| Objective:To investigate the effect of obstructive sleep apnea(OSA)on clinical cardiovascular events in patients with acute coronary syndrome(ACS).Methods:The Two researchers independently searched Cochrane library,PubMed,Web of Knowledge,Embase,China Knowledge Network,Wanfang Database,Weipu Chinese Science and Technology Journal Database,and China Biomedical Literature Database to search for related studies of patients with ACS and OSA.The search time was limited to since its establishment Archive to December 31,2018,using RevMan5.3software for meta-analysis.Results:The meta-analysis showed that there was no statistical difference in the risk ratio of ACS with moderate to severe OSA compared with ACS non/mild OSA(OR=1.56,95% CI 0.57-4.29,Z=0.87,P>0.05).After excluding the included articles one by one,after excluding Ondrej Ludka,the number of patients in moderate/ severe OSA group was more than that in non/mild OSA group(OR=2.24,95%CI1.13-4,45,Z=2.3,P <0.05).The risk of major adverse cardiovascular events(Major adverse cardiac events,MACE)in moderate/severe OSA group was higher than that in non/mild OSA group(OR=2.36,95% CI 1.15-3.59,Z=4.01,P<0.05).According to the different types of MACE(including cardiogenic death,non-fatal myocardial infarction,non-fatal stroke,target vessel revascularization,readmission due to unstable angina pectoris or heart failure,etc.),the subgroup analysis was carried out according to the occurrence of cardiac death,non-fatal myocardial infarction,non-fatal stroke,revascularization of target blood vessels,readmission due to unstable angina pectoris or heart failure,etc.The risk of unplanned revascularization in the moderate/severe OSA group was higher than that in the non/mild OSA group(OR=2.90,95% CI 1.37-6.14,Z=2.78,P<0.05).The risk of recurrent angina pectorisin moderate/severe OSA group was higher than that in non/mild OSA group(OR=4.68,95% CI 2.06-10.62,Z=3.69,P<0.05).There was no significant difference in cardiogenic death between non/mild OSA group and moderate/severe OSA group(OR=1.57,95% CI 0.56-4.42,Z=0.86,P >0.05).There was no significant difference in heart failure between non/mild OSA group and moderate/severe OSA group(OR=1.18,95% CI 0.31-4.50,Z=0.24,P >0.05).The incidence of one coronary artery lesion in moderate/severe OSA group was lower than that in non/mild OSA group(OR=0.68,95% CI0.54-0.87,Z=3.14,P <0.05).There was no significant difference in the occurrence of two coronary artery lesions between the non/mild OSA group and the moderate/severe OSA group(OR=1.10,95% CI 0.88-1.36,Z=0.83,P>0.05).The risk of 3 coronary artery lesions in moderate/severe OSA group was higher than that in non/ mild OSA group(OR=1.51,95% CI1.20-1.91,Z=3.52,P<0.05).The risk of multi-vessel coronary artery disease in moderate / severe OSA group was higher than that in non/mild OSA group(OR=1.79,95% CI 1.44-2.23,Z=5.2,P<0.05).The left ventricular ejection fraction(LVEF)of ACS complicated with OSA was statistically analyzed.Left ventricular ejection fraction(LVEF)was lower and cardiac function was worse in moderate/severe OSA group than in non/mild OSA group(OR=-1.66,95% CI-2.62--0.71,Z=3.4,P<0.05).Conclusion:ACS with moderate/severe OSA may be more common than ACS with non/mild OSA,with poor prognosis,and the risk of MACE is higher in moderate/severe OSA group than in non/mild OSA group,especially in unplanned re-revascularization and recurrent angina pectoris.In moderate/severe OSA group,the number of coronary artery lesions was more,left ventricular ejection fraction was lower,and cardiac function was worse. |
