Prevalence of sleep-disordered breathing in acute coronary syndrome: a systemic review and meta-analysis

Huang, Zifang; Zheng, Zhengda; Luo, Yun; Li, Suhua; Zhu, Jun; Liu, Jinlai

doi:10.1007/s11325-016-1398-9

Cited by 14 publications

(9 citation statements)

References 66 publications

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“…Furthermore, since all studies included in the meta-analysis established the diagnosis after hospital admission, this proportion may estimate the true prevalence of undiagnosed OSA. As a comparison, a recent systematic review and meta-analysis of 32 studies of ACS patients reported a pooled prevalence of sleep-disordered breathing (SDB) at 69%, 43%, and 25% using diagnostic thresholds of AHI > 5, 15, 30 events per hour, respectively [49]. In contrast to our analysis, these studies did not distinguish between OSA and CSA, and therefore contribute to a higher estimate of SDB.…”

Section: Prevalence Of Osa Among Hospitalized Cvd Patientscontrasting

confidence: 86%

Prevalence of Undiagnosed Obstructive Sleep Apnea Among Patients Hospitalized for Cardiovascular Disease and Associated In-Hospital Outcomes: A Scoping Review

Suen

Wong

Ryan

et al. 2020

JCM

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Background: Obstructive sleep apnea (OSA) is associated with long-term cardiovascular morbidity and is highly prevalent in patients with cardiovascular disease (CVD). The objectives of this scoping review were to determine the prevalence of OSA inpatients hospitalized for CVD and to map the range of in-hospital outcomes associated with OSA. Methods: We searched MEDLINE(R), Embase, and Cochrane Databases for articles published from 1946–2018. We included studies involving non-surgical adults with OSA or at high risk of OSA who were hospitalized for CVD. The outcomes were considered as in-hospital if they were collected from admission up to 30 days post-discharge from hospital. Results: After the screening of 4642 articles, 26 studies were included for qualitative synthesis. Eligible studies included patients presenting with acute coronary syndromes (n = 19), congestive heart failure (n = 6), or any cardiovascular disease (n = 1). The pooled prevalence of OSA in cardiac inpatients was 48% (95% CI: 42–53). The in-hospital outcomes reported were mortality (n = 4), length of stay (n = 8), left ventricular ejection fraction (n = 8), peak troponin (n = 7), peak B-type natriuretic peptide (n = 4), and composite cardiovascular complications (n = 2). Conclusions: OSA is highly prevalent in the cardiac inpatient population. The outcomes reported included mortality, cardiac function, cardiac biomarkers, and resource utilization. There are significant knowledge gaps regarding the effect of treatment and OSA severity on these outcomes. The findings from this review serve to inform further areas of research on the management of OSA among patients with CVD.

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Section: Prevalence Of Osa Among Hospitalized Cvd Patientscontrasting

confidence: 86%

Prevalence of Undiagnosed Obstructive Sleep Apnea Among Patients Hospitalized for Cardiovascular Disease and Associated In-Hospital Outcomes: A Scoping Review

Suen

Wong

Ryan

et al. 2020

JCM

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“…Another area of current interest is whether OSA may modify the outcomes of acute coronary syndromes (ACS). OSA prevalence is high in patients with ACS, and severe OSA occurs in 25% of the patients [39]. The ongoing ISAACC trial (Impact of Continuous Positive Airway Pressure on Patients with ACS and Nonsleepy OSA) will provide long-term data on the effects of treating OSA in this population [40].…”

Section: Common Comorbidities In Osa Patientsmentioning

confidence: 99%

Obstructive sleep apnea and comorbidities: a dangerous liaison

Bonsignore

Baiamonte

Mazzuca

et al. 2019

Multidiscip Respir Med

188

116

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Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbidities, will help to provide better individualized care. The unsatisfactory adherence to CPAP in patients without daytime sleepiness should prompt clinicians to examine the overall risk profile of each patient in order to identify subjects at high risk for worse prognosis and provide the optimal treatment not only for OSA, but also for comorbidities.

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“…Studies using portable devices with limited numbers of parameters (cardiorespiratory polygraphy) showed a pooled prevalence of 77%, while polysomnography studies demonstrated a mean prevalence of 60%. The authors did not find substantial differences between studies performed in different ethnic groups [29]. These data on OSA in ACS patients clearly exceed the figures of SDB in the general population.…”

Section: Osa and Acs: Associations Sex Differences And Phenotypingmentioning

confidence: 64%

“…The consequences of breathing disturbances during sleep (sleep disordered breathing (SDB)), including hypoxia/re-oxygenation, oxidative stress, systemic inflammation, arousals and increased work of breathing, suggest a correlation between OSA and ACS. HUANG et al [29] performed a meta-analysis to evaluate the prevalence of SDB in ACS. They analysed 32 studies including 3360 patients.…”

Section: Osa and Acs: Associations Sex Differences And Phenotypingmentioning

confidence: 99%

Obstructive sleep apnoea in acute coronary syndrome

2019

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Obstructive sleep apnoea (OSA) syndrome affects about 13% of the male and 7–9% of the female population. Hypoxia, oxidative stress and systemic inflammation link OSA and cardiovascular and metabolic consequences, including coronary artery disease. Current research has identified several clinical phenotypes, and the combination of breathing disturbances during sleep, systemic effects and end-organ damage might help to develop personalised therapeutic approaches. It is unclear whether OSA is a risk factor for acute coronary syndrome (ACS) and might affect its outcome. On the one hand, OSA in patients with ACS may worsen prognosis; on the other hand, OSA-related hypoxaemia could favour the development of coronary collaterals, thereby exerting a protective effect. It is unknown whether positive airway pressure treatment may influence adverse events and consequences of ACS. In non-sleepy patients with OSA and stable coronary artery disease, randomised controlled trials failed to show that continuous positive airway pressure (CPAP) treatment protected against cardiovascular events. Conversely, uncontrolled studies suggested positive effects of CPAP treatment in such patients. Fewer data are available in subjects with ACS and OSA, and results of randomised controlled studies on the effects of CPAP are expected shortly. Meanwhile, the search for reliable markers of risk continues. Recent studies suggest that daytime sleepiness may indicate a more severe OSA phenotype with regard to cardiovascular risk. Finally, some studies suggest sex-related differences. The picture is still incomplete, and the potential role of OSA in patients with ACS awaits confirmation, as well as clear definition of subgroups with different degrees of risk.

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Prevalence of sleep-disordered breathing in acute coronary syndrome: a systemic review and meta-analysis

Abstract: High prevalence of all SDB, moderate-to-severe SDB, and severe SDB was found in ACS patients. It is clinically important to screen for SDB in patients with ACS.

Cited by 14 publications

References 66 publications

Prevalence of Undiagnosed Obstructive Sleep Apnea Among Patients Hospitalized for Cardiovascular Disease and Associated In-Hospital Outcomes: A Scoping Review

Prevalence of Undiagnosed Obstructive Sleep Apnea Among Patients Hospitalized for Cardiovascular Disease and Associated In-Hospital Outcomes: A Scoping Review

Obstructive sleep apnea and comorbidities: a dangerous liaison

Obstructive sleep apnoea in acute coronary syndrome

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