Platelet function in patients with obstructivesleep apnoea syndrome

Abstract

Patients with obstructive sleep apnoea syndrome (OSAS) are subject to an increased cardiovascular morbidity including myocardial infarction and stroke. Platelets play an important role in the pathogenesis and triggering of acute cardiovascular syndromes. So far, the influence of OSAS on platelet function is not fully understood. Platelet aggregability to epinephrine, collagen, arachidonic acid, and adenosine diphosphate in vitro was measured in 17 consecutive male patients (53.0±2.1 yrs) with polysomnographically verified OSAS and compared with that of 15 male controls (50.1±3.6 yrs) at 20:00 h, 24:00 h, and 06:00 h. In addition, the long‐term effects of continuous positive airway pressure (CPAP) therapy on platelet aggregability was assessed after 6 months. Platelet aggregation in vitro induced by epinephrine showed a slight increase overnight in the untreated OSAS patients ( ns) whereas it decreased slightly ( ns) in the controls and in the treated OSAS patients. Pretherapeutic platelet aggregability was significantly lowered by CPAP therapy both at 24:00 h (64.0±6.5 versus 55.3±6.7%, p<0.05) and at 06:00 h (64.1±6.5 versus 45.8±7.6%; p=0.01). Platelet aggregability during sleep in the controls resembled that found in patients with OSAS during CPAP therapy. The results suggest that obstructive sleep apnoea syndrome contributes, at least in part, to platelet dysfunction and that long‐term continuous positive airway pressure treatment may reduce platelet aggregability.

Effects of Obstructive Sleep Apnea with Intermittent Hypoxia on Platelet Aggregability

“…There are several reports assessing the platelet activation status in patients with OSA 9) ; however, platelet aggregability is a more direct way of investigating platelet aggregation. There have been only two small-scale studies on platelet aggregability including 32 or 23 OSA patients, respectively, and these studies reported that the maximal aggregation rates of platelets at baseline between the OSA and control groups exhibited no differences 10,11) . Here, we systematically analyzed platelet aggregability by the optical aggregometer method in 124 OSA-suspected subjects at baseline and in 23 nCPAP-treated patients among them until 90 days.…”

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

“…[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.…”

Syndrome d'apnées du sommeil et déficits cognitifs associés chez des patients avec ischémie cérébrale transitoire /

“…De plus, il apparaît que le SAS accroît la coagulabilité du sang. En effet, les catécholamines sont augmentées chez les patients avec SAS et peuvent activer les plaquettes, ce qui augmente le risque de formation de caillots sanguins (Eisensehr et al, 1998;Sanner et al, 2000). Les patients avec AVC et SAS ont un taux sanguin de fibrinogènes plus élevé que les patients avec AVC sans SAS, ce qui contribue également à l'hypercoagulabilité du sang.…”

“…Une corrélation positive a été trouvée entre le taux de fibrinogène et la sévérité du SAS (Wessendorf et al, 2000b). Le traitement par CPAP permet de normaliser l'activation plaquettaire et le taux sanguin de fibrinogène (Sanner et al, 2000;Wessendorf et al, 2000b). …”