Carlos Henrique G Uchôa1, Naury de Jesus Danzi-Soares2, Flávia S Nunes2, Altay A L de Souza3, Flávia B Nerbass2, Rodrigo P Pedrosa4, Luiz Antonio M César5, Geraldo Lorenzi-Filho2, Luciano F Drager6. 1. Sleep Laboratory, Pulmonary Division, University of São Paulo Medical School, São Paulo; Hypertension Unit, University of São Paulo Medical School, São Paulo. 2. Sleep Laboratory, Pulmonary Division, University of São Paulo Medical School, São Paulo. 3. Physicobiology Department, Federal University, São Paulo. 4. Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Pernambuco, Brazil. 5. Clinical Unit of Chronic Coronary Heart Disease, Heart Institute (InCor), University of São Paulo Medical School, São Paulo. 6. Hypertension Unit, University of São Paulo Medical School, São Paulo; Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo. Electronic address: luciano.drager@incor.usp.br.
Abstract
BACKGROUND: The impact of OSA on new cardiovascular events in patients undergoing coronary artery bypass graft (CABG) surgery is poorly explored. METHODS: Consecutive patients referred for CABG underwent clinical evaluation and standard polysomnography in the preoperative period. CABG surgery data, including percentage of off-pump and on-pump CABG, number of grafts, and intraoperative complications, were collected. The primary end point was major adverse cardiac or cerebrovascular events (MACCEs) (combined events of all-cause death, myocardial infarction, repeated revascularization, and cerebrovascular events). Secondary end points included individual MACCEs, typical angina, and arrhythmias. Patients were evaluated at 30 days (short-term) and up to 6.1 years (long term) after CABG. RESULTS: We studied 67 patients (50 men; mean age, 58 ± 8 years; mean BMI, 28.5 ± 4.1 kg/m2). OSA (apnea-hypopnea index ≥ 15 events/h) was present in 56% of the population. The patients were followed for a mean of 4.5 years (range, 3.2-6.1 years). No differences were observed in the short-term follow-up. In contrast, MACCE (35% vs 16%, P = .02), new revascularization (19% vs 0%, P = .01), episodes of typical angina (30% vs 7%, P = .02), and atrial fibrillation (22% vs 0%, P = .0068) were more common in patients with than without OSA in the long-term follow-up. OSA was an independent factor associated with the occurrence of MACCE, repeated revascularization, typical angina, and atrial fibrillation in the multivariate analysis. CONCLUSIONS: OSA is independently associated with a higher rate of long-term cardiovascular events after CABG and may have prognostic and economic significance in CABG surgery.
BACKGROUND: The impact of OSA on new cardiovascular events in patients undergoing coronary artery bypass graft (CABG) surgery is poorly explored. METHODS: Consecutive patients referred for CABG underwent clinical evaluation and standard polysomnography in the preoperative period. CABG surgery data, including percentage of off-pump and on-pump CABG, number of grafts, and intraoperative complications, were collected. The primary end point was major adverse cardiac or cerebrovascular events (MACCEs) (combined events of all-cause death, myocardial infarction, repeated revascularization, and cerebrovascular events). Secondary end points included individual MACCEs, typical angina, and arrhythmias. Patients were evaluated at 30 days (short-term) and up to 6.1 years (long term) after CABG. RESULTS: We studied 67 patients (50 men; mean age, 58 ± 8 years; mean BMI, 28.5 ± 4.1 kg/m2). OSA (apnea-hypopnea index ≥ 15 events/h) was present in 56% of the population. The patients were followed for a mean of 4.5 years (range, 3.2-6.1 years). No differences were observed in the short-term follow-up. In contrast, MACCE (35% vs 16%, P = .02), new revascularization (19% vs 0%, P = .01), episodes of typical angina (30% vs 7%, P = .02), and atrial fibrillation (22% vs 0%, P = .0068) were more common in patients with than without OSA in the long-term follow-up. OSA was an independent factor associated with the occurrence of MACCE, repeated revascularization, typical angina, and atrial fibrillation in the multivariate analysis. CONCLUSIONS: OSA is independently associated with a higher rate of long-term cardiovascular events after CABG and may have prognostic and economic significance in CABG surgery.
Authors: Luciano F Drager; Vsevolod Y Polotsky; Christopher P O'Donnell; Sergio L Cravo; Geraldo Lorenzi-Filho; Benedito H Machado Journal: Am J Physiol Heart Circ Physiol Date: 2015-07-31 Impact factor: 4.733
Authors: Luciano F Drager; Thauany M Tavoni; Vanessa M Silva; Raul D Santos; Rodrigo P Pedrosa; Luiz A Bortolotto; Carmen G Vinagre; Vsevolod Y Polotsky; Geraldo Lorenzi-Filho; Raul C Maranhao Journal: J Lipid Res Date: 2018-04-08 Impact factor: 5.922
Authors: Maria Tafelmeier; Teresa Weizenegger; Sarah Ripfel; Miriam Fauser; Bernhard Floerchinger; Daniele Camboni; York Zausig; Sigrid Wittmann; Marzena A Drzymalski; Florian Zeman; Christof Schmid; Lars S Maier; Stefan Wagner; Michael Arzt Journal: Clin Res Cardiol Date: 2018-06-12 Impact factor: 5.460