Germaine Loo1, Adeline Y Tan2, Chieh-Yang Koo3, Bee-Choo Tai4, Mark Richards5, Chi-Hang Lee6. 1. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 2. Division of Respiratory and Critical Care Medicine, National University Health System, Singapore. 3. Department of Cardiology, National University Heart Centre Singapore, Singapore. 4. Saw Swee Hock School of Public Health, National University of Singapore, Singapore. 5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, Singapore. 6. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, Singapore. Electronic address: mdclchr@nus.edu.sg.
Abstract
OBJECTIVE: We aimed to determine the prognostic implications of obstructive sleep apnea (OSA) diagnosed during the recovery phase of acute coronary syndrome (ACS). METHODS: Patients presenting with ACS and treated with percutaneous coronary intervention were recruited prospectively for a home-based sleep study within 30 days of hospital discharge. Major adverse cardiac and cerebrovascular events (MACCEs) assessed included cardiac death, myocardial infarction, stroke, unplanned revascularization, and hospitalization for heart failure. RESULTS: Of the 85 patients recruited, 68 successfully completed the study. The median time from percutaneous coronary intervention to sleep study was 14 days (interquartile range: 7.5-27 days). OSA was diagnosed in 24 patients (35.3%) (apnea-hypopnea index > or =15). A drug-eluting stent was implanted into the target lesion in 45 patients (66.2%). None of the study patients had received treatment for OSA. At 24-month follow-up, the MACCE incidence was 34.9% in the OSA group and 5.1% in the non-OSA group (P=0.008, log-rank test). After adjusting for the possible confounding effect of age, gender, coronary intervention indications, hypertension, smoking, and body mass index, OSA remained an independent predictor of MACCEs (adjusted hazard ratio, 6.95; 95% confidence interval, 1.17-41.4; P=0.033). CONCLUSION: OSA diagnosed in patients treated with percutaneous coronary intervention for ACS by post-discharge sleep studies conducted 2 weeks after percutaneous coronary intervention was independently associated with MACCEs at 24-month follow-up.
OBJECTIVE: We aimed to determine the prognostic implications of obstructive sleep apnea (OSA) diagnosed during the recovery phase of acute coronary syndrome (ACS). METHODS:Patients presenting with ACS and treated with percutaneous coronary intervention were recruited prospectively for a home-based sleep study within 30 days of hospital discharge. Major adverse cardiac and cerebrovascular events (MACCEs) assessed included cardiac death, myocardial infarction, stroke, unplanned revascularization, and hospitalization for heart failure. RESULTS: Of the 85 patients recruited, 68 successfully completed the study. The median time from percutaneous coronary intervention to sleep study was 14 days (interquartile range: 7.5-27 days). OSA was diagnosed in 24 patients (35.3%) (apnea-hypopnea index > or =15). A drug-eluting stent was implanted into the target lesion in 45 patients (66.2%). None of the study patients had received treatment for OSA. At 24-month follow-up, the MACCE incidence was 34.9% in the OSA group and 5.1% in the non-OSA group (P=0.008, log-rank test). After adjusting for the possible confounding effect of age, gender, coronary intervention indications, hypertension, smoking, and body mass index, OSA remained an independent predictor of MACCEs (adjusted hazard ratio, 6.95; 95% confidence interval, 1.17-41.4; P=0.033). CONCLUSION: OSA diagnosed in patients treated with percutaneous coronary intervention for ACS by post-discharge sleep studies conducted 2 weeks after percutaneous coronary intervention was independently associated with MACCEs at 24-month follow-up.
Authors: R Nisha Aurora; Ciprian Crainiceanu; Daniel J Gottlieb; Ji Soo Kim; Naresh M Punjabi Journal: Am J Respir Crit Care Med Date: 2018-03-01 Impact factor: 21.405
Authors: Flavia C Maia; Alessandra C Goulart; Luciano F Drager; Henrique L Staniak; Itamar de Souza Santos; Paulo Andrade Lotufo; Isabela M Bensenor Journal: Arq Bras Cardiol Date: 2017-01 Impact factor: 2.000