Impact of Obstructive Sleep Apnea on the Levels of Placental Growth Factor (PlGF) and Their Value for Predicting Short-Term Adverse Outcomes in Patients with Acute Coronary Syndrome

Abstract

BackgroundPlacental growth factor (PlGF) induces angiogenesis and promotes tissue repair, and plasma PlGF levels change markedly during acute myocardial infarction (AMI). Currently, the impact of obstructive sleep apnea (OSA) in patients with AMI is a subject of debate. Our objective was to evaluate the relationships between PlGF levels and both the severity of acute coronary syndrome (ACS) and short-term outcomes after ACS in patients with and without OSA.MethodsA total of 538 consecutive patients (312 OSA patients and 226 controls) admitted for ACS were included in this study. All patients underwent polygraphy in the first 72 hours after hospital admission. The severity of disease and short-term prognoses were evaluated during the hospitalization period. Plasma PlGF levels were measured using an electrochemiluminescence immunoassay.ResultsPatients with OSA were significantly older and more frequently hypertensive and had higher BMIs than those without OSA. After adjusting for age, smoking status, BMI and hypertension, PlGF levels were significantly elevated in patients with OSA compared with patients without OSA (19.9 pg/mL, interquartile range: 16.6–24.5 pg/mL; 18.5 pg/mL, interquartile range: 14.7–22.7 pg/mL; p<0.001), and a higher apnea-hypopnea index (AHI) was associated with higher PlGF concentrations (p<0.003). Patients with higher levels of PlGF had also an increased odds ratio for the presence of 3 or more diseased vessels and for a Killip score>1, even after adjustment.ConclusionsThe results of this study show that in patients with ACS, elevated plasma levels of PlGF are associated with the presence of OSA and with adverse outcomes during short-term follow-up.Trial RegistrationClinicalTrials.gov NCT01335087

Circulating Anti-Sorting Nexins 16 Antibodies as an Emerging Biomarker of Coronary Artery Disease in Patients with Obstructive Sleep Apnea

“…Sun et al [32] reported that higher circulating ESM-1, previously named endothelial cell-specific molecule-1, correlated with the presence of CAD in patients with OSA. Furthermore, several studies demonstrated that the level of placental growth factor (PIGF), as a biomarker of ACS, was significantly higher in patients with OSA [33]. Thus, although a single marker might not be sufficient as a predictive biomarker of ACS in patients with OSA, a combination of several biomarkers including SNX-16 Ab may have a predictive potential in future clinical practice.…”

Obstructive sleep apnoea in acute coronary syndrome

“…After adjusting for these parameters, PIGF levels were significantly higher in OSA patients compared to controls and the AHI correlated with PIGF. In addition, patients with high PIGF levels showed more diseased vessels [70]. MATSUMURA et al…”

“…As hypoxia induces PIGF, it might be hypothesised that the presence and severity of OSA influence its plasma level. BARCELO et al [70] included 538 patients admitted for ACS; 312 were defined as OSA patients (AHI >15 events•h −1 ), while 226 served as controls. The two groups differed in age, BMI and prevalence of hypertension; all these parameters had higher values in the OSA group.…”

Cell Death Biomarkers and Obstructive Sleep Apnea: Implications in the Acute Coronary Syndrome

“…3,4 Although OSA has been suggested as an independent risk factor for cardiovascular events, the molecular mechanisms underlying such relationship are not clear to date. 5,6 During cell death, intracellular components are leaked into the bloodstream. Therefore, a myriad of biochemical markers is currently detected and quantified in blood for the assessment of human pathologies.…”

“…; Aina Yañez 2,3 ; Laura Fueyo 1 ; Mónica de la Peña 2,4,5 ; Javier Pierola 2 ; Alicia Sánchez-de-la-Torre 5,6 ; Olga Mediano 5,7 ; Valentín Cabriada-Nuño 8 ; María José Masdeu 9 ; Joaquin Teran-Santos 5,10 ; Joaquin Duran-Cantolla 5,11 ; Juan Fernando Masa 5,12 ; Jorge Abad 5,13 ; Manuel Sanchez-de-la-Torre 5,6 ; Ferran Barbé 5,6 ; Antònia Barceló 1,2,5…”