Effect of CPAP treatment on plasma high sensitivity troponin levels in patients with obstructive sleep apnea

Barceló, Antònia; Esquinas, Cristina; Bauçà, Josep Miquel; Piérola, Javier; Peña, Mónica de la; Arqué, Meritxell; Sánchez‐de‐la‐Torre, Manuel; Alonso-Fernández, Alberto; Barbé, Ferrán

doi:10.1016/j.rmed.2014.04.005

Cited by 20 publications

(19 citation statements)

References 13 publications

(11 reference statements)

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“…In an interesting finding, Barcelo and colleagues found an unanticipated increase in hs-cTnT levels after treatment with PAP for 12 months, compared with controls without OSA [130]. Subjective assessment of PAP adherence was not explicitly described in this study, and as such this may impact interpretation of the results.…”

Section: The Role Of Pap Therapy and Troponinsmentioning

confidence: 68%

“…Current evidence (see Table 3) primarily suggests that PAP adherence does not affect cTns [133][134][135] in the overall OSA population. However, one study showed a change in the levels of cTn, an increase in hs-cTnT levels with CPAP use [130].…”

Section: The Role Of Pap Therapy and Troponinsmentioning

confidence: 99%

“…Studies have suggested that the association between cTns and OSA is higher specifically in patients with OSA who have a known history of existing heart disease or a constellation of known cardiovascular risk factors [60,61,66,72,[129][130]. In a 2014 cross-sectional study using only OSA patients from the Akershus Sleep Apnea Project (ASAP) cohort (AHI >5), Einvik and colleagues found that after adjustment for age, gender, CAD and a host of factors associated with cardiovascular risk, increased OSA severity and nocturnal desaturations were independently associated with increased levels of hs-cTnI [60].…”

Section: Troponins As a Marker Of Cardiovascular Risk In Tjamentioning

confidence: 99%

“…Potential mechanisms by which PAP therapy may in fact raise hs-cTnT levels have been suggested and include cardiac adaptation, turnover of cardiomyocytes and a reversible change in the membrane permeability of cardiomyocytes, along with variations in intrathoracic pressures leading to increased hs-cTnT levels. The rise in this biomarker may therefore signal a repair process or evidence of cardiac stress that could occur with PAP therapy within this particular subgroup [130].…”

Section: The Role Of Pap Therapy and Troponinsmentioning

confidence: 99%

“…As with cTns, four studies showed that a rise in NT-proBNP levels after emergency TJA predicts in-hospital cardiac events [129,134] and increased 1- [128,129] and 2-year [130] mortality in patients aged 60-86 years, but did not predict 6-month mortality or cardiac complications in older adults aged 85 ± 9.6 years [132], who may have other competing co-morbidities. Table 5 summarizes data from studies that evaluated BNPs following elective TJA.…”

Section: Brain Natriuretic Peptides As a Marker Of Cardiovascular Rismentioning

confidence: 99%

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Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

et al. 2016

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Obstructive sleep apnea (OSA) is highly prevalent in patients undergoing total joint arthroplasty (TJA) and is a major risk factor for postoperative cardiovascular complications and death. Recognizing this, the American Society of Anesthesiologists urges clinicians to implement special considerations in the perioperative care of OSA patients. However, as the volume of patients presenting for TJA increases, resources to implement these recommendations are limited. This necessitates mechanisms to efficiently risk stratify patients having OSA who may be susceptible to post-TJA cardiovascular complications. We explore the role of perioperative measurement of cardiac troponins (cTns) and brain natriuretic peptides (BNPs) in helping determine which OSA patients are at increased risk for post-TJA cardiovascular-related morbidity.

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Section: The Role Of Pap Therapy and Troponinsmentioning

confidence: 68%

Section: The Role Of Pap Therapy and Troponinsmentioning

confidence: 99%

Section: Troponins As a Marker Of Cardiovascular Risk In Tjamentioning

confidence: 99%

Section: The Role Of Pap Therapy and Troponinsmentioning

confidence: 99%

Section: Brain Natriuretic Peptides As a Marker Of Cardiovascular Rismentioning

confidence: 99%

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Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

et al. 2016

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Markers of Myocardial Ischemia in Patients With Coronary Artery Disease and Obstructive Sleep Apnea: Effect of Continuous Positive Airway Pressure Therapy

Valo

Wons

Moeller

et al. 2015

Clinical Cardiology

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Background: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular complications. OSA and coronary artery disease (CAD) share the same risk factors and coexist in many patients. In previous studies, repeated nocturnal cardiac ischemic events in OSA patients with CAD have been reported. Hypothesis: We hypothesized that OSA may precipitate myocardial ischemia, evidenced by ST-segment depression and elevated N-terminal brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TropT) levels in patients with severe OSA and concomitant CAD. We also aimed to evaluate if the effects could be reversed by continuous positive airway pressure (CPAP) therapy. Methods: Twenty-one patients with severe OSA (apnea-hypopnea index >15/h, nadir oxygen desaturation ≤80%), and coexisting CAD underwent in-hospital polysomnography at baseline and under CPAP. Blood samples for hs-TropT and NT-proBNP measurements were drawn prior and immediately after sleep. ST-segment depression was measured at the time of maximum oxygen desaturation during sleep. Results: CPAP significantly decreased elevated NT-proBNP levels from 475 ± 654 pg/mL before sleep to 353 ± 573 pg/mL after sleep and attenuated ST-segment depression during sleep. hs-TropT was not elevated and did not differ after nocturnal oxygen desaturation at baseline and after CPAP. Conclusions: CPAP significantly reduced NT-proBNP in patients suffering from severe OSA and coexisting CAD. Repeated nocturnal myocardial ischemia did not cause myocyte necrosis evidenced by elevated hs-TropT or ST-segment depression.

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Effect of positive airway pressure on cardiac troponins in patients with sleep‐disordered breathing: A meta‐analysis

Wu¹,

Hong

Zhao

et al. 2022

Clinical Cardiology

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Background Cardiac troponins are highly sensitive and specific biomarkers for cardiac injury. Previous studies evaluating the effect of positive airway pressure (PAP) on cardiac troponins in patients with sleep‐disordered breathing (SDB) have yielded conflicting results. The meta‐analysis was performed to examine the effect of PAP on cardiac troponins in SDB patients. Methods PubMed, Web of Science, and EMBASE before September 2021 on original English language studies were searched. The data on cardiac troponins in both baseline and post‐PAP treatment were extracted from all studies. The data on the change of cardiac troponins in both PAP and control group were extracted from randomized controlled trials. Standardized mean difference (SMD) was used to synthesize quantitative results. Results A total of 11 studies were included. PAP treatment was not associated with a significant change in cardiac troponin T between the baseline and post‐PAP treatment (SMD = −0.163, 95% confidence interval [CI] = −0.652 to 0.326, z = 0.65, p = .514). The pooled estimate of SMD of cardiac troponin I between the pre‐ and post‐PAP treatment was 0.287, and the 95% CI was −0.586 to 1.160 (z = 0.64, p = .519). The pooled SMD of change of cardiac troponin T between the PAP group and control group was −0.473 (95% CI = −1.198 to 0.252, z = 1.28, p = .201). Conclusions This meta‐analysis revealed that PAP treatment was not associated with any change of cardiac troponin in SDB patients.

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Effect of CPAP treatment on plasma high sensitivity troponin levels in patients with obstructive sleep apnea

Cited by 20 publications

References 13 publications

Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

Markers of Myocardial Ischemia in Patients With Coronary Artery Disease and Obstructive Sleep Apnea: Effect of Continuous Positive Airway Pressure Therapy

Effect of positive airway pressure on cardiac troponins in patients with sleep‐disordered breathing: A meta‐analysis

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