Effects Of Moderate To Severe Obstructive Sleep Apnea On Cardiac Function In Patients With Acute Coronary Syndrome After PCI

Objectives: In this study,the influence of moderate to severe obstructive sleep apnea(OSA)on cardiac function after percutaneous coronary intervention(PCI)for acute coronary syndrome(ACS)was discussed to clarify the relationship between sleep apnea and cardiac insufficiency.According to the relationship,we provided some advices on early diagnosis,the improvement of treatment measures,and later cardiac rehabilitation for patients with obstructive sleep apnea(OSA),who has undergone direct percutaneous coronary intervention(PCI)for acute coronary syndrome.Methods: From September 2018 to November 2019,patients with acute coronary syndrome admitted to the Department of cardiovascular medicine of our hospital were selected as the subjects of study.Polysomnography(PSG)was improved within 7 days after admission.According to the condition of adult OSA,they were divided into non /mild sleep apnea group and the moderate to severe sleep apnea group.The general data,blood lipid,creatinine,myocardial zymogram,postoperative echocardiography and early postoperative cardiac function(including six minutes walking test and cardiopulmonary function evaluation)were analyzed and compared between the two groups.Results: In this study,161 patients were included,including 83 patients in non / mild sleep apnea group and 78 patients in moderate to severe sleep apnea group.Compared the two groups of patients:(1)There were significant differences in gender,body mass index(BMI)and hypertension between the two groups(P < 0.05),but there were no significant differences in age,smoking history,drinking history,family history and diabetes between the two groups(P > 0.05).(2)In the moderate to severe OSA group,coronary multi vessel disease was significantly higher than that in non/ mild OSA group There was no significant difference in ACS type,culprit vessel and TIMI blood flow recovery between the two groups(P > 0.05).(3)There was no significant difference in the peak of Tn I,CK,CK-MB,creatinine,triglyceride and LDL between the two groups(P > 0.05).(4)The left ventricular short axis shortening rate(LVFS)and left ventricular ejection fraction(LVEF)in the moderate to severe OSA group were lower than those in the non / mild OSA group,but there was no significant difference between the vascular lesions in the neck B ultrasound(P > 0.05).(5)The proportion of severe cardiac insufficiency in the six minute walking test after operation,and the proportion of C and D grades of postoperative cardiopulmonary function in patients with moderate or severe OSA were significantly higher than those in patients without or mild OSA.Conclusions: Moderate to severe OSA may aggravate myocardial remodeling and cardiac dysfunction after PCI in patients with acute coronary syndrome,and often complicated with severe coronary lesions,which has a certain impact on the short-term and long-term prognosis of ACS patients.