The Effect of Sleep Apnea on Cardiovascular Events in Different Acute Coronary Syndrome Phenotypes

Opportunities for Cardiovascular Benefits in Treating Obstructive Sleep Apnea in the Secondary Prevention Scenario

“…The main findings of the study indicate a significant effect of moderate–severe OSA on the risk of recurrent CV events observed only in patients in the “no-previous-CVD” subgroup ( 13 ). Patients with OSA in this subgroup had an increased risk of recurrent CV events with an adjusted hazard ratio (HR) of 1.54 (95% confidence interval [95% CI], 1.06–2.24).…”

“…In this issue of the Journal , Zapater and colleagues (pp. 1698–1706 ) shed light upon the phenotypes and therapeutic opportunities for mitigating CV risk in OSA ( 13 ). They reported the results of a secondary analysis of the ISAACC study, aimed at understanding the impact of moderate–severe OSA on the incidence of CV disease in 1,701 patients with ACS of different CV risk phenotypes ( 13 ).…”

“…1698–1706 ) shed light upon the phenotypes and therapeutic opportunities for mitigating CV risk in OSA ( 13 ). They reported the results of a secondary analysis of the ISAACC study, aimed at understanding the impact of moderate–severe OSA on the incidence of CV disease in 1,701 patients with ACS of different CV risk phenotypes ( 13 ). The authors define CV risk phenotypes using unsupervised approaches to help tease out the known clinical heterogeneity of OSA, a strategy that has been demonstrated to be valuable in understanding CV disease risk in other clinical domains in OSA such as clinical symptoms ( 11 ) and polysomnographic characteristics ( 14 ).…”

Does Heart Rate Play a Role in Cardiovascular Outcome in Patients with Obstructive Sleep Apnea?

“…The effect of obstructive sleep apnea (OSA) on cardiovascular events in different acute coronary syndrome (ACS) subgroups were investigated by Zapater and colleagues ( 1 ) in a post hoc analysis of the ISAACC (Continuous Positive Airway Pressure in Patients with ACS and OSA) study, including 1,701 patients admitted for ACS. The cardiovascular risk subgroups were explored via the analysis of different cardiovascular (CV) risk phenotypes.…”

Reply to Sankari: Does Heart Rate Play a Role in Cardiovascular Outcome in Patients with Obstructive Sleep Apnea?

“…We would like to thank Dr. Sankari for his interest in our article ( 1 ). In response to his comment on our study, we would like to present detailed information about the medications in the two groups of patients based on the phenotypes analyzed, which included some specific chronotropic drugs.…”