Patients admitted to the hospital for acute coronary syndrome were likely to have obstructive sleep apnea, according to preliminary findings presented at SLEEP 2018, the Annual Meeting of the Associated Professional Sleep Societies.
“Elucidating the effects of obstructive sleep apnea on cardiovascular outcomes in acute coronary syndrome is crucial in risk assessments and therapeutic recommendations for affected individualism,” Ridhwan Y. Baba, MB BS, pulmonary and critical care fellow at the MetroHealth System in Cleveland, and colleagues wrote in the abstract.
Between April 29, 2017 and Nov. 20, 2017, researchers conducted a prospective observational study of 21 patients older than 18 years who were admitted for acute coronary syndrome, had coronary revascularization during admission and underwent inpatient overnight sleep studies. Baba and colleagues defined acute coronary syndrome as either ST segment elevation (STEMI), non-ST segment elevation (non-STEMI) or unstable angina. A level III portable diagnostic device was used to monitor sleep and patients were categorized into two groups depending on apnea-hypopnea index, with obstructed sleep apnea (OSA) defined as having an apnea-hypopnea index of 15 or more and non-OSA, defined as having an apnea-hypopnea index of less than 15.
According to the abstract, the primary endpoint was 30-day major adverse cardiovascular events (MACE), which is a composite endpoint of cardiovascular death, nonfatal MI, stroke and the need for an unplanned and repeat revascularization. Individual MACE outcomes, heart failure requiring rehospitalization and all-cause mortality were included as secondary outcomes.
Of the 21 eligible patients, 13 had adequate sleep data, including seven with non-STEMI, four with STEMI and two with unstable angina, according to the abstract. OSA was discovered in 53.8% of patients. The mean apnea-hypopnea index of the OSA group was 27.1 events per hour vs. 5.6 events per hour in the non-OSA group. Researchers did not observe any MACE events in the non-OSA group, though one event — unplanned revascularization — occurred in the OSA group. Additionally, they discovered that a heart failure diagnosis and cardiogenic shock during hospitalization were more likely in the non-OSA group compared with the OSA group.
Although Baba and colleagues discovered a high rate of OSA among patients admitted with acute coronary syndrome, the sample size was not large enough to make any conclusions regarding primary endpoints.
“A larger sample size is being recruited to identify any significant differences in the primary endpoints,” Baba and colleagues wrote. – by Marley Ghizzone
Baba RY, et al. Impact of obstructive sleep apnea on clinical outcomes in acute coronary syndrome. Presented at: Sleep 2018, the Annual Meeting of the Associated Professional Sleep Societies; June 2-6; Baltimore.
Healio Family Medicine was unable to confirm financial disclosures at the time of publication.