Obstructive Sleep Apnea Is Associated With Increased Severity of Coronary Artery Disease and Worse Cardiovascular Outcomes

Pendahuluan. Penyakit jantung koroner (PJK) dan obstructive sleep apnea (OSA) merupakan dua masalah kesehatan yang umum dan kompleks. Keduanya memiliki risiko tinggi terjadinya kematian jantung mendadak (KJM). Dispersi QT (QTd) pada elektrogram merupakan ukuran heterogenitas repolarisasi miokardial yang mampu memprediksi kejadian aritmia ventrikular yang menjadi penyebab KJM. Selama ini, belum ada publikasi mengenai hubungan keparahan PJK dengan QTd pada pasien OSA di Indonesia. Metode. Dilakukan studi potong lintang pada 29 pasien PJK yang disertai OSA selama tahun 2015 yang telah menjalani korangiografi dan polisomnografi dengan dispersi QT dari hasil rekaman jantung di Rumah Sakit Cipto Mangunkusumo, Jakarta. Dispersi QT (QTd) didapat dari selisih QT terkoreksi (QTc) maksimum dengan QTc minimum. Keparahan PJK dinilai dengan skor Gensini yang didapat dari hasil rekaman korangiografi di cathlab. Hasil. Didapatkan median skor Gensini 10 (rentang 1-112). Rerata QTc maks 459,76 mdet (simpang baku [SB] 41,39 mdet), rerata QTc min 386,72 mdet (SB 31,61 mdet), dan median QTd 56 mdet (rentang 14-201 mdet). Uji korelasi Spearman menunjukkan adanya korelasi positif lemah antara skor Gensini dengan QTd (r = 0,494; p = 0,006). Simpulan. Keparahan PJK berdasarkan skor Gensini yang disertai OSA berkorelasi positif lemah dengan QTd.

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“…5 Hasil penelitian Mantini, dkk. 6 menunjukkan bahwa OSA memengaruhi derajat keparahan PJK yang diukur menggunakan skor Gensini.…”

Section: Pendahuluanunclassified

Korelasi Keparahan Penyakit Jantung Koroner dengan Dispersi QT pada Pasien Obstructive Sleep Apnea (OSA)

Rasmijon¹,

Yamin²,

Hutauruk³

et al. 2019

JPDI

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Relationship between severity of obstructive sleep apnea and adverse cardiac outcomes in non-diabetic patients presenting with myocardial infarction

Zhao

Loh

Loo

et al. 2015

Eur Arch Otorhinolaryngol

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Previous studies that have reported an association between obstructive sleep apnea and adverse cardiac events were confounded by a high prevalence of diabetes mellitus. We investigated the relationship between obstructive sleep apnea and the occurrence of major adverse cardiac events in non-diabetic patients who presented with ST-segment elevation myocardial infarction. A total of 41 patients who underwent overnight sleep screening within 5 days after admission for myocardial infarction from January 2007 to December 2008 were identified. Major adverse cardiac events-defined as a composite of cardiac death, non-fatal myocardial infarction, hospitalization for angina and congestive heart failure at 5-year follow-up-were determined. The patients were divided into two groups: those who experienced major adverse cardiac events and those who did not. In the overall cohort, the prevalence of obesity was 4.9 %. A total of 13 (31.7 %) patients had major adverse cardiac events. The mean apnea-hypopnea index was 25.4 ± 20.3. The group that experienced major adverse cardiac events had a higher apnea-hypopnea index than the group that did not (36.1 ± 21.0 vs 20.4 ± 18.2; P = 0.016). After adjusting for the resolution of ST-segment elevation and the use of a glycoprotein IIb/IIIa inhibitor, logistic regression analysis revealed that the apnea-hypopnea index remained an independent predictor of major adverse cardiac events (odds ratio 1.044; 95 % confidence interval 1.003-1.086; P = 0.033). In non-diabetic patients, the severity of obstructive sleep apnea was associated with the occurrence of major adverse cardiac events at 5-year follow-up after ST-segment elevation myocardial infarction.

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Obstructive Sleep Apnea Is Associated With Increased Severity of Coronary Artery Disease and Worse Cardiovascular Outcomes

Cited by 2 publications

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Korelasi Keparahan Penyakit Jantung Koroner dengan Dispersi QT pada Pasien Obstructive Sleep Apnea (OSA)

Korelasi Keparahan Penyakit Jantung Koroner dengan Dispersi QT pada Pasien Obstructive Sleep Apnea (OSA)

Relationship between severity of obstructive sleep apnea and adverse cardiac outcomes in non-diabetic patients presenting with myocardial infarction

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