Impact of Sleep‐Disordered Breathing on Long‐Term Outcomes in Patients With Acute Coronary Syndrome Who Have Undergone Primary Percutaneous Coronary Intervention

Author:

Mazaki Toru1,Kasai Takatoshi23,Yokoi Hiroyoshi4,Kuramitsu Shoichi5,Yamaji Kyohei5,Morinaga Takashi5,Masuda Hisaki5,Shirai Shinichi5,Ando Kenji5

Affiliation:

1. Department of Cardiology, Kobe Central Hospital, Kobe, Japan

2. Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan

3. Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan

4. Department of Cardiology, Fukuoka Sanno Hospital, Fukuoka, Japan

5. Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan

Abstract

Background Sleep‐disordered breathing ( SDB ) has been recognized as an important risk factor for cardiovascular diseases; however, the impact of SDB on long‐term outcomes in patients with acute coronary syndrome has not been fully evaluated. Methods and Results We performed overnight cardiorespiratory monitoring of 241 patients with acute coronary syndrome who were successfully treated with primary percutaneous coronary intervention between January 2005 and December 2008. The presence of SDB was defined as apnea–hypopnea index ≥5 events per hour. The end point was incidence of major adverse cardiocerebrovascular events, defined as a composite of all‐cause death, recurrence of acute coronary syndrome, nonfatal stroke, and hospital admission for congestive heart failure. Patients were followed for a median period of 5.6 years. Among the 241 patients who were finally enrolled, comorbidity of SDB with acute coronary syndrome was found in 126 patients (52.3%). The cumulative incidence of major adverse cardiocerebrovascular events was significantly higher in patients with SDB than in those without SDB (21.4% versus 7.8%, P =0.006). Multivariable analysis revealed that the presence of SDB was a significant predictor of major adverse cardiocerebrovascular events (hazard ratio 2.28, 95% CI 1.06–4.92; P =0.035). Conclusions The study's results showed that the presence of SDB among patients with acute coronary syndrome following primary percutaneous coronary intervention is associated with a higher incidence of major adverse cardiocerebrovascular events during long‐term follow‐up.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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