The Impact Of Sleep Apnea Hypopnea Syndrome On Coronary Artery Disease

Background and Object: Increasing evidences had proved that Sleep Apnea Hypopnea Syndrome(SAHS)is highly relative with Coronary Atherosclerotic Heart Disease(CAD).Patients with CAD always became much more severe when combining with untreated SAHS.The object of this study is to prove if SAHS is relative with CAD combining with multivessel disease.And to explore if SAHS is the risk factor of multivessel disease.Method: Collecting suspected CAD patients of Vasculocardiology Deparment in Guangzhou first people's hospital between 1.2018 to 12.2019.All of the patients were undergone the Home Sleep Apnea Testing(HSAT)and divided as control group(AHI<5/hours)and mild-SAHS group(m-SAHS group)(5?AHI < 15/hours)and middle-to-severe-SAHS group(ms-SAHS group)(AHI?15/hours).We compare the clinical data of each groups to see if there is statistic differences.Coronary angiography/ percutaneous coronary intervention is performed on the patients who is in need.We compare the result of coronary angiography and Gensini Score to see if SAHS has an impact on CAD combining multivessel disease.Result: Totally 102 patients were included in this study.Including 33 patients in control group,36 patients in m-SAHS group and 33 in ms-SAHS group.We found that BMI ofms-SAHS group is significantly higher than that in control group(27.0±0.56 v.s.23.3±0.55 kg/m2,p<0.01)and m-SAHS group(27.0±0.56 v.s.24.9±0.52 kg/m2,p<0.05).The level of Hb A1 c of ms-SAHS group is also significantly higher than that in control group(6.64±0.22 v.s.5.72±0.11%,p<0.01).There were in total 71 patients undergone coronary angiography/ percutaneous coronary intervention,account for 69.6% of all the patients.Reanalysed the examination results of the patients undergoing coronary angiography/ PCI,we foung that the level of hs-CRP of ms-SAHS group is significantly higher than that of control group(p < 0.05).After analyzing the result of coronary angiography and calculating Gensini Score,we found that the incident of multivessel disease in ms-SAHS group is higher than control group(69.2% v.s.26.3%,p<0.01)and m-SAHS group(69.2% v.s.34.6%,p<0.05),and the Gensini Score of ms-SAHS group is also found higher than control group(27.81±4.50 v.s.13.90±2.93,p<0.05)and m-SAHS group(27.81±4.50 v.s.13.65±3.70,p<0.05).We excluded control group to analyze the relation of Gensini Score and AHI,and found linear regression between Gensini Score and AHI(=14.167+0.456 X,p < 0.05).Through Logistic regression analyze,we found ms-SAHS increases the risk of CAD combining with multivessel disease,comparing with control group(OR=5.952,95%CI 1.288-27.498,p<0.05)and m-SAHS group(OR=6.652,95%CI 1.566-28.035,p<0.05).Conclusion: Ms-SAHS can impact the progress of CAD.The incident of multivessel disease is higher in ms-SAHS group than control group.Ms-SAHS significantly increase the risk of CAD combining with multivessel disease.Inflammatory maybe one of the mechanism that SAHS bring damage to cardiovascular system.