Effects of Obstructive Sleep Apnea on Cardiac Function and Clinical Outcomes in Chinese Patients with ST-Elevation Myocardial Infarction

Liu, Baoxin; Guo, Rong; Zhou, Shunping; Xie, Shuanshuan; Wang, Ke

doi:10.1155/2014/908582

Cited by 7 publications

(10 citation statements)

References 44 publications

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“…This almost certainly led to underestimation of the actual prevalence of OSA in our population. The prevalence of 1.3% observed in our cohort is markedly less than the 45% to 65% noted in studies where PSG was used . However, our estimates are similar to other studies using administrative data .…”

Section: Discussionsupporting

confidence: 62%

Recognized Obstructive Sleep Apnea is Associated With Improved In‐Hospital Outcomes After ST Elevation Myocardial Infarction

Mohananey

Villablanca

Gupta

et al. 2017

JAHA

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BackgroundObstructive sleep apnea (OSA) is an independent risk factor for many cardiovascular conditions such as coronary artery disease, myocardial infarction, systemic hypertension, pulmonary hypertension, and stroke. However, the association of OSA with outcomes in patients hospitalized for ST‐elevation myocardial infarction remains controversial.Methods and ResultsWe used the nation‐wide inpatient sample between 2003 and 2011 to identify patients with a primary discharge diagnosis of ST‐elevation myocardial infarction and then used the International Classification of Diseases, Clinical Modification code 327.23 to identify a group of patients with OSA. The primary outcome of interest was in‐hospital mortality, and secondary outcomes were in‐hospital cardiac arrest, length of stay and hospital charges. Our cohort included 1 850 625 patients with ST‐elevation myocardial infarction, of which 1.3% (24 623) had documented OSA. OSA patients were younger and more likely to be male, smokers, and have chronic pulmonary disease, depression, hypertension, known history of coronary artery disease, dyslipidemia, obesity, and renal failure (P<0.001 for all). Patients with OSA had significantly decreased in‐hospital mortality (adjusted odds ratio, 0.78 [95% CI, 0.73–0.84]), longer hospital stay (5.00±4.68 versus 4.85±5.96 days), and incurred greater hospital charges ($79 460.12±70 621.91 versus $62 889.91±69 124.15). There was no difference in incidence of in‐hospital cardiac arrest (adjusted odds ratio, 0.93 [95% CI, 0.84–1.03]) between these 2 groups.Conclusion ST‐elevation myocardial infarction patients with recognized OSA had significantly decreased mortality compared with patients without OSA. Although patients with OSA had longer hospital stays and incurred greater hospital charges, there was no difference in incidence of in‐hospital cardiac arrest.

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Section: Discussionsupporting

confidence: 62%

Recognized Obstructive Sleep Apnea is Associated With Improved In‐Hospital Outcomes After ST Elevation Myocardial Infarction

Mohananey

Villablanca

Gupta

et al. 2017

JAHA

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“…We did not detect a significant difference for the occurrence of MACE or MACCE between patients with or without OSA. OSA has been identified as an independent risk factor for MACE after ST-elevation myocardial infarction [25], repeat revascularization after percutaneous coronary intervention [26], and the occurrence of MACCE after coronary artery bypass graft surgery [27]. In contrast to our study, these cohorts only included patients with coronary heart disease (CHD) that underwent an intervention or operation.…”

Section: Mace or Maccementioning

confidence: 98%

Morbidity and mortality in patients with cardiovascular risk factors and obstructive sleep apnoea: results from the DIAST-CHF cohort

