Is the Morning Peak of Acute Myocardial Infarction’s Onset Due to Sleep-Related Breathing Disorders?

Aboyans, Victor; Cassat, Claude; Lacroix, Philippe; Tapie, P; Tabaraud, F; Pesteil, Francis; Bertin, F.; Laskar, Marc; Virot, P

doi:10.1159/000047315

Cited by 21 publications

(17 citation statements)

References 41 publications

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“…In a study reported by Aboyans et al, 10 no patient with sleep apnoea had MI between 0:00 and 5:59 hours. Only Kuniyoshi et al 8 examined the differences in circadian variation of MI onset between OSA and control patients.…”

Section: Discussionmentioning

confidence: 83%

Obstructive sleep apnoea increases the incidence of morning peak of onset in acute myocardial infarction

Nakashima

Henmi

Minami

et al. 2013

European Heart Journal: Acute Cardiovascular Care

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Section: Discussionmentioning

confidence: 83%

Obstructive sleep apnoea increases the incidence of morning peak of onset in acute myocardial infarction

Nakashima

Henmi

Minami

et al. 2013

European Heart Journal: Acute Cardiovascular Care

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“…10 However, in a study that included 40 middle-aged men, the peak of MI onset was reported to be between 6 AM and 12 PM in those with SA. 11 …”

Section: Introductionmentioning

confidence: 99%

Sleep apnea prevalence in acute myocardial infarction — The Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study

Ludka

Štěpánová

Vyskočilová

et al. 2014

International Journal of Cardiology

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Background While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients. Methods We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 hours post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (<5 events/hour), mild SA (5–15 events/hour), moderate SA (15–30 events/hour), and severe SA (≥30 events/hour). Results Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI ≥ 5 events/hour, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6AM–12PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12AM–6AM (all p<0.05). Conclusion There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6AM–noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined.

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“…[10][11][12] SDB was related with heart strain due to apnea and various cardiovascular diseases. Some studies have reported a relationship between SDB and myocardial ischemia, 2,[13][14][15] arrhythmia, [16][17][18] sudden death, 19) platelet coagulation, 20) and inflammatory cytokines, 21,22) all of which may trigger heart failure. These factors could therefore possibly cause heart failure between midnight and dawn.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Sleep-Disordered Breathing Level and Acute Onset Time of Congestive Heart Failure

et al. 2008

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SUMMARYSleep-disordered breathing (SDB) is frequently observed in patients with congestive heart failure. Recent studies have shown that SDB negatively affects the onset of congestive heart failure; however, no studies have addressed the relationship between the level of SDB and the onset time of acute dyspnea. We hypothesized that SDB affects the acute onset time of dyspnea (AOT) and investigated the relationship between SDB and AOT.We examined 80 patients (mean age, 61.6 years) with congestive heart failure in a clinically stable condition. AOT was divided into 5 time periods (0:00 -6:00, 6:00 -12:00, 12:00 -18:00, 18:00 -24:00, and unknown). The apnea-hypopnea index (AHI) was obtained based on the results of polysomnography (PSG) to evaluate the severity of SDB.Acute dyspnea occurred in 59 (73.7%) of the 80 patients. When we divided the patients into an AHI < 5 group and an AHI ≧ 5 group, there was no significant difference in the AOT; however, a significant difference was observed in those divided into AHI < 20 and AHI ≧ 20 groups (P < 0.001). The patients with AHI ≧ 20 had more acute dyspnea between 18:00 -24:00 and between 0:00 -6:00 than those with AHI < 20 (32% and 19%, and 4.1% and 4.1%, respectively).Severe SDB patients tended to have acute dyspnea between midnight and dawn. The results suggest SDB might be one of the risk factors of heart failure. (Int Heart J 2008; 49: 471-480) Key words: Sleep apnea, Heart failure, Circadian rhythm SLEEP-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and hypopnea events during sleep. Sleep apnea syndrome (SAS) is defined as SDB with 30 or more apnea events including a minimum 10 second reported that OSAS patients are at 2.38 times higher risk for the onset of heart failure and OSAS is defined as an independent prognostic factor of heart failure. Sympathetic nerve activity is augmented and blood pressure is elevated gradually before waking up. In patients with SDB, the onset time of heart diseases is estimated to be between midnight and dawn. In 1995, Franklin, et al 2) reported that SDB might affect hypoxemia and ST changes, thus resulting in the onset of angina pectoris during the night. To date, no study has reported a relationship between SDB in patients with congestive heart failure and the acute onset time of heart failure. Angiotensin converting enzyme (ACE) inhibitors and β-blockers are generally administered to patients with heart failure. Recently, the prevention of heart failure has gained broad attention. If many patients with SDB suffer from heart failure between midnight and dawn, the development of an appropriate SDB treatment could possibly prevent such events. This study investigated the severity of apnea in patients with congestive heart failure and evaluated the relationship between SDB and acute onset time. METHODSSubjects: This retrospective study was conducted in 80 consecutive patients with congestive heart failure who were admitted to St. Marianna University School of Medicine Hospital, Kawasaki, Jap...

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Is the Morning Peak of Acute Myocardial Infarction’s Onset Due to Sleep-Related Breathing Disorders?

Cited by 21 publications

References 41 publications

Obstructive sleep apnoea increases the incidence of morning peak of onset in acute myocardial infarction

Obstructive sleep apnoea increases the incidence of morning peak of onset in acute myocardial infarction

Sleep apnea prevalence in acute myocardial infarction — The Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study

Relationship Between Sleep-Disordered Breathing Level and Acute Onset Time of Congestive Heart Failure

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