High frequency of coronary artery ectasia in obstructive sleep apnea

Portillo, Juan; Hernandez, Boris Miguel; Bazurto, María Angélica; Echeverri, Darío; Cabrales, Jaime

doi:10.5664/jcsm.9598

Cited by 2 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Determining the characteristics related with the existence and severity of CAE may thus be advantageous for the therapy of these individuals. Previous research has demonstrated that inflammation and atherosclerosis play important roles in the development of CAE, although the fundamental causes of ectasia production are still not entirely understood [15].…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Ectasia as a Predictor of Major Adverse Cardiac Events in Patients with Acute ST Elevation Myocardial Infarction

Saad

Gaafar²,

Salama³

et al. 2023

View full text Add to dashboard Cite

Background: Coronary artery ectasia (CAE) is characterised as localised or widespread non-obstructive lesions of the epicardial coronary arteries with a luminal dilation more than 1.5 times the neighbouring normal segments or vessel diameter. Isolated CAE is CAE in the absence of severe coronary artery stenosis. This aberrant dilatation of coronary arteries can produce angina pectoris and even myocardial infarction in people without coronary artery disease owing to vasospasm, dissection, or thrombus. The purpose of this study was to evaluate the connection between CAE and major adverse cardiac events (MACE) following acute myocardial infarction with ST elevation. Methods: This was a prospective cohort study which was carried out on 300 cases. Cases were divided into two groups: Group I: including about 22 STEMI cases with CAE and Group II: including about 278 STEMI cases without CAE. All cases in this study were subjected to full history taking, clinical examination, laboratory tests, standard 12-leads ECG, resting transthoracic echocardiography (TTE), and coronary angiography. Results: Regarding MACE in the studied groups, Incidence of reinfarction and cardiac death were significant higher in cases with STEMI and CAE than cases with STEMI alone. In univariate regression analysis, CAE (OR: 3.59, p value =0.022) was a significant predictor of cardiac death but age, male sex, and EF were not. Also, in multivariate regression analysis CAE (OR: 3.49, p value =0.029) was a significant predictor of cardiac death but age, male sex, and EF were not smoking with high warfarin consumption. Further, Markis classification 1 and 3 were the most frequent phenotype among cases. In STEMI cases, the incidence of reinfarction and cardiac death were significantly higher in cases with STEMI and CAE than cases with STEMI alone. So, CAE is a significant predictor of cardiac death.

show abstract

Section: Discussionmentioning

confidence: 99%

Coronary Artery Ectasia as a Predictor of Major Adverse Cardiac Events in Patients with Acute ST Elevation Myocardial Infarction

Saad

Gaafar²,

Salama³

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Obstructive sleep apnea (OSA), which is characterized by recurrent episodes of an upper airway collapse leading to partial or total loss of breathing, intermittent hypoxemia, and arousals, affects 34% of middle-aged men and 17% of middle-aged women in the general population [ 1 ] and almost 63% of the adults with coronary artery disease (CAD) [ 2 ]. OSA was also shown to be related to cardiovascular risk factors [ 3 ], arrhythmias [ 4 ], reduced hearth rate variability [ 5 ], as well as structural cardiac phenotypes associated with higher CAD risk such as right ventricular strain and coronary artery ectasia [ 6 , 7 ]. Most importantly, OSA may accelerate the cardiovascular disease’s progression, contributing to the worse outcomes and mortality [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Current Smoking Determines the Levels of Circulating MPO and MMP-9 in Adults with Coronary Artery Disease and Obstructive Sleep Apnea

Özkan

Çelik

Yucel‐Lindberg

et al. 2023

JCM

View full text Add to dashboard Cite

(1) Background: Obstructive sleep apnea (OSA) is common in patients with coronary artery disease (CAD), in which a rupture of atherosclerotic plaques and oxidative stress play a role in the initiation and progression of the disorder. Circulating levels of myeloperoxidase (MPO), as an oxidative stress marker, as well as matrix metalloproteinase-9 (MMP-9), as a destabilizer of plaques, are known to be elevated in patients with CAD and are associated with worse prognosis. Some studies have suggested that OSA is associated with MPO and MMP-9, but the effect of OSA on these biomarkers in cardiac cohorts is unknown. (2) Aims: We addressed the determinants of high MPO and MMP-9 in a CAD cohort with concomitant OSA. (3) Materials and Methods: The current study was a secondary analysis of the RICCADSA trial that was conducted in Sweden between 2005 and 2013. A total of 502 revascularized CAD patients with OSA (apnea–hypopnea index [AHI] ≥ 15 events/h; n = 391) or no-OSA (AHI < 5 events/h; n = 101), based on a home sleep apnea test, and who had blood samples at baseline were included in the analysis. The patients were dichotomized into a high or low MPO and MMP-9 groups, based on the median cut-off values. (4) Results: The mean age of the participants was 63.9 (±8.6), and 84% of the study cohort were men. Median values of MPO and MMP-9 levels were 116 ng/mL and 269 ng/mL, respectively. In different multivariate linear and logistic regression models, neither OSA nor OSA severity in terms of AHI and oxygenation indices were associated with the high MPO and MMP-9 levels. Current smoking was significantly associated with both high MPO (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.06–2.84; p = 0.030) and high MMP-9 levels (OR 2.41, 95% CI 1.44–4.03; p < 0.001), respectively. Other significant determinants were revealed as beta blocker use (OR 1.81, 95% CI 1.04–3.16; p = 0.036) for high MPO as well as male sex (OR 2.07, 95% CI 1.23–3.50; p = 0.006) and calcium antagonist use (OR 1.91, 95% CI 1.18–3.09; p = 0.008) for high MMP-9 levels. (5) Conclusions: Current smoking, but not OSA, was significantly associated with high MPO and MMP-9 levels in this revascularized CAD cohort. Smoking status should be seriously taken into consideration while evaluating the effects of OSA and its treatment on long-term adverse cardiovascular outcomes in adults with CAD.

show abstract

High frequency of coronary artery ectasia in obstructive sleep apnea

Cited by 2 publications

References 24 publications

Coronary Artery Ectasia as a Predictor of Major Adverse Cardiac Events in Patients with Acute ST Elevation Myocardial Infarction

Coronary Artery Ectasia as a Predictor of Major Adverse Cardiac Events in Patients with Acute ST Elevation Myocardial Infarction

Current Smoking Determines the Levels of Circulating MPO and MMP-9 in Adults with Coronary Artery Disease and Obstructive Sleep Apnea

Contact Info

Product

Resources

About