Haarmann

Koch

Bonsch

et al. 2019

Respiratory Medicine

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Study objectives: Aim of the study was to investigate the association between obstructive sleep apnoea (OSA) and cardiovascular morbidity and mortality in a cohort of patients with cardiovascular risk factors. Methods: In this prospective study, 378 patients of the DIAST-CHF cohort were screened for OSA by home polygraphy. Inclusion criteria were risk factors for diastolic heart failure, such as hypertension, diabetes mellitus, atherosclerotic disease, or history of chronic heart failure. Patients were followed up after 1, 2, 5, 9 and 10 years for the occurrence of major adverse cardiac and cerebrovascular events (MACE and MACCE). Results: 344 patients were included in the analysis, of which 60% were diagnosed with OSA (apnoea-hypopnoea index ≥5/h). Overall mortality was higher in the OSA group (14.9% vs. 5.9%; p = 0.007), but significance disappeared after adjustment for age and sex (hazard ratio (HR) 1.89, 95% confidence interval (CI) 0.86-4.16, p = 0.12). There was no significant difference in the occurrence of MACE or MACCE in patients with OSA compared to those without OSA (MACE: 31% vs. 30%; p = 0.61; MACCE: 32% vs. 30%; p = 0.53). Conclusion:We did not find evidence of an adverse effect of OSA on cardiovascular morbidity and mortality in a cohort of patients with cardiovascular risk factors.

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“…Sixteen studies reported an increased Hazard ratio (HR) of MACCEs outcomes with SDB compared with controls in patients with myocardial ischemia, 12,13,16,18,19,20,21,22,23,24,25,26,27,28,29,30 with the combined HR of 1.66(95% CI 1.41-1.94, P< 0.0001) (Fig 2). Some evidence of statistical heterogeneity (Cochran Q = 23.00, p=0.08; I 2 = 35%) was found by pooled effect size, which might be in part attributable to 1 randomized controlled trial.…”

Section: Major Adverse Cardiovascular or Cerebrovascular Events (Macces)mentioning

confidence: 99%

Association of Sleep-Disordered Breathing With Cardiovascular Events and Death in patients With Ischemic Heart Disease: A systematic review and meta-analysis

Zhang

Tan

Miao

et al. 2021

Preprint

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Objective Previous studies have identified that sleep-disordered breathing is associated with the increased risk of cardiovascular disease. However, CPAP, the preferred treatment of sleep apnea, does not appear to reduce the risk of adverse cardiovascular events and deaths in ischemic heart disease. Our aim was to determine whether OSA can be a prognostic factor for cardiovascular adverse events and deaths in patients with ischemia heart disease. Methods We searched Medline via PubMed, Embase, and the Cochrane Library database for clinical studies reporting the major adverse cardiac outcomes of SDB in patients with myocardial ischemia. Sleep apnea tests is mainly performed with cardiorespiratory polygraphy or portable diagnostic device. Summary hazard ratio(HR) and 95% CIs were conducted using random-effects meta-analysis. Results Eighteen literatures were included, with total participants of 9,138. Sixteen studies reported MACCEs, there was significant association of SDB with MACCES (HR, 1.66[95% CI, 1.41 to 1.94]; P< 0.0001), all-cause mortality (HR, 1.39[95% CI 1.12 to 1.73], P=0.0027) and cardiovascular mortality (HR, 2.12[95% CI 1.23 to 3.65], P=0.007). Subgroup analysis showed that one study was the cause of heterogeneity, while no correlation between SDB and outcomes for sleep apnea severity, follow-up time or whether surgery was performed. Conclusion SDB is associated with adverse cardiac outcomes in patients with ischemic heart disease, suggesting that sleep apnea can be screened for patients with ischemic heart disease, which can be used as a clinically relevant strategy of secondary prevention to reduce the risk of adverse outcomes.

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Effects of Obstructive Sleep Apnea on Cardiac Function and Clinical Outcomes in Chinese Patients with ST-Elevation Myocardial Infarction

Cited by 7 publications

References 44 publications

Recognized Obstructive Sleep Apnea is Associated With Improved In‐Hospital Outcomes After ST Elevation Myocardial Infarction

Recognized Obstructive Sleep Apnea is Associated With Improved In‐Hospital Outcomes After ST Elevation Myocardial Infarction

Morbidity and mortality in patients with cardiovascular risk factors and obstructive sleep apnoea: results from the DIAST-CHF cohort

Association of Sleep-Disordered Breathing With Cardiovascular Events and Death in patients With Ischemic Heart Disease: A systematic review and meta-analysis

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