Biomarker panel in sleep apnea patients after an acute coronary event

Bauça, Josep Miquel; Barceló, Antònia; Fueyo, Laura; Sanchís, Pilar; Piérola, Javier; Peña, Mónica de la; Arqué, Meritxell; Gómez, Cristina; Morell-García, Daniel; Sánchez-de-la-Torre, Alicia; Sánchez‐de‐la‐Torre, Manuel; Abad, Jorge; Durán-Cantolla, Joaquín; Mediano, Olga; Masdeu, María José; Gajate, Amaia Urrutia; Masa, Juan F.; Barbé, Ferrán

doi:10.1016/j.clinbiochem.2019.03.015

Cited by 2 publications

(4 citation statements)

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“…To our best knowledge, the current study is, to date, the largest study with 502 adults with CAD and concomitant OSA (n = 391) and no-OSA (n = 111) investigating the association of OSA with MPO and MMP-9 in CAD. The secondary analysis of a subgroup of patients from the ISAACC cohort included 361 adults with acute coronary syndrome and found no significant differences between patients with OSA versus no-OSA [30], which is in line with our results. In our RICCADSA cohort, the proportion of current smokers at baseline were 17% among the patients with OSA and 26% in no-OSA whereas corresponding numbers were 44.5% vs. 47.4%, respectively, in the ISAACC trial.…”

Section: Discussionsupporting

confidence: 90%

“…The methodology of the main trial has been explained in detail previously [ 31 , 32 , 33 ]. In brief, CAD patients who underwent revascularization (percutaneous coronary intervention or CABG) in Skaraborg County, West Sweden, were invited to participate [ 30 ]. All participants were investigated with home sleep apnea testing (HSAT) in a stable condition following the revascularization procedure.…”

Section: Methodsmentioning

confidence: 99%

“…The study participants’ anthropometrics, smoking habits, medical history, and medications were obtained from the medical records as previously described [ 30 ]. Body mass index (BMI) was calculated by dividing weight (kg) by square of the height (m).…”

Section: Methodsmentioning

confidence: 99%

“…Circulating MMP-9 levels were found to be elevated among patients with CAD and concomitant OSA in a small Turkish case–control study [ 29 ]. Recently, no significant differences were found regarding the circulating MPO and MMP-9 levels in 209 CAD patients with OSA compared to the levels in 152 patients without OSA among the participants of the ISAACC (CPAP in Patients with Acute Coronary Syndrome and OSA) trial [ 30 ]. Of note, almost half of the ISAACC study cohort were current smokers at baseline, which might have contributed to neutral findings with regard to the composite endpoints in that study.…”

Section: Introductionmentioning

confidence: 99%

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Current Smoking Determines the Levels of Circulating MPO and MMP-9 in Adults with Coronary Artery Disease and Obstructive Sleep Apnea

Özkan

Çelik

Yucel‐Lindberg

et al. 2023

JCM

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(1) Background: Obstructive sleep apnea (OSA) is common in patients with coronary artery disease (CAD), in which a rupture of atherosclerotic plaques and oxidative stress play a role in the initiation and progression of the disorder. Circulating levels of myeloperoxidase (MPO), as an oxidative stress marker, as well as matrix metalloproteinase-9 (MMP-9), as a destabilizer of plaques, are known to be elevated in patients with CAD and are associated with worse prognosis. Some studies have suggested that OSA is associated with MPO and MMP-9, but the effect of OSA on these biomarkers in cardiac cohorts is unknown. (2) Aims: We addressed the determinants of high MPO and MMP-9 in a CAD cohort with concomitant OSA. (3) Materials and Methods: The current study was a secondary analysis of the RICCADSA trial that was conducted in Sweden between 2005 and 2013. A total of 502 revascularized CAD patients with OSA (apnea–hypopnea index [AHI] ≥ 15 events/h; n = 391) or no-OSA (AHI < 5 events/h; n = 101), based on a home sleep apnea test, and who had blood samples at baseline were included in the analysis. The patients were dichotomized into a high or low MPO and MMP-9 groups, based on the median cut-off values. (4) Results: The mean age of the participants was 63.9 (±8.6), and 84% of the study cohort were men. Median values of MPO and MMP-9 levels were 116 ng/mL and 269 ng/mL, respectively. In different multivariate linear and logistic regression models, neither OSA nor OSA severity in terms of AHI and oxygenation indices were associated with the high MPO and MMP-9 levels. Current smoking was significantly associated with both high MPO (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.06–2.84; p = 0.030) and high MMP-9 levels (OR 2.41, 95% CI 1.44–4.03; p < 0.001), respectively. Other significant determinants were revealed as beta blocker use (OR 1.81, 95% CI 1.04–3.16; p = 0.036) for high MPO as well as male sex (OR 2.07, 95% CI 1.23–3.50; p = 0.006) and calcium antagonist use (OR 1.91, 95% CI 1.18–3.09; p = 0.008) for high MMP-9 levels. (5) Conclusions: Current smoking, but not OSA, was significantly associated with high MPO and MMP-9 levels in this revascularized CAD cohort. Smoking status should be seriously taken into consideration while evaluating the effects of OSA and its treatment on long-term adverse cardiovascular outcomes in adults with CAD.

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Section: Discussionsupporting

confidence: 90%