Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p<0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):
Background:The developing world is currently facing a double epidemic of communicable and non-communicable diseases. There is a growing body of knowledge recognizing an interaction between the two epidemics. Here we report a case of active pulmonary tuberculosis and acute myocardial infarction. Case presentation: A 73 year old male who had recently been diagnosed with hypertension but with an otherwise unremarkable past medical history presented to the emergency department of the Timor-Leste National Referral Hospital with chest pain and shortness of breath of one weeks duration. There was a positive history of intermittent fever, dry cough and weight loss over the preceding 3-4 weeks. His 12-lead electrocardiogram showed ST-segment elevation in the inferior leads and chest X-ray was characteristic of miliary tuberculosis. Echocardiography showed low ejection fraction and left ventricular inferior wall aneurysm. Cardiac enzymes as well as cardiac catheterization were not available in the hospital. He was managed with medical therapy for myocardial infarction without reperfusion therapy. He initially showed improvement in his clinical parameters (Chest pain, Heart rate, Blood pressure, Oxygen saturations, and fever) but succumbed to sudden cardiac arrest after 10 days of hospital admission. Post mortem examination was not done. Conclusion: The presentation of acute myocardial infarction in this patient with active tuberculosis and an otherwise benign past medical history is in support of reports that tuberculosis plays an active role in the pathogenesis of acute myocardial infarction in some patients presenting with these two diseases.
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