Impact of Obstructive Sleep Apnea on Platelet Function Profiles in Patients With Acute Coronary Syndrome Taking Dual Antiplatelet Therapy

Gong, Wei; Xiao, Wang; Fan, Jingyao; Nie, Shaoping; Wei, Yongxiang

doi:10.1161/jaha.118.008808

Cited by 11 publications

(13 citation statements)

References 32 publications

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“…OSA has been identified as an independent risk factor for a large number of diseases. Among these, acute coronary syndrome (ACS) [ 111 ], atrial fibrillation (AF) [ 112 , 113 ], stroke [ 114 ], and venous thromboembolism (VTE) [ 115 , 116 ] are prominently represented.…”

Section: Potential Therapiesmentioning

confidence: 99%

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Obstructive Sleep Apnea, Hypercoagulability, and the Blood–Brain Barrier

Zolotoff

Bertoletti

Gozal

et al. 2021

JCM

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Obstructive sleep apnea (OSA) is characterized by repeated episodes of intermittent hypoxia (IH) and is recognized as an independent risk factor for vascular diseases that are mediated by a multitude of mechanistic pathophysiological cascades including procoagulant factors. The pro-coagulant state contributes to the development of blood clots and to the increase in the permeability of the blood–brain barrier (BBB). Such alteration of BBB may alter brain function and increase the risk of neurodegenerative diseases. We aim to provide a narrative review of the relationship between the hypercoagulable state, observed in OSA and characterized by increased coagulation factor activity, as well as platelet activation, and the underlying neural dysfunction, as related to disruption of the BBB. We aim to provide a critical overview of the existing evidence about the effect of OSA on the coagulation balance (characterized by increased coagulation factor activity and platelet activation) as on the BBB. Then, we will present the emerging data on the effect of BBB disruption on the risk of underlying neural dysfunction. Finally, we will discuss the potential of OSA therapy on the coagulation balance and the improvement of BBB.

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Section: Potential Therapiesmentioning

confidence: 99%

“…As previously discussed, OSA is associated with an increased level of platelet volume indices and with platelet reactivity linked to the AHI index [ 111 , 117 ]. These findings may have direct involvement in the elevated prevalence of ischemic complications among ACS patients with OSA.…”

Section: Potential Therapiesmentioning

confidence: 99%

Obstructive Sleep Apnea, Hypercoagulability, and the Blood–Brain Barrier

Zolotoff

Bertoletti

Gozal

et al. 2021

JCM

View full text Add to dashboard Cite

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“…MPV and platelet distribution width (PDW) are higher in severe OSA compared to control group, but no significant differences between controls and patients with mild and moderate OSA were observed. Mean platelet volume and red blood cell distribution width changed significantly after 3-month CPAP treatment [ 98 , 99 ].…”

Section: Platelet Functionmentioning

confidence: 99%

“…Moreover, patients with OSA were characterized by significantly lower inhibitory rate of the ADP-dependent aggregation. OSA patients were more likely to have high residual platelet reactivity after acetylsalicylic acid or clopidogrel therapy [ 98 ]. OSA-related intermittent hypoxia and reoxygenation frequency contributed to platelet hyperaggregability for ADP more than total hypoxic time during the sleep.…”

Section: Platelet Functionmentioning

confidence: 99%

Cardiovascular Disorders Triggered by Obstructive Sleep Apnea—A Focus on Endothelium and Blood Components

Mochol

Gawryś

Gajecki

et al. 2021

IJMS

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Obstructive sleep apnea (OSA) is known to be an independent cardiovascular risk factor. Among arousal from sleep, increased thoracic pressure and enhanced sympathetic activation, intermittent hypoxia is now considered as one of the most important pathophysiological mechanisms contributing to the development of endothelial dysfunction. Nevertheless, not much is known about blood components, which justifies the current review. This review focuses on molecular mechanisms triggered by sleep apnea. The recurrent periods of hypoxemia followed by reoxygenation promote reactive oxygen species (ROS) overproduction and increase inflammatory response. In this review paper we also intend to summarize the effect of treatment with continuous positive airway pressure (CPAP) on changes in the profile of the endothelial function and its subsequent potential clinical advantage in lowering cardiovascular risk in other comorbidities such as diabetes, atherosclerosis, hypertension, atrial fibrillation. Moreover, this paper is aimed at explaining how the presence of OSA may affect platelet function and exert effects on rheological activity of erythrocytes, which could also be the key to explaining an increased risk of stroke.

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“…There are several studies in the literature about the relationship between platelet indices and OSAS (13)(14)(15). However, to our best knowledge the relation between platelet mass and OSAS has not been investigated previously.…”

Section: Introductionmentioning

confidence: 99%

Levels of Total Platelet Mass in Patients Admitted to Emergency Department and Diagnosed with Obstructive Sleep Apnea Syndrome

Şeyhanlı¹,

Yasak²

2021

Eurasian J Emerg Med

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Aim:The objective of this study was to investigate the possibility of a relationship between the value of the platelet mass index and obstructive sleep apnea syndrome (OSAS) and to compare biochemical parameters among comorbidity groups in OSAS patients. Materials and Methods:The patients were divided into two groups; the patient group consisted of patients who had previously presented to the emergency department of our hospital and were diagnosed with OSAS through polysomnography, while the control group included individuals who had no diagnosed chronic diseases.The patients in the OSAS group were further divided into subgroups of patients with diabetes, diabetes + hypertension, diabetes + hyperlipidemia, diabetes + cardiovascular disease, diabetes + hypertension + hyperlipidemia, hyperlipidemia, cardiovascular disease, and hypertension.Physical examination, complete blood count, and biochemical test outcomes of both groups as well as polysomnography data of the patient group were evaluated retrospectively. Results:The mean BMI value was statistically significantly higher in OSAS patients than in with patients of the control group (24.28±1.00 vs 29.73±2.51 kg/m 2 ). The mean platelet volume (MPV) was significantly higher in the control group (10.13±1.09) than in the OSAS group (7.98±1.32) (p<0.001). The total platelet mass index, calculated by multiplying the platelet count by the MPV, was significantly higher in the control group (2,737.92±548.90) than in the OSAS patient group (2,104.89±462.86) (p<0.001). Conclusion:According to the results of this study, the platelet mass index, MPV, and/or total platelet count are not diagnostic. However, in patients presenting to the emergency department with complaints of fatigue, headache, inattention, and daytime drowsiness, they may be warning parameters indicating the possibility of OSAS.

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Impact of Obstructive Sleep Apnea on Platelet Function Profiles in Patients With Acute Coronary Syndrome Taking Dual Antiplatelet Therapy

Cited by 11 publications

References 32 publications

Obstructive Sleep Apnea, Hypercoagulability, and the Blood–Brain Barrier

Obstructive Sleep Apnea, Hypercoagulability, and the Blood–Brain Barrier

Cardiovascular Disorders Triggered by Obstructive Sleep Apnea—A Focus on Endothelium and Blood Components

Levels of Total Platelet Mass in Patients Admitted to Emergency Department and Diagnosed with Obstructive Sleep Apnea Syndrome

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