Effect Of Obstructive Sleep Apnea Syndrome On Coronary Heart Disease

BackgroundCoronary heart disease(CHD) is a gradually becoming the first killer of human health，Obstructive sleep apnea syndrome (OSAS) is a complex diseases of an upper airway obstruction for some reason, patients with sleep apnea, accompanied by hypoxia, snoring, daytime sleepiness and other symptoms. OSAS tend to affect people’s quality of life and cardiovascular health. Studies suggest that OSAS often directly caused or indirectly induced cardiovascular disease including coronary heart disease, heart failure, hypertension, arrhythmia and stroke. According to the survey,1/5of the population suffers from obstructive sleep apnea syndrome,75%to80%of patients can benefit from the treatment, improve clinical status and retard disease progression. This reflects the significance of relationship between OSAS and coronary heart disease.In the foreign countries, some reports on the study between OSAS and coronary heart disease have been published to prove that there is a certain relationship between them.But this is less and more confined to the summary of the theoretical study of foreigner, In the domestic.objectiveTo explore the relationship in OSAS patients between AHI, ODI index with severity of coronary lesions, as well as the MACEs comparison after PCI of the patients with Different levels of OSAS.MethodsTo52patients in our hospital from November2010to August2011, whose Outpatient diagnostic is coronary heart disease and chest pain for check. After admission, we recorded the patient’s age, gender and medical history data, and blood biochemical results, the degree of coronary lesions in patients using CAG. According to the result of coronary angiography, patients were divided into4groups:Non-CAD group (14cases), single-vessel group (13cases), double-vessel group (11cases), three-vessel group (14cases), compare the biochemical results among each groups. Then based on the results of PSG patients were divided into non-OSAS group (12cases), mild OSAS group (15cases), moderate OSAS group (13cases), severe OSAS group (12cases), analyse the correlation between AHI、ODI and the severity of coronary lesions among each groups. A survival analysis about MACEs occurs was performed on patients after PCI, after an follow-up of201days for average.Result1、There are no significant difference in gender, age, smoking and drinking history as well as triglycerides, high density lipoprotein among the four groups(p>0.05). In the hs-CRP, TC, LDL-C and the AHI、ODI aspects, multi-vessel group was significantly higher than the single-vessel group and non-CAD group, the difference was statistically significant (p<0.05).2、Coronary heart disease patients were higher than those in non-coronary heart disease patients in TC and LDL-C, the difference was statistically significant (p <0.05), but this was not statistically significant among the groups with coronary heart disease (single vessel group, double-vessel group and three-vessel group)(p>0.05); Coronary heart disease patients were also higher than those in non-coronary heart disease patients in hs-CRP, the difference was statistically significant (p<0.05), and there was statistically significant among the groups with coronary heart disease(p <0.05).3、 A positive correlation between AHI、ODI and coronary artery disease extent, respectively (r=0.77, p<0.01),(r=0.76, p<0.01).4、Group with AHI=15, PSG-positive group was significantly higher than the PSG-negative group in incidence of MACEs(26.1%vs6.7%;p=0.035).Conclusion1、TC, LDL-C hs-CRP are closely related with the coronary severity in patients with coronary heart disease.2、AHI、ODI reflect the severity of coronary lesions in patients with coronary heart disease.3、coronary heart disease Patients after PCI with high AHI had a higher possibility of MACE.