H Ben Ahmed1, H Boussaid2, S Longo3, R Tlili4, S Fazaa5, H Baccar6, M R Boujnah7. 1. Department of cardiology, Charles Nicolle University Hospital, 1006 Bab Saadoun, Tunisia. Electronic address: halfaouine2002@yahoo.fr. 2. Department of cardiology, Charles Nicolle University Hospital, 1006 Bab Saadoun, Tunisia. Electronic address: boussaidhoussem@hotmail.fr. 3. Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: salma.longo@yahoo.fr. 4. Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: ramihenia@gmail.com. 5. Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: fazaasamia@yahoo.fr. 6. Department of cardiology, Charles Nicolle University Hospital, 1006 Bab Saadoun, Tunisia. Electronic address: baccar.hedi@yahoo.fr. 7. Department of Cardiology, Mongi Slim University Hospital, Sidi Daoud, 2046 La Marsa, Tunisia. Electronic address: rachidboujnah@yahoo.fr.
Abstract
BACKGROUND: Obstructive sleep apnea (OSA) may lead to myocardial preconditioning by increasing coronary collateral vessel recruitment in patients with acute coronary occlusion. AIM: To determine the relationship between the severity of obstructive sleep apnea and coronary collaterality during acute myocardial infarction. METHODS: This study prospectively included 71 patients with an inaugural myocardial infarction who had undergone a coronary angiography within 24h of onset. All patients underwent an overnight polygraph before discharge and were classified according to the apnea-hypopnea index (AHI). Coronary collaterals were scored by visual analyses and according to the Rentrop grading system. RESULTS: Mean age was 59±11years and 83% of patients were men. All patients had complete or subtotal occlusion of the infarct-related artery. After the sleep study, patients were divided into two groups: 25 were suffering from OSA (AHI>15/h). Patients with OSA showed better collateral vessel development (Rentrop score≥1) compared to non-OSA patients (68 vs. 41%, P=0.032). AHI was significantly higher in patients with developed coronary collaterals (Rentrop≥1) compared to those without collaterality (17.74±13.2 vs. 12.24±10.9, P=0.025). CONCLUSION: Coronary collateral development may be increased in OSA patients who are presenting with a first myocardial infarction.
BACKGROUND:Obstructive sleep apnea (OSA) may lead to myocardial preconditioning by increasing coronary collateral vessel recruitment in patients with acute coronary occlusion. AIM: To determine the relationship between the severity of obstructive sleep apnea and coronary collaterality during acute myocardial infarction. METHODS: This study prospectively included 71 patients with an inaugural myocardial infarction who had undergone a coronary angiography within 24h of onset. All patients underwent an overnight polygraph before discharge and were classified according to the apnea-hypopnea index (AHI). Coronary collaterals were scored by visual analyses and according to the Rentrop grading system. RESULTS: Mean age was 59±11years and 83% of patients were men. All patients had complete or subtotal occlusion of the infarct-related artery. After the sleep study, patients were divided into two groups: 25 were suffering from OSA (AHI>15/h). Patients with OSA showed better collateral vessel development (Rentrop score≥1) compared to non-OSA patients (68 vs. 41%, P=0.032). AHI was significantly higher in patients with developed coronary collaterals (Rentrop≥1) compared to those without collaterality (17.74±13.2 vs. 12.24±10.9, P=0.025). CONCLUSION: Coronary collateral development may be increased in OSA patients who are presenting with a first myocardial infarction.
Authors: Nura Festic; David Alejos; Vikas Bansal; Lesia Mooney; Paul A Fredrickson; Pablo R Castillo; Emir Festic Journal: J Clin Sleep Med Date: 2018-01-15 Impact factor: 4.062