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Central Sleep Apnoea Is Related to the Severity and Short-Term Prognosis of Acute Coronary Syndrome

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To evaluate the relation of central sleep apnoea (CSA) to the severity and short-term prognosis of patients who experience acute coronary syndrome (ACS).

Methods: Observational study with cross-sectional and longitudinal analyses. Patients acutely admitted to participating hospitals because of ACS underwent respiratory polygraphy during the first 24 to 72 h. CSA was defined as an apnoea-hypopnoea index (AHI) >15 events•h-1 (>50% of central apnoeas). ACS severity (Killip class, ejection fraction, number of diseased vessels and peak plasma troponin) was evaluated at baseline, and short-term prognosis (length of hospitalization, complications and mortality) was evaluated at discharge.

Results: A total of 68 CSA patients (AHI 31±18 events•h−1, 64±12 years, 87% males) and 92 controls (AHI 7±5 events•h−1, 62±12 years, 84% males) were included in the analyses. After adjusting for age, body mass index, hypertension and smoking status, patients diagnosed with CSA spent more days in the coronary unit compared with controls (3.7±2.9 vs. 1.5±1.7; p<0.001) and had a worse Killip class (Killip I: 16% vs. 96%; p<0.001). No differences were observed in ejection fraction estimates.

Conclusions: CSA patients exhibited increased ACS severity as indicated by their Killip classification. These patients had a worse prognosis, with longer lengths of stay in the coronary care units. Our results highlight the relevance of CSA in patients suffering ACS episodes and suggest that diagnosing CSA may be a useful strategy to improve the management of certain ACS patients.

No MeSH data available.


Related in: MedlinePlus

Mean length of stay in the coronary care unit according to central sleep apnoea severity.CCU: coronary care unit; CSA: central sleep apnoea; AHI: apnoea—hypopnoea index. P-values correspond to a model using CSA severity categories as a continuous variable, adjusted by age, sex, body mass index, tobacco (current or former smoker versus non-smoker) and hypertension.
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pone.0167031.g002: Mean length of stay in the coronary care unit according to central sleep apnoea severity.CCU: coronary care unit; CSA: central sleep apnoea; AHI: apnoea—hypopnoea index. P-values correspond to a model using CSA severity categories as a continuous variable, adjusted by age, sex, body mass index, tobacco (current or former smoker versus non-smoker) and hypertension.

Mentions: The differences between the CSA and control patients in the variables related to the short-term prognosis following ACS are presented in Table 3. The length of stay in the CCU was significantly longer for CSA patients (3.7 ±2.9days compared with 1.5 ±1.7 days for controls, p<0.001). When this relationship was analysed according to CSA severity, defined as AHI ≤30 or >30 events·h−1, a significant trend towards longer CCU stays according to CSA severity was revealed (Fig 2). In this sense, it is reassuring that CSA patients were more prone to cardiovascular complications during hospitalization than controls (24% vs. 10%, p = 0.058), although this difference did not reach statistical significance due to low statistical power. The main cardiovascular complications in our study were arrhythmias, heart failure, pulmonary oedema, hypertensive crisis, re-infarction, and cardiac arrest. Notably, only 2 CSA patients died during their hospital stay.


Central Sleep Apnoea Is Related to the Severity and Short-Term Prognosis of Acute Coronary Syndrome
Mean length of stay in the coronary care unit according to central sleep apnoea severity.CCU: coronary care unit; CSA: central sleep apnoea; AHI: apnoea—hypopnoea index. P-values correspond to a model using CSA severity categories as a continuous variable, adjusted by age, sex, body mass index, tobacco (current or former smoker versus non-smoker) and hypertension.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120829&req=5

pone.0167031.g002: Mean length of stay in the coronary care unit according to central sleep apnoea severity.CCU: coronary care unit; CSA: central sleep apnoea; AHI: apnoea—hypopnoea index. P-values correspond to a model using CSA severity categories as a continuous variable, adjusted by age, sex, body mass index, tobacco (current or former smoker versus non-smoker) and hypertension.
Mentions: The differences between the CSA and control patients in the variables related to the short-term prognosis following ACS are presented in Table 3. The length of stay in the CCU was significantly longer for CSA patients (3.7 ±2.9days compared with 1.5 ±1.7 days for controls, p<0.001). When this relationship was analysed according to CSA severity, defined as AHI ≤30 or >30 events·h−1, a significant trend towards longer CCU stays according to CSA severity was revealed (Fig 2). In this sense, it is reassuring that CSA patients were more prone to cardiovascular complications during hospitalization than controls (24% vs. 10%, p = 0.058), although this difference did not reach statistical significance due to low statistical power. The main cardiovascular complications in our study were arrhythmias, heart failure, pulmonary oedema, hypertensive crisis, re-infarction, and cardiac arrest. Notably, only 2 CSA patients died during their hospital stay.

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To evaluate the relation of central sleep apnoea (CSA) to the severity and short-term prognosis of patients who experience acute coronary syndrome (ACS).

Methods: Observational study with cross-sectional and longitudinal analyses. Patients acutely admitted to participating hospitals because of ACS underwent respiratory polygraphy during the first 24 to 72 h. CSA was defined as an apnoea-hypopnoea index (AHI) &gt;15 events&bull;h-1 (&gt;50% of central apnoeas). ACS severity (Killip class, ejection fraction, number of diseased vessels and peak plasma troponin) was evaluated at baseline, and short-term prognosis (length of hospitalization, complications and mortality) was evaluated at discharge.

Results: A total of 68 CSA patients (AHI 31&plusmn;18 events&bull;h&minus;1, 64&plusmn;12 years, 87% males) and 92 controls (AHI 7&plusmn;5 events&bull;h&minus;1, 62&plusmn;12 years, 84% males) were included in the analyses. After adjusting for age, body mass index, hypertension and smoking status, patients diagnosed with CSA spent more days in the coronary unit compared with controls (3.7&plusmn;2.9 vs. 1.5&plusmn;1.7; p&lt;0.001) and had a worse Killip class (Killip I: 16% vs. 96%; p&lt;0.001). No differences were observed in ejection fraction estimates.

Conclusions: CSA patients exhibited increased ACS severity as indicated by their Killip classification. These patients had a worse prognosis, with longer lengths of stay in the coronary care units. Our results highlight the relevance of CSA in patients suffering ACS episodes and suggest that diagnosing CSA may be a useful strategy to improve the management of certain ACS patients.

No MeSH data available.


Related in: MedlinePlus