with OSA. No evidence indicated that OSA is associated with impaired microvascular perfusion after primary PCI.
BACKGROUND: We investigated the prevalence and predictors of obstructive sleep apnea (OSA) in patients admitted to the hospital for acute myocardial infarction and whether OSA has any association with microvascular perfusion after primary percutaneous coronary intervention (PCI). METHODS: Recruited patients were scheduled to undergo an overnight sleep study between 2 and 5 days after primary PCI. An apnea-hypopnea index (AHI) of > or = 15 was considered diagnostic of OSA. Impaired microvascular perfusion after primary PCI was defined as an ST-segment resolution of < or = 70%, myocardial blush grade 0 or 1, or a corrected Thrombolysis in Myocardial Infarction (TIMI) [antegrade flow scale] frame count > 28. RESULTS: Sleep study was performed in 120 patients and completed in 105 patients (study cohort, mean age 53 +/- 10 years, male 98%) with uncomplicated myocardial infarction. An AHI was > or = 15 in 69 patients (OSA-positive), giving a prevalence of 65.7%. Diabetes mellitus was found to be a significant risk factor for OSA (odds ratio, 2.86; 95% confidence interval, 1.06 to 8.24; p = 0.033). There were no differences between OSA-positive and OSA-negative groups with regard to the percentage of patients with < or = 70% ST-segment resolution (73% vs 64%, respectively; p = 0.411), myocardial blush grade 0 or 1 (39.1% vs 38.9%, respectively; p = 1.000), or corrected TIMI frame count > 28 (21.7% vs 25.0%, respectively; p = 0.807). CONCLUSIONS: We found a high prevalence of previously undiagnosed OSA in patients admitted with acute myocardial infarction. Diabetes mellitus was independently associated with OSA. No evidence indicated that OSA is associated with impaired microvascular perfusion after primary PCI.
Authors: Nick A Antic; Emma Heeley; Craig S Anderson; Yuanming Luo; Jiguang Wang; Bruce Neal; Ron Grunstein; Ferran Barbe; Geraldo Lorenzi-Filho; Shaoguang Huang; Susan Redline; Nanshan Zhong; R Doug McEvoy Journal: Sleep Date: 2015-08-01 Impact factor: 5.849
Authors: Dominik Linz; Holger Woehrle; Thomas Bitter; Henrik Fox; Martin R Cowie; Michael Böhm; Olaf Oldenburg Journal: Clin Res Cardiol Date: 2015-04-23 Impact factor: 5.460
Authors: Fatima H Sert Kuniyoshi; Mark R Zellmer; Andrew D Calvin; Francisco Lopez-Jimenez; Felipe N Albuquerque; Christelle van der Walt; Ivani C Trombetta; Sean M Caples; Abu S Shamsuzzaman; Jan Bukartyk; Tomas Konecny; Apoor S Gami; Tomas Kara; Virend K Somers Journal: Chest Date: 2011-05-19 Impact factor: 9.410
Authors: Shuchita Gupta; Beatriz Cepeda-Valery; Abel Romero-Corral; Abu Shamsuzzaman; Virend K Somers; Gregg S Pressman Journal: J Clin Sleep Med Date: 2012-12-15 Impact factor: 4.062
Authors: Bernardo J Selim; Brian B Koo; Li Qin; Sangchoon Jeon; Christine Won; Nancy S Redeker; Rachel J Lampert; John P Concato; Dawn M Bravata; Jared Ferguson; Kingman Strohl; Adam Bennett; Andrey Zinchuk; Henry K Yaggi Journal: J Clin Sleep Med Date: 2016-06-15 Impact factor: 4.062