Contribution of Obstructive Sleep Apnoea to Cognitive Functioning of Males With Coronary Artery Disease: A Relationship With Endocrine and Inflammatory Biomarkers

Abstract

IntroductionOur exploratory study aimed to determine whether obstructive sleep apnoea (OSA) could affect cognitive functioning in males with coronary artery disease (CAD), and whether such impact could be associated with changes in thyroid hormones and inflammatory marker regulation on cognitive functioning.MethodWe evaluated different endocrine and inflammatory biomarkers, including free triiodothyronine [fT3], free tetraiodothyronine [fT4], N-terminal pro-B-type natriuretic peptide [NT-pro-BNP], and high-sensitivity C-reactive protein [hs-CRP] serum levels in 328 males (x¯ = 57 ± 10 years), undergoing cardiac rehabilitation after an acute coronary event. Participants underwent full-night polysomnography and were classified in mild/non-OSA (n = 253) and OSA (n = 75) according to an apnoea-hypopnoea index ≥ 15 event/h. Cognitive functioning testing included the Digit Span Test, Digit Symbol Test (DSST), and Trail Making Test. Analyses of variance assessed the impact of OSA on cognitive functioning and possible relationships of fT3/fT4, NT-pro-BNP and with hs-CRP on cognitive measures.ResultsSignificant group (OSA, mild/non-OSA) × NT-pro-BNP (<157.0 vs. ≥157.0, ng/L) interactions were found for the DSST raw score (F(2,324) = 3.58, p = 0.014). Decomposition of interactions showed that the DSST scores of the OSA group with NT-pro-BNP ≥ 157.0 ng/L (M = 33.2; SD = 8.1) were significantly lower, p = 0.031, than those of the mild/non-OSA with NT-pro-BNP < 157.0 ng/L (M = 37.7; SD = 8.9).ConclusionThese findings indicate that males with OSA and clinically elevated NT-pro-BNP levels experienced inferior psychomotor performance compared to those without OSA and reduced NT-pro-BNP levels.

Role of sleep disorders in patients with cardiovascular disease: A systematic review

“…A total of 66795 references were identified in the two databases. After careful reading, 78 articles were included in this systemic review [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] ...…”

“… Combie high quality Men No OSA N = 374/55.0 ± 9.2yrs OSA N = 286/59.0 ± 8.8yrs Women No OSA N = 156/60.5 ± 7.9yrs OSA N = 63/63 ± 6.9yrs 15 Katsumata2020 [ 42 ] Japan Cross-sectional study CAD OSA N = 178 Polysomnography Elevated SNX16-Ab level associated with the history of CAD. Combie high quality Healthy adults N = 64/42.5yrs OSA N = 82/59yrs ACS N = 96/67yrs 16 Kazukauskiene2022 [ 37 ] Lithuania Cross-sectional study CAD OSA N = 328/57 ± 10yrs Polysomnography CAD males with OSA and clinically elevated NT-proBNP levels experienced inferior psychomotor performance Combie high quality OSA N = 75/59.7 ± 8.1yrs No OSA N = 253/56.1 ± 10.1yrs 17 Khan2014 [ 34 ] Pakistan Cross-sectional study CAD OSA N = 400 Berlin questionnaire A significant proportion of CAD patients are at high risk of OSA in Paki...…”

“…In this review, 22 studies [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ] focused on sleep disorders in patients with CAD. Three studies [ [25] , [26] , [27] ] reported a high prevalence of sleep disorders in patients with CAD.…”

“…Four studies [ [28] , [29] , [30] , [31] ] elucidated the adverse effects of sleep disorders on cardiac function and reported increased adverse cardiac outcomes in patients with CAD and OSA. Seven studies [ [32] , [33] , [34] , [35] , [36] , [37] , [38] ] uncovered an association between psychological conditions and sleep disorders in patients with CAD. The personality disorders included type D personality, depression, anxiety, and cognition.…”

“…Sleep disorders also affect cognitive function in patients with CAD. Kazukauskiene et al [ 37 ] evaluated the inflammatory factors and NT-proBNP levels in men with CAD and OSA. They found that OSA and NT-proBNP levels were associated with cognitive dysfunction.…”