Impact of obstructive sleep apnea in recruitment of coronary collaterality during inaugural acute myocardial infarction

Ahmed, Habib Ben; Boussaid, H.; Longo, S.; Tlili, Rami; Fazaa, S.; Baccar, H.; Boujnah, Mohamed Rachid

doi:10.1016/j.ancard.2015.01.014

Cited by 23 publications

(20 citation statements)

References 30 publications

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“…Interestingly in OSA patients with total coronary occlusion, collateral development was significantly higher than in non-OSA patients with the same coronary occlusion (Rentrop score 2.4 ± 0.7 vs. 1.61 ± 1.2, p = 0.02, respectively) [34]. Similar finding supporting increased coronary collaterals in inaugural AMI patients with OSA was also reported more recently [35].…”

Section: Development Of Coronary Collaterals In Acute Coronary Syndromessupporting

confidence: 80%

Intermittent Hypoxia and Obstructive Sleep Apnea: Mechanisms, Interindividual Responses and Clinical Insights

Lavie¹

2020

Atherosclerosis, Arteriosclerosis and Arteriolosclerosis

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Obstructive sleep apnea (OSA), a nightly respiratory condition, is characterized by recurrent upper airway collapse causing intermittent hypoxia (IH) resembling ischemia and reperfusion (I/R). Consequently, blood oxygenation levels are cyclically reduced; sleep fragmentation and sympathetic activation develop, thus invoking oxidative stress and inflammation. OSA is a major risk factor for cardio-/ cerebrovascular morbidity and mortality. However, not all OSA patients develop cardio-/cerebrovascular disease, even if suffering from similar OSA severity. Possibly, this results from interindividual differences in responses to a given hypoxic stimulus involving gene polymorphism in oxygen-regulated transcription factors and downstream genes. The current review is aimed at highlighting potentially protective mechanisms induced by IH and OSA, rather than its well-established deleterious effects, while focusing on acute coronary syndromes. Therefore, protective mechanisms revealed in I/R biology and exhibited in vitro and in animal models utilizing IH followed by a severe ischemia are discussed and linked to acute myocardial infarction patients with concomitant OSA. The roles of endothelial progenitor cells, their proliferative and angiogenic properties, and collateral formation are emphasized in the clinical setting, as well as heterogenic interindividual responses to identical hypoxic stimuli. These findings might represent potential predictors to cardio-/cerebrovascular health, by identifying patients at higher or lower cardiovascular risk.

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Section: Development Of Coronary Collaterals In Acute Coronary Syndromessupporting

confidence: 80%

Intermittent Hypoxia and Obstructive Sleep Apnea: Mechanisms, Interindividual Responses and Clinical Insights

Lavie¹

2020

Atherosclerosis, Arteriosclerosis and Arteriolosclerosis

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“…demonstrated increased coronary collaterals by coronary angiogram in individuals with obstructive sleep apnoea who presented with acute coronary occlusion compared to similar patients without obstructive sleep apnoea . Individuals with increased collateral circulation developed smaller territories of myocardial infarction, which the authors attributed to maintained perfusion through collaterals . It is well‐established that recurrent myocardial ischemia promotes coronary collateral vessel development, and we hypothesize this compensatory angiogenesis occurs in the pulmonary vasculature as well .…”

Section: Discussionmentioning

confidence: 74%

“…Ahmed et al . demonstrated increased coronary collaterals by coronary angiogram in individuals with obstructive sleep apnoea who presented with acute coronary occlusion compared to similar patients without obstructive sleep apnoea . Individuals with increased collateral circulation developed smaller territories of myocardial infarction, which the authors attributed to maintained perfusion through collaterals .…”

Section: Discussionmentioning

confidence: 93%

Pulmonary infarction secondary to pulmonary embolism: An evolving paradigm

et al. 2018

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“…Cifci et al (30) also concluded that OSAS did not induce myocardial damage enough to increase CK, CK-MB and troponin I. Some reports (11,31) showed that patients with SAHS could have more collateral vessels, which may lead to myocardial preconditioning. However, our study did not support this finding.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies about the effect of SAHS on AMI showed that SAHS would worsen the condition in patients with AMI. However, other studies in recent years showed that because of developed collateral vessels (11) and ischaemic preconditioning (12), SAHS may play a protective role for the heart from AMI. This was also supported by reported cases (13).…”

Section: Introductionmentioning

confidence: 99%

The relationship between apnoea hypopnoea index and Gensini score in patients with acute myocardial infarction undergoing emergency primary percutaneous coronary intervention

Zhu

Wang

et al. 2017

J. Thorac. Dis.

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Background: Sleep apnoea hypopnoea syndrome (SAHS) is characterised by repetitive nocturnal hypoxemia and has a high prevalence among patients with acute myocardial infarction (AMI). But there are few studies on patients with AMI undergoing emergency primary percutaneous coronary intervention (pPCI).In this study, we want to find the prevalence of SAHS among patients with AMI undergoing emergency pPCI and determine whether SAHS would worsen the condition among these people, and especially affect the damage degree of the coronary artery Methods: Over four months, 95 patients admitted for the first time for AMI were observed. All of them had emergency primary PCIs. A total of 86 patients accepted the sleep study and were divided into four groups according to the apnoea hypopnoea index (AHI): SAHS was diagnosed when AHI ≥5/h and was defined as mild for AHI ≥5/h and <15/h, moderate for AHI ≥15/h and <30/h, and severe for AHI ≥30/h. On the contrary, the patients whose AHI <5/h were Non-SAHS. And the characteristics of the patients among these four groups were compared. According to the time of chest pain onset, the number of the patients between SAHS and non-SAHS, and patients' AHI during three intervals of one day were measured and compared;Makers including the sensitivity of serum troponin T (hs-TnT), creatine kinase isoenzyme MB (CK-MB), left ventricular ejection fraction (LVEF), pro-brain-type natriuretic peptide (pro-BNP), Gensini score and collateral vessels between the SAHS and non-SAHS were compared. And the relationships between the AHI of these patients and the markers were analysed. Results: Of the 86 patients studied, 65 had SAHS, representing a SAHS prevalence of 75.58% among patients with AMI undergoing emergency pPCI. There were significant differences in average ages, smoking and arrhythmia (P<0.05) between these four groups. There was no significant difference between AMI patients with or without SAHS regarding the day-night pattern. But there showed significant differences between SAHS and non-SAHS in Gensini score (P<0.05) and pro-BNP (P<0.05). Also, there were positive correlations between AHI and Gensini score (r=0.490, P<0.05) and pro-BNP (r=0.338, P<0.05). Conclusions: Among patients with AMI undergoing emergency pPCI, there is a high prevalence of SAHS.There are also positive correlations between AHI and Gensini score, and pro-BNP. Therefore, guided by the results, should we conduct a routine screening to those patients normally and could we relieve the damage to the coronary artery by curing the SAHS?

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Impact of obstructive sleep apnea in recruitment of coronary collaterality during inaugural acute myocardial infarction

Cited by 23 publications

References 30 publications

Intermittent Hypoxia and Obstructive Sleep Apnea: Mechanisms, Interindividual Responses and Clinical Insights

Intermittent Hypoxia and Obstructive Sleep Apnea: Mechanisms, Interindividual Responses and Clinical Insights

Pulmonary infarction secondary to pulmonary embolism: An evolving paradigm

The relationship between apnoea hypopnoea index and Gensini score in patients with acute myocardial infarction undergoing emergency primary percutaneous coronary intervention

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