Impact of Obstructive Sleep Apnea on Clinical and Angiographic Outcomes Following Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome

Yumino, Dai; Tsurumi, Yukio; Takagi, Atsushi; Suzuki, Kaori; Kasanuki, Hiroshi

doi:10.1016/j.amjcard.2006.07.055

Cited by 197 publications

(172 citation statements)

References 22 publications

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“…First, we found that the presence of SDB was associated with poor long‐term outcomes in ACS patients following primary PCI, consistent with previous reports in which only patients with stable CAD were enrolled3, 4, 6 or short‐term outcomes were investigated in ACS patients following PCI 5, 7. This association was confirmed by several separate analytical techniques: conventional multivariable analysis using the presence or absence of SDB, multivariable analysis using AHI quartiles or logarithm‐transformed AHI instead of presence or absence of SDB, and comparisons using matched patients based on PS.…”

Section: Discussionsupporting

confidence: 90%

“…Conversely, several studies have shown a more obvious relationship between SDB and clinical outcomes in patients with CAD 3, 4, 5, 6, 7. Among patients with CAD, those with acute coronary syndrome (ACS) generally have higher mortality than patients with stable angina; moreover, prognosis following ACS remains poor despite therapeutic advances including percutaneous coronary intervention (PCI) 8, 9.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Sleep‐Disordered Breathing on Long‐Term Outcomes in Patients With Acute Coronary Syndrome Who Have Undergone Primary Percutaneous Coronary Intervention

Mazaki

Kasai

Yokoi³

et al. 2016

JAHA

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BackgroundSleep‐disordered breathing (SDB) has been recognized as an important risk factor for cardiovascular diseases; however, the impact of SDB on long‐term outcomes in patients with acute coronary syndrome has not been fully evaluated.Methods and ResultsWe performed overnight cardiorespiratory monitoring of 241 patients with acute coronary syndrome who were successfully treated with primary percutaneous coronary intervention between January 2005 and December 2008. The presence of SDB was defined as apnea–hypopnea index ≥5 events per hour. The end point was incidence of major adverse cardiocerebrovascular events, defined as a composite of all‐cause death, recurrence of acute coronary syndrome, nonfatal stroke, and hospital admission for congestive heart failure. Patients were followed for a median period of 5.6 years. Among the 241 patients who were finally enrolled, comorbidity of SDB with acute coronary syndrome was found in 126 patients (52.3%). The cumulative incidence of major adverse cardiocerebrovascular events was significantly higher in patients with SDB than in those without SDB (21.4% versus 7.8%, P=0.006). Multivariable analysis revealed that the presence of SDB was a significant predictor of major adverse cardiocerebrovascular events (hazard ratio 2.28, 95% CI 1.06–4.92; P=0.035).ConclusionsThe study's results showed that the presence of SDB among patients with acute coronary syndrome following primary percutaneous coronary intervention is associated with a higher incidence of major adverse cardiocerebrovascular events during long‐term follow‐up.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Impact of Sleep‐Disordered Breathing on Long‐Term Outcomes in Patients With Acute Coronary Syndrome Who Have Undergone Primary Percutaneous Coronary Intervention

Mazaki

Kasai

Yokoi³

et al. 2016

JAHA

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“…The prevalence of sleep apnoea in the acute phase after a first AMI in the current study is confirmed by several previous studies [5,6,[25][26][27]. NAKASHIMA et al [6] and YUMINO et al [25] performed their sleep studies between 14-21 days after primary PCI, whereas other previous studies used a similar time-point to the present study to assess sleep apnoea at baseline (,5 days after AMI) [5,26,28].…”

Section: Sleep-related Disorders S Buchner Et Alsupporting

confidence: 61%

“…NAKASHIMA et al [6] and YUMINO et al [25] performed their sleep studies between 14-21 days after primary PCI, whereas other previous studies used a similar time-point to the present study to assess sleep apnoea at baseline (,5 days after AMI) [5,26,28].…”

Section: Sleep-related Disorders S Buchner Et Almentioning

confidence: 91%

Natural course of sleep-disordered breathing after acute myocardial infarction

et al. 2012

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The aim of this study was to test whether an improvement of left ventricular ejection fraction (EF) in the early phase after acute myocardial infarction is associated with a reduction of the severity of central and obstructive sleep apnoea.40 consecutive patients with acute myocardial infarction underwent polysomnography and cardiovascular magnetic resonance imaging within 5 days and 12 weeks after the event to assess sleep apnoea and cardiac function. We stratified the sample in patients who improved their left ventricular EF within 12 weeks by o5% (improved EF group, DEF 9¡1%, n516) and in those who did not (unchanged EF group, DEF -1¡1%, n524).Prevalence of sleep apnoea (o15 apnoea and hypopnoea events?h -1 ) within f5 days after myocardial infarction was 55%. Apnoea and hypopnoea events?h -1 were significantly more reduced in the improved EF group compared with the unchanged EF group (-10¡3 versus 1¡3 events?h -1 ; p50.036). This reduction was based on a significant alleviation of obstructive events (-7¡2 versus 4¡3 events?h -1 ; p50.009), while the reduction of central events was similar between groups (p50.906).An improvement of cardiac function early after myocardial infarction is associated with an alleviation of sleep apnoea. This finding suggests that re-evaluation of treatment indication for sleep apnoea is needed when a change in cardiac function occurs.

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“…OSA may trigger the rupture of vulnerable plaques, leading to acute myocardial infarction 11,12 . OSA has been identified as an independent predictor of angiographic and clinical outcomes in coronary artery disease, such as cardiac death, myocardial infarction and reinfarction or revascularization after percutaneous coronary intervention 13,14 .…”

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confidence: 99%

Obstructive sleep apnea, detected by the Berlin Questionnaire: an associated risk factor for coronary artery disease

et al. 2012

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Obstructive sleep apnea (OSA), a risk factor for coronary artery disease, remains under diagnosed. We investigated if OSA identified by the Berlin Questionnaire (BQ) is associated with the risk of coronary artery disease. Cases were patients referred for elective coronariography. The cases were classified with significant coronary lesions (stenosis > 50% in an epicardial coronary) or without significant coronary lesions. Controls were selected from a population-based sample. Positive BQ results were identified in 135 (41.2%) of 328 cases, in contrast with 151 (34.4%) of 439 control subjects (p = 0.03). In a multinomial logistic analysis, the risk for OSA identified by the BQ was independently associated with coronary artery disease in cases with lesions of at least 50% (OR = 1.53; 95%CI: 1.02-2.30; p = 0.04). The risk from OSA identified by the BQ was higher in younger subjects (40-59 years) (OR = 1.76; 95%CI: 1.05-2.97; p = 0.03) and in women (OR = 3.56; 95%CI: 1.64-7.72; p = 0.001). In conclusion, OSA identified by the BQ greatly increases the risks of coronary artery disease in patients having significant coronary artery lesions indicated by anangiogram, particularly in younger individuals and in women.

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Impact of Obstructive Sleep Apnea on Clinical and Angiographic Outcomes Following Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome

Cited by 197 publications

References 22 publications

Impact of Sleep‐Disordered Breathing on Long‐Term Outcomes in Patients With Acute Coronary Syndrome Who Have Undergone Primary Percutaneous Coronary Intervention

Impact of Sleep‐Disordered Breathing on Long‐Term Outcomes in Patients With Acute Coronary Syndrome Who Have Undergone Primary Percutaneous Coronary Intervention

Natural course of sleep-disordered breathing after acute myocardial infarction

Obstructive sleep apnea, detected by the Berlin Questionnaire: an associated risk factor for coronary artery disease

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