BackgroundObstructive sleep apnea (OSA) is a very often clinical condition that can be
associated with high mortality risk, particularly in coronary heart disease
(CHD). The diagnosis of OSA is not always accessible via the gold-standard
method polysomnography.ObjectiveTo evaluate long-term influence of the high risk for OSA on fatal and
non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary
Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a
surrogate.MethodsBerlin questionnaire, a screening questionnaire for OSA, was applied in 639
cases of ACS 30 days after the index event. Cox regression
proportional-hazards model was used to calculate the hazard ratio (HR) of
all-cause, cardiovascular and CHD (myocardial infarction) mortality, as well
as, the combined endpoint of fatal or recurrent non-fatal CHD.ResultsThe high-risk group for OSA had higher frequencies of previous
personal/family history of CHD and diabetes, in addition to a poorer
event-free survival, as compared to the low-risk group (p-log-rank=0.03).
The HR for fatal or recurrent non-fatal CHD was 4.26 (95% confidence
interval, 1.18 - 15.36) in patients at high risk for OSA compared to those
at low risk for OSA after a 2.6-year mean follow-up.ConclusionsUsing Berlin questionnaire, we were able to identify high risk for OSA as an
independent predictor of non-fatal reinfarction or CHD mortality in post-ACS
individuals in a long-term follow-up.