The Relationship Between Carotid Stenosis And Central Sleep Apnea In Patients With Coronary Heart Disease

ObjectiveThe purpose of this study was to investigate the difference of central sleep apnea?CSA?in patients with coronary heart disease?CHD?and different degrees of carotid stenosis?CS?.To explore the the correlation between risk factors of atherosclerosis?AS??different degrees of CS and CSA.The risk factors and predictive value of CS for CSA,and the median survival time of patients with different degrees of CS.Subject and Methods1.Subgroups:Our study included 232 patients who underwent coronary angiograph?CAG?examination at Tianjin Chest Hospital,from October 2016 to December2018.There were 58 cases in the control group?n=58?,58 cases in the CHD group?n=58?,and 116 cases in the CHD combined with CS?CHD+CS?group?n=116?.According to peak systolic velocity of carotid artery?PSV?,CHD+CS was divided into mild?CHD+CS 1%⁵0%?group?n=62?,moderate?CHD+CS 50%⁶9%?group?n=32?and severe?CHD+CS>70%?group?n=22?.2.Data Collection:Patients were collected general clinical data,laboratory indicators,and CAG?carotid ultrasonography and PSG test results.Such as PSV,carotid intima-media thickness?IMT?;PSG test results:central sleep apnea index?CSAI?,apnea hypopnea index?AHI?,oxygen desatuation index?ODI?,minimum oxygen saturation SpO₂?the lowest SpO₂,LSpO₂?,SpO2<90 time?T<90?and other data.Result1.CHD+CS group,CHD group and control group were compared:LDL-C and HCY were statistically significant?P<0.05?.2.There were significant differences in the history of hypertension,HCY,TG,LDL-C,AIP,CSAI,AHI,ODI,and LSpO₂ between the mild,moderate,and severe groups?P<0.05?.3.Analysis of carotid stenosis indicators PSV,IMT and PSG results showed positive correlation between CSA indicators CSAI?R=0.813,0.571?,ODI?R=0.652,0.452,respectively?,and PSV and AHI?R=0.847?.,PSV is negatively correlated with LSpO₂?R=-0.314?.AS risk factors smoking,history of hypertension,history of diabetes,TC,TG,LDL-C,AIP were positively correlated with CSAI?R=0.231,0.198,0.245,0.362,0.414,0.335,0.320,respectively??P<0.05?.4.Logistic regression analysis showed that PSV?OR=1.097,95%CI 1.001¹.202?and IMT?OR=0.218,95%CI 1.007².500?were independent risk factors for CSA?P<0.05?.5.The ROC curve shows that PSV has a higher predictive value for CSA.The optimal cutoff point for PSV is 143 cm/s,sensitivity is 39%,specificity is 96%,and the area under the diagnostic curve?AUC?is 0.604,95%CI 0.540 to 0.740.Has a reliable diagnostic performance?P<0.05?.6.KM curve showed that patients with CHD+CS were followed up for 12 months.The primary end point was re-admission of patients for various reasons.The median survival time of patients with CS mild,moderate,and severe groups was 11.056.?95%CI 10.547¹1.566?month,10.159?95%CI 8.831¹1.487?month and 9.453?95%CI 8.121¹0.785?month,the log rank was 2.319,P=0.314,?P>0.05?.ConclusionThere was a significant difference in the degree of carotid artery stenosis,and it was positively correlated with PSV and IMT of carotid stenosis,and negatively correlated with LSpO₂.PSV and IMT were independent risk factors for CSA,and PSV had higher CSA.Predicting value can increase the importance of CSA in patients with carotid stenosis,and it is of great significance for CSA prevention and intervention